Nicola Reavley, Anna Ross, Gayle McNaught, Rachel Green, Amy J. Morgan
AIMS: Reducing stigma and discrimination has been a priority in many national mental health policies for decades. Focusing efforts requires us to understand where this has the greatest impact on people with mental health problems. In 2024, we conducted a nationally representative survey that aimed to assess the burden of discrimination (as a product of frequency and impacts of experiences). Secondary aims were to quantify the types of discrimination experienced in different life domains and the sociodemographic and mental health problem characteristics of those experiencing higher burden. METHODS: = 2613) were asked about the past 12-month frequency and impact of their experiences of discrimination in a broad range of settings, including family, friends, workplaces and health services. The data were initially analysed using percent frequencies and 95% confidence intervals. A burden score was calculated for each domain, incorporating frequency and impact among those who reported discrimination experiences. RESULTS: Overall, discrimination in social life was the most common (43.6% [95% CI 41.2, 45.9]), followed by discrimination from family (41.4% [95% CI 39.1, 43.7]) or in making or keeping friends (41.0% [95% CI 38.7, 43.3]). However, the highest burden was from discrimination in finding or keeping a job, in dating/intimate relationships, in housing (including renting or public housing) and in obtaining welfare benefits or disability pensions. The most common type of discrimination experience in the workplace and among friends, family and partners was of people lacking understanding of the impact of the person's mental health problem. People aged 35-64 years were more likely than those aged 18-34 years to report higher burden in multiple domains; people with depression or attention-deficit/hyperactivity disorder also reported burden in more domains than people with anxiety or severe mental health conditions. Overall, 67.7% (95% CI 65.5, 69.9) agreed that stigma and discrimination was worse than the mental health problem itself. CONCLUSIONS: Our study suggests that reducing the frequency and impact of discrimination in workplaces, welfare benefits and housing should be key targets for policy and practice. Improving the capacity of people in workplaces and intimate partners, families and friendship groups to better understand the impacts of mental health problems on individuals should also be a priority.