Mental health inequalities in the UK: Who’s falling through the gaps?

One in four people will experience a mental health problem at some point each year. While everyone has their own experience with mental health, different communities experience unique challenges, and not all communities have equal access to support.

An analysis of NHS data by Rethink Mental Illness found that eight times as many people are still waiting for mental health treatment after 18 months, compared to physical health care.

NHS waiting times is just one hurdle to accessing timely mental health support. But once we overlay the challenges that intersectionality brings, we can begin to understand where the inequities in accessing appropriate care begin.

For example, members of the LGBTQ+ community are more likely to experience mental health problems due to discrimination, homophobia, transphobia, bullying or social rejection, according to the NHS. In fact, half of LGBTQ+ individuals experienced depression in the last year, compared to 16% of the general UK population.

This marked difference indicates the importance of considering intersectionality when reviewing data. If we overlook the nuances of individual groups, we gloss over the unique challenges experienced by these groups, which are often perpetuated by social rejection, bias and discrimination. They will simply continue to fall through the gaps.

Mental ill-health stigma in the workplace

Stigma and prejudice around mental ill-health seeps into the workplace, too. In 2024, one in five employees took time off due to mental health issues. But despite mental health problems being common in the workplace, 73% of UK employees feel unable to disclose mental ill-health for fear of jeopardising their careers, evidencing the underlying stigma.

Underrepresented or disadvantaged groups face another layer of challenges, due to discrimination around factors such as race, religion, age, disability, sex, gender or sexuality. For example, 41% of black and minority ethnic employees have faced racism in the last five years, which can negatively impact mental health.

The role of ‘othering’ in discrimination

Before we can begin to address the biases that lead to discrimination, we must first understand them. There are over 175 different types of biases, which contribute to our perceptions, judgements and behaviours towards others. Subconsciously, we make judgements about people – or groups of people – which are often rooted in our own personal biases and stereotypes.

Often, these covert (and sometimes overt) biases act as invisible barriers that exclude people or groups who are perceived as different or less favourable. Essentially, it is akin to thinking, ‘they are not like me’. This marginalisation process creates a sense of ‘othering’, leading to a ‘them’ and ‘us’ group.

‘Othering’ can lead to the mistreatment or dehumanisation of a marginalised group by a larger group, fuelling the damaging effects on mental wellbeing. The nature of ‘othering’ becomes particularly detrimental when individuals experience it across multiple dimensions of their identity, creating compounding feelings of exclusion and isolation.

It therefore goes without saying that there is a strong link between wellbeing and feeling a sense of belonging. Looking at the workplace, employees who have a sense of belonging have a 56% increase in job performance, a 50% decrease in turnover risk, and a 75% reduction in sick days, according to a Harvard Business Review report.

With social exclusion being such a major contributor to poor mental health, it is imperative that organisations create a sense of belonging and inclusivity. Employers must remain cognisant of the effects of intersectionality, and must work to uncover unconscious biases, shatter stigma and become consciously inclusive towards employees from all backgrounds.

Promoting mental wellbeing through inclusion and belonging

To be consciously inclusive around mental health in the workplace, organisations need to first acknowledge the unique challenges faced by disadvantaged or minority groups and understand the relationship between them. For example, people who experience multiple forms of discrimination are more likely to experience mental health problems compared to those who do not face discrimination.

The next section of this piece illustrates some of the challenges faced by protected groups (specifically in relation to race, gender, sexuality, age and disability) under the Equality Act 2010, offering examples of the interplay between them.

Racial inequalities in mental health

People who experience structural racism face worse mental health as a result, with other intersections, such as disability, age and sexuality, amplifying the effects of racism, according to the Institute of Health Equity. Further evidence suggests that racism is often followed by mental illness, especially depression, with a greater likelihood of hallucinations and delusions in those affected.

When being admitted to hospital for psychiatric care, black people are more likely to have police involvement, and are more likely to be detained in a secure unit under the Mental Health Act 1983. Despite this, they are less likely to receive psychotherapy compared to white patients, instead receiving higher doses of medication.

