Nationally representative surveys of experiences of discrimination and positive treatment in people with mental health problems in Australia: Changes over 10 years.

Reducing stigma and discrimination has been a priority in many national mental health policies for decades. The aim of this study was to explore population-level changes in experiences of discrimination and positive treatment between 2014 and 2024. Large nationally representative surveys of Australian adults were conducted in 2014 and 2024. For each, those who reported a mental health problem or scored high on a screening questionnaire (n = 1381 in 2014, n = 2613 in 2024) were asked about experiences of discrimination and positive treatment in multiple settings. Regression analyses were used to explore whether changes between survey years were significant at p<.01, adjusting for sociodemographic variables of age, gender, education level, country of birth, type of mental health problem and receipt of a diagnosis or treatment. In 2024, participants were more likely than in 2014 to report experiencing discrimination (OR = 1.77 [99%CI 1.38,2.26], p < 0.001) and in family, friends, partners, health professionals, workplace and neighbourhood settings. In 2024, any positive treatment was less common (OR = 0.67 [99%CI 0.52,0.88], p < 0.001), but more common in friends, family, workplace and health professional settings. Increases in discrimination were generally greater than those for positive treatment, and were largest in family, neighbourhood, finding work and health professionals. Study findings highlight the need for sustained and targeted efforts to tackle discrimination and improve support. Any interventions should be carefully developed and disseminated based on their ability to bring about tangible behaviour change in their target audiences, without inadvertently heightening sensitivity to perceived threats.