Nationally representative surveys of disclosure of mental health problems in Australia: changes over 10 years

Abstract

Abstract Aims Disclosure of a mental health problem carries both risks and benefits. It can be seen as a measure of perceptions of the social environment in which people with mental health problems live, work and study. A nationally representative Australian survey conducted in 2014 showed that, in many settings, non-disclosure was more common than disclosure. This study aimed to investigate whether disclosure in a broad range of settings has changed since the 2014 national survey. Methods Large nationally representative surveys of Australian adults were conducted in 2014 and 2024. For each, those who reported a mental health problem or were experiencing high psychological distress (n = 1381 in 2014, n = 2613 in 2024) were asked about disclosure in multiple settings. Regression analyses were used to explore whether changes between survey years were significant at p < 0.01, adjusting for sociodemographic variables of age, gender, education level, language spoken at home, country of birth and type of mental health problem. Secondary analyses assessed the sociodemographic and mental health problem characteristics associated with changes. Results In 2024, participants were less likely than in 2014 to have disclosed to friends, partners, family members and some people in the neighbourhood, with relative risk ratios (RRRs) ranging from 0.33 (99% confidence interval [CI]: 0.23, 0.48; p < 0.001) for all family members to 0.64 (99% CI: 0.46, 0.88; p < 0.001) for some people in the neighbourhood. Workplace disclosure did not change significantly. For health professionals not involved in mental health treatment, the RRRs of disclosure were higher in 2024 than in 2014 (RRR = 1.56 [99% CI: 1.16, 2.10; p < 0.001] for disclosure to some and RRR = 2.31 [99% CI: 1.61, 3.32; p < 0.001] for disclosure to all). Conclusions Except for disclosure to health professionals not involved in mental health treatment, there have been decreases or no changes in disclosure of a mental health problem in most settings over the last 10 years. This likely reflects both perceptions of, and actual, reductions in supportive social environments. Urgent action is needed to ensure that, for people who do disclose a mental health problem, the benefits strongly outweigh the risks.