Attitudes to mental illness: 2023 summary report

October 2024

About this report

Mind’s vision is for everyone experiencing a mental health problem to get both the support and respect they deserve. This won’t happen if stigma and discrimination persist. However, to successfully tackle stigma, we need to understand the scale of the problem we’re facing. The Attitudes to Mental Illness research is designed to give a comprehensive and detailed account of mental health stigma in England, and allow us to track it over time. At Mind, we’ll use the findings to inform our campaigns, advice and strategy, and to reignite the conversation about stigma in England.

Dr Sarah Hughes, CEO Mind

Social movements around the world have been organising for decades in the collective mission to eradicate mental health stigma and discrimination, an experience that has blighted the lives of too many of us. Mind has worked with people with lived experience of mental illness, grassroots groups, and a vibrant community of allies and supporters.

We have shared our stories, campaigned for equality, shared evidence-based information, challenged media stereotypes, and developed innovative services and interventions. Some might think that we have won the battle for mental health equality; others have suggested we have gone too far. We at Mind do not agree either way and this report outlines why.

The good news is that it is true we have seen a change over the decades – a steady improvement in attitudes, behaviours, understanding and knowledge around mental health. People and communities recognise that we all have mental health – a spectrum of experiences that is affected by a variety of factors such as childhood, relationships, poverty, and racism. The way we talk about mental health today is worlds away from when I started my career in the early 1990s. I can see that a space has been created in public discourse that has seen the biggest and most positive impact on those of us living with common mental health conditions such as depression and anxiety. This should be a source of pride for all of us who have been part of this collective effort. Can you hear the “but”…

The areas of most concern in this report include a drop in knowledge, declining trust in community based mental health support (such that people do not believe they will get the help they need), and changes in some of the intended behaviour metrics. These shifts strike at the heart of sustainable change and so we must remain vigilant in tackling stigma and discrimination.

The opportunity we can see in this data, though, is that there are indicators holding strong, including workplace attitudes showing improvements in perceived and actual stigma. Previous gains in tackling prejudice have largely been maintained, suggesting that the nation is ready for the next step in challenging mental health stigma. We can also see that there are green shoots of a narrowing of the stigma gap between more common mental health conditions on the one hand and serious mental illness, or the least understood experiences, on the other.

But the stark reality is that progress is fragile largely because of social and economic volatility. For example, we see a pattern over the years that public attitudes towards the most vulnerable in our society can harden during a financial crisis. It is therefore sadly unsurprising that we are reporting a mixed picture showing some of the measures tracking attitudes and behaviours going in the wrong direction.

Sadly, we suspect that things have further deteriorated since this field work was done in 2023. One of the ways we know this is that there is a downturn in the way media portray and talk about mental illness, alongside a general feeling of permissiveness for old, stigmatising tropes. Negative comments made by high-profile politicians and people in the public eye matter. That is why we will continue to challenge negative portrayals used in the public domain; it really matters. No roll back is acceptable.

We also know that mental health awareness sometimes courts controversy and there are valid questions about whether we have reached saturation point, whether society has over-medicalised human experience, whether people living with the least understood conditions have felt any significant benefit, and whether the experiences of the global majority have been overlooked in mental health discourse. This is the moment we need to answer these important challenges. 

So, what next? Taking all of this into account we at Mind propose to ramp up mental health campaigning and our anti-stigma work. We have made a renewed commitment and believe that the radical change we need to see in this work to make it better for all is to centre those of us most at risk of exclusion and poor outcomes, who are discriminated and ignored. We call this approach ‘designing from the margins’. We are going deep, and we think this report tells us that the nation is ready for this next step.

Denise Martin, lived experience volunteer and champion, Mind

I grew up through the 1970s 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. There wasn’t the medical knowledge that there is nowadays either.

It was only in the 90s that conversations about mental health really started, which is when I qualified as a mental health nurse. 10 years ago, I applied for a new job. I made a pact to disclose my diagnosis on the employment form because I didn’t want to hide anymore. I was offered the job during the interview, but they withdrew the offer after they saw my form.

The experience made me feel like less of a person. I could have done the job with my eyes shut, but once they learned I had bipolar that’s all they could see. 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.

I first accessed psychiatric services when I was 15 years old, but I didn’t receive a diagnosis of bipolar until I was 22. In fact, that was the first time I heard the term ‘mental health’ used. The people I spoke to didn’t believe what I was experiencing. I don’t think they had the experience to deal with me, so I was treated appallingly.  

I couldn’t speak openly about my mental health, not even generally, let alone bipolar which was very misunderstood. Talking about it with friends and colleagues was simply a ‘no go’ area. My parents didn’t understand, and I have a fractured relationship with them to this day because of that. So, like many during that time, I felt alone, ashamed and afraid.

Thankfully, public knowledge of mental health has improved. Over the years I’ve seen a positive shift in how people talk about and behave around people with mental health problems. Mind and Rethink Mental Illness’s anti-stigma campaign Time to Change was a big driver in that shift. I was involved in the campaign from start to finish as a lived experience champion. I shared my story at events and campaigned to help people understand mental health better. But the end of Time to Change and the start of the pandemic halted those face-to-face conversations, and I worry the cracks are starting to show. That’s why it’s so important we take action to tackle stigma now. Otherwise, there’s a risk things will slip back to how they once were.  

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. It's vital people with influence speak up and our new government acknowledges the damage stigma can do, examines the fear it’s routed in, and works with charities like Mind to combat it. Together, we can end stigma. But we can’t do it alone.

Read the introduction