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Home | Institute of Psychiatry, Psychology & Neuroscience | Health Service and Population
Research | Research | Centre for Innovation and Evaluation in Mental Health | Community
Mental Health | Sapphire research programme
Sapphire research programme
Sapphire research programme
SAPPHIRE was a five year research programme on mental health-related stigma and
discrimination.
It focused mainly on three areas:
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Access to mental healthcare
How physical health care is provided
Employment
Our programme of research studies led to the production of: best available evidence on
population education regarding stigma and discrimination; legal requirements on disclosing
psychiatric history; a decision-aid on job applications; DVDs for training courses; and four
standardised scales to assess the impact of discrimination and associated financial costs.
Here you will find summaries of independent research funded by the National Institute for
Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG0606-1053). The views expressed are those of the author(s) and not necessarily those of the
NHS, the NIHR or the Department of Health. The Sapphire team also acknowledges the support
of the Mental Health Research Network which assisted with a number of the SAPPHIRE studies.
Why was the research carried out?
Stigma and discrimination have been described by many people with mental illness as more
disabling than the illness itself. Our research concurs with this experience, and shows that stigma
and discrimination faced by people with mental illness is frequent and often severe, adversely
affecting health outcomes by impairing: (i) help seeking and access to healthcare, (ii) the
provision of physical and mental healthcare, and (iii) participation in employment, which for
many is a critical aspect of recovery from mental illness.
How was the research undertaken?
The research comprised an inter-related portfolio of methodological studies; analytical studies;
intervention studies and knowledge transfer actions.
Methodological studies: This work developed four standardised outcome measures relating to
stigma and discrimination. We undertook further validation of the Discrimination and Stigma
Scale (DISC) to assess experiences of discrimination and created a new measure, the
Questionnaire on Anticipated Discrimination (QUAD) scale. We also established the
psychometric properties of the scale of clinicians’ attitudes to people with mental illness (MICA)
to assess views of health and social care staff about providing mental and physical healthcare to
people with mental illness, and created a new scale to measure the financial costs associated with
stigma and discrimination (CODA).
Analytical studies: We conducted analytical studies to better understand the nature of stigma
and discrimination. A knowledge synthesis comprising of a Cochrane systematic review of mass
media anti-stigma interventions (CREDO) and a consensus study on messages for anti-stigma
campaigns (MOSAIC) was undertaken. The MIRIAD study compared discrimination in different
diagnostic groups and by ethnicity, gender and age, and examined how this related to mental
health help-seeking. A further analytical study (SPHERE) investigated care in Emergency
Departments and developed understanding about diagnostic over-shadowing (the misattribution
of physical illness to mental illness).
Intervention studies: The CORAL study continues the development and initial testing of a
decision aid on disclosure of mental health status in job seeking, and examines the decisions of
employers in relation to such disclosure. The Perspectives study compares live and filmed
service user training materials to increase mental health awareness in a sample of nursing
students, as forms of active ‘social contact’.
Knowledge transfer components: This included publication of findings to specialist and nonspecialist audiences, production of a training material and dissimination of results at national and
international conferences and using social media.
Where did it happen?
The research was primarily based at the Institute of Psychiatry and in the South London and
Maudsley NHS Foundation Trust. Specific projects were in collaboration with other
organisations detailed in the project sections.
Who was involved?
The Principal Investigator was Professor Graham Thornicroft, who worked with the SAPPHIRE
research team and collaborators.
What was the timescale?
The Programme began in 2008 and ended in February 2014.
Find out more:
The information provided here and the papers and documents it has links to will provide a good
overview of our work in the Sapphire programme. If you have any further queries please contact:
Professor Graham Thornicroft
E: graham.thornicroft@kcl.ac.uk
Sapphire Summit
It was held on the 4th July 2013 as part of
our knowledge transfer.
> News: IoP hosts major summit to challenge stigma and discrimination in mental health
> Programme of the summit
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Centre for Innovation and Evaluation in Mental Health
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Community Mental Health
o Research projects
 CMH Research Projects
 Crimson project
 Sapphire research programme
 Analytical studies
 Cochrane Review of Evidence: Discrimination Outcomes
(CREDO)
 Mental Illness-Related Investigations on Discrimination:
The MIRIAD Study
 Messages in Anti-Stigma Campaigns (MOSAIC)
 Qualitative study
 Stigma: Physical Health Equality Research & Evaluation
(SPHERE): An exploratory study
 Intervention
 Disclosing a mental illness in employment-seeking contexts
(CORAL)
 The Perspectives Study
 Publications
 Talking to Prof Graham Thornicroft
o CMH Measures
o Camberwell Assessment of Need (CAN)
o Contact Us
Mental Health Nursing
Service User Research Enterprise (SURE)
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interview with professor graham thornicroft
measurements and RESOURCES
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