Research led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London and commissioned by Mind warns that public attitudes to mental health have seen their first decline in over 10 years.
The new research, which is due to be published in BJPsych Open, informed Mind's latest Attitudes to Mental Illness report and is the most comprehensive analysis of the state of stigma around mental health in England. The report was published today on World Mental Health Day 2024.
The researchers examined three components of public attitudes to mental health: knowledge, attitudes and behaviours. While there has been a worrying shift in some measures, the research also shows some areas of improvements and reasons for optimism. This includes increased public acceptance of people with depression and schizophrenia and improved workplace attitudes.
Behaviour - concerns about living with or near someone with mental health problems
Overall, intended behaviour towards people with mental health is down to 2009 levels. The shift is largely driven by changing views in people's willingness to live with or near someone with mental health problems.
When asked if they'd be willing to live with someone with mental health problems only 55% said they would, down from 66% in 2019. And when asked whether they'd be willing to live nearby to someone with mental health problems 75% said they would, down from 81% in 2019.
Knowledge - pessimism about people's ability to recover
Public knowledge of some aspects of mental health have also fallen back to 2009 levels. This is driven by increasing pessimism around the ability of people with mental health problems to recover and lack of knowledge around how to support people with mental health problems.
When asked if people with mental health problems could fully recover 59% of people agreed, down from 67% in 2019. And when asked if they knew what advice to give a friend to get professional help with a mental health problem 60% agreed, down from 66% in 2019. This may be the result of public concerns about the issues faced when trying to access mental health services.
Attitudes - community care concerns
Attitudes to mental health have dropped to 2014 levels, driven by declining attitudes to community-based care. A complex picture shows that while decreases in prejudice achieved in the past fifteen years have been maintained, there is declining faith in the suitability and efficacy of care for people with mental health problems in communities.
When asked whether the best therapy for many people with mental illness is to be part of a normal community 72% agreed, down from 79% in 2019. At the same time, only 11% of respondents agreed that there were sufficient services for people with mental illness (down from 16% in 2019).
Reasons for optimism - improving acceptance of depression and schizophrenia
Since 2007 people are now more likely to say they'd be willing to make friends with someone with depression or schizophrenia, as well as have them as a colleague, accept them into their family and have them provide childcare.
The largest shifts show that 80% of people would now accept someone with depression marrying into their family, up from 53% in 2007. For schizophrenia, those figures have moved from 37% in 2007 to 72% in 2023.
There have also been significant improvements in perceptions of schizophrenia and depression in the workplace since 2015. But there is still a perception these conditions affect people's chances of promotion more than a physical condition like diabetes.
What lies behind these shifts is not certain, but the pandemic and the cost-of-living crisis could be significant contributors. These events likely made it harder to access care and to recover from mental illness. It is also possible that the end of 'Time to Change' - a national anti-stigma programme - in 2021 contributed to the increases in stigma we are seeing.
Professor Claire Henderson, Clinical Professor of Public Mental Health at King's IoPPN
Professor Henderson continued: "The drop offs in scores relating to knowledge and support for community care for people with mental illness suggest some aspects of mental health stigma are on the rise after years of improvement, which is something that needs to be addressed.
"We predict that the aspects of stigma that worsened since 2019 will improve if and when economic conditions and access to treatment for common mental illnesses improve. However, it remains to be seen whether the improvements seen over the course of Time to Change can be regained in the absence of such a programme."
Dr Sarah Hughes, Chief Executive of Mind, said:
"The warning lights are flashing on mental health stigma. The progress we've made in recent years has been hard won, but this research shows it's fragile and not fixed. I am deeply worried the deteriorating discourse around mental health we see in parts of the media and on social media means these trends will continue.
"When mental health stigma worsens, people with mental health problems day-to-day experiences get harder and there are real-world consequences. Worsening stigma can mean greater social isolation and exclusion, it can lead to self-stigma and shame, and it can lead to people feeling unable to seek the treatment they need.
"Addressing mental health stigma is the foundation on which other change is built. If mental health is a source of ignorance, discrimination and shame we will not get the investment in and reform of the mental health system we need to start turning around the mental health crisis.
Denise Martin, Lived Experience Volunteer/Champion, Mind, said:
"I grew up through the 70s and 80s when mental health stigma was commonplace. Mental health education was non-existent, derogatory terms were thrown around and the name-calling was horrific. I couldn't speak openly about my mental health, not even generally, let alone bipolar which was very misunderstood.
"When I qualified mental health nurse, I made a pact with myself to disclose my diagnosis because I didn't want to hide anymore. Several years ago, I was offered a job, but the offer was withdrawn after they became aware of my condition. The whole episode made me feel less of a person. After that, I experienced depression and let my registration as a nurse lapse after 28 years of practicing. I haven't been well or confident enough to enter employment since."
In a world without stigma, I wouldn't have to hide who I am. I hope that one day we can live in a world where people with mental health problems aren't feared or defined by their diagnosis.
Denise Martin, Lived Experience Volunteer/Champion, Mind
The Attitudes to Mental Illness survey tracks changes in mental health knowledge and behaviour since 2009 and attitudes related to mental health since 2008. The research has been carried out annually in England since 2008, moving to every two years since 2017.
There were 1,638 respondents to the 2023 wave of the Attitudes to Mental Illness survey. The team at the IoPPN has carried out analysis for every wave of the Attitudes to Mental Illness survey.
