NHS Health Scotland
Outcome Indicators
4.10 Activities, policies and legislation to reduce discrimination and stigma associated with mental health problems, the six equality strands and social economic status will reduce barriers to services and improve the experience of services for these populations; increase knowledge about and change attitudes amongst the whole population and reduce discriminatory policies, structures and behaviour across organizations and the population. This, in turn, will contribute to increasing equality and decreasing discrimination.

Foresight suggests that measures to enhance social inclusion, combat stigma and discrimination against persons with mental ill-health should be a core nationally-funded component of mental health service activity. A range of whole population anti-discriminatory activities focusing on mental health problems have been identified in Foresight on the basis of consensus across the expert and stakeholder communities to reduce discrimination against people with mental health problems and other equality groups[1]. A systems model of stigma has been developed by Foresight in conjunction with the work of Thornicroft (2006) to guide interventions to combat stigma and discrimination and enhance social inclusion. Activities include: providing accurate public information, supporting professionals to provide information about diagnosis, guidance to the media, increasing access to services and implementation of anti-discriminatory policies and practices across government departments.

To date there is no highly processed evidence for the effectiveness of these interventions, however, it is suggested here that activities at the individual, community and population level are likely to have an impact on knowledge, attitudes and behavioural intentions of individuals, service providers, employers and society. Informed by evidence of effectiveness NICE public health guidance 06 Behaviour change at the population, community and individual levels presents a set of generic principles and recommended actions to guide the planning and delivery of public health activities to change health related behaviour at individual, community or population level. The NHS Health Scotland Commentary on this guidance supported these actions points subject, where appropriate, to adaptation to fit Scottish organisational arrangements.[2] This guidance could be used to inform anti-discriminatory activities.


  1. Foresight Mental Capital and Wellbeing Project (2008). Final Report. The Government Office for Science, London..

  2. NHS Health Scotland (2007). Health Scotland Commentary on NICE Public Health Guidance: Behaviour change at population, community and individual levels. NHS Health Scotland: Edinburgh.