Stigma, discrimination and social exclusion: What's in a word?

There is mounting evidence that British service users face pervasive discrimination in areas of life ranging from work to parenting, insurance to driving licenses. Some studies suggest that certain forms of discrimination have increased during the 1990s, perhaps because of saturation media coverage of the supposed- but not actual- rise in homicides committed by people with mental health problems. One of the key concepts used to investigate the problems that users of mental health services face in their relationships to other people, and to society at large, is 'stigma'. This concept is used to frame questions of public attitudes about mental illness, users' self-perceptions and the unfavourable treatment they receive. It is often stated or implied that if we can break down 'stigma' we can transform users' position in society, their opportunities and wellbeing. This paper examines the limitations of both the concept of 'stigma' and the way it is applied, and reviews the growing literature on discrimination, which is seen as a more promising model on which to base social change.