Background: Since 2009 Time to Change has included among its strategies a social marketing campaign to tackle
the stigma surrounding mental health problems. At the start of its third phase (2016–2021) the target group of the
campaign was kept as people aged between mid-twenties and mid-forties but changed to middle-low income
groups and the content was focused on men.
Methods: Participants (n = 3700) were recruited through an online market research panel, before and after each
burst of the campaign. They completed an online questionnaire evaluating knowledge (Mental Health Knowledge
Schedule, MAKS); attitudes (Community Attitudes toward Mental Illness, CAMI); and desire for social distance
(Intended Behaviour subscale of the Reported and Intended Behaviour Scale, RIBS). Socio-demographic data and
awareness of the campaign were also collected.
Results: For each of the 3 bursts, significant pre-post awareness differences were found (OR = 2.83, CI = 1.90–4.20,
p < 0.001; OR = 1.72, CI = 1.22–2.42, p = 0.002; OR = 1.41, CI = 1.01–1.97, p = 0.043),
and awareness at the end of the third burst was 33%. Demographic factors associated with awareness for one or
more bursts included having children, familiarity with mental illness, male sex, being Black, Asian or other ethnic
minorities and living in London or the East Midlands regions. An improvement across bursts in the “living with”
subscale item of the RIBS, and in the “recover” and “advice to a friend” MAKS items were found. Familiarity with
mental illness had the strongest association with all outcome measures, while the awareness of the campaign was
also related with higher scores in MAKS and RIBS.
Conclusions: These interim results suggest that the campaign is reaching and having an impact on its new target
audience to a similar extent as did the TTC phase 1 campaign. While over the course of TTC we have found no
evidence that demographic differences in stigma have widened, and indeed those by age group and region of
England have narrowed, those for socioeconomic status, ethnicity and sex have so far remained unchanged. By
targeting a lower socioeconomic group and creating relatively greater awareness among men and in Black and
ethnic minority groups, the campaign is showing the potential to address these persistent differences in stigma
