Pull yourself together! a survey of the stigma and discrimination faced by people who experience mental distress. The Mental Health Foundation. 2000. 27 pp. £10.00 (pb). ISBN: 0-901944-87-4

What is the best way to influence mental health policy? One approach used by the Mental Health Foundation, the UK's largest mental health charity, is to publish reports that aim to educate and inform on mental health issues. Concern that the stigmatisation of mental illness prevents individuals acknowledging their difficulties and seeking appropriate help was the impetus behind this survey.

This reviewer's problem was whether to read this report as scientific literature, or as an account of individuals' experiences. The postal survey included health professionals and service users on the charity's mailing list. Supporters of a campaigning body are more likely to report their negative experiences and this raises the question of what population those surveyed represent. In addition, a response rate of only 13% calls into doubt the validity of the study.

Of the replies received, 70% reported discrimination in various settings, and respondents were asked to describe their experiences. Stigmatising views encountered included the fear that mental illness is contagious and that it represents a character flaw. Several people perceived that their mental distress had been dismissed by doctors and that comorbid physical problems were taken less seriously. The difficulties in finding appropriate health care and applying for work, or the experiences of being shunned by friends and families, are sobering reading.

This is where the report is more successful, as narrative rather than as quantitative research. As such, the study is a useful resource for those planning qualitative research into stigma and mental health. In addition it provides suggestions on how stigma can be challenged. These include the proposal that interested organisations combine in an anti-discrimination campaign.

Disappointingly, the authors seem to be unaware of the College's Changing Minds Campaign, which suggests that communication between the College, charities and self-help groups must be improved if we are to get the message across. Perhaps we need to combine the emotive accounts contained in this survey with the rigour of scientific research.

The instruction of the report's title should be addressed at the mental health charities and at the College. When we pull ‘ourselves’ together, our influence on mental health policy will be greatly enhanced.