An ‘NHS Race and Health Observatory’ report, which surveyed patients from black, Asian and other ethnic minority backgrounds, found ‘alarming rates of racial or ethnic discrimination’ in primary healthcare. As a result, people from minority ethnic backgrounds are less likely to seek mental health support, and therefore more likely to end up in crisis care.

Looking more specifically at the workplace, 70% of ethnic minority employees witnessed or experienced racism in the workplace, with the under-representation of ethnic minorities in leadership roles exemplifying the structural racism discussed above.

In addition, employees from minority ethnic backgrounds continue to face hurdles in career progression due to discrimination and unconscious bias. These career barriers, social inequalities and lack of representation have a compounding effect on mental wellbeing.

What can organisations learn from this?

Organisations should promote racial diversity within their leadership teams to ensure that they are connecting unique perspectives, helping to mitigate bias and ‘othering’, as previously discussed. A 2023 report by McKinsey illustrates the benefit of a diverse leadership team, stating ‘Companies in the top quartile for both gender and ethnic diversity in executive teams are on average 9 percent more likely to outperform their peers.’

Employers should review current policies and processes to identify and address biases, particularly around recruitment and promotions. Job applicants with ethnic-sounding names receive fewer callbacks, compared to those with English-sounding names, despite having equal qualifications. This fact demonstrates that racial biases are prevalent within workplace processes. It is therefore crucial that employers seek to mitigate the biases that perpetuate damaging stereotypes and contribute to the ‘glass ceiling’ effect for ethnic minority employees.

Organisations can also utilise safe spaces or employee resource groups (ERGs), which are useful tools for employees from racial and ethnic minority groups to discuss mental health problems without feeling stigmatised. Having a safe space to feel heard and supported can help employees feel valued and foster a sense of belonging. Read more about ERGs here or watch our on-demand webinar on ERG best practice.

Finally, all employees should be expected to partake in anti-racism training to help mitigate race-based discrimination, which so negatively affects wellbeing. For example, FAIRER Consulting’s ‘Let’s talk about racism at work’ programme explores how to proactively address racism in the workplace, helping organisations to move towards a more diverse and inclusive culture.

Gender and transgender mental health disparities

Gender and gender identity play a significant role in shaping mental health experiences and outcomes. Understanding these gender nuances is therefore pivotal in fostering an inclusive and psychologically safe environment.

For example, women are three times more likely than men to experience common mental health problems, such as depression or anxiety, according to the Mental Health Foundation. In addition, they are more likely to experience gender bias in mental health treatment, with their concerns often being dismissed due to being perceived as emotional, thus leading to misdiagnosis and poorer health outcomes.

For women who have given birth, it is pertinent to acknowledge the impact of postpartum depression. One in 10 women experience postpartum depression within a year of giving birth, and fathers and non-birthing partners can also be affected. Symptoms, such as persistent sadness and feelings of worthlessness, can greatly impact daily functioning, and a return to work can often heighten these symptoms.

Postpartum depression in black mothers is 13% higher than any other race, which can be attributed to systematic racism and a lack of culturally competent healthcare. Despite this fact, white women are more likely to be offered treatment for postpartum depression.

In contrast, men report lower rates of diagnosed mental health problems and are less likely to seek help due to the stereotypical unemotional, stoic male archetype. As a result, men are more likely to be underdiagnosed for depression, often viewing mental health treatment as anti-masculine and unacceptable, with black men more likely to hide their mental health struggles. This gender bias, coupled with a lack of support groups for men, results in men being silenced by stigma, and accounting for three-quarters of suicide deaths in the UK.

In fact, male suicide rates are the highest they have been since 1999, with middle-aged men (aged 40-50) being the most at risk, often due to mid-life challenges, relationship breakdowns and socio-economic factors, according to Samaritans. Within this group, the highest rates of suicide were in disabled men, the unemployed, or single men.

Transgender people are up to five times more likely than cis-gendered people to have a long-term mental health condition, with the risk increasing again for non-binary transgendered individuals, largely due to transphobia, discrimination and violence.

A report by the University of Manchester and the Proud Trust and LGBT Foundation found that those with a gender identity other than cisgender were more likely to report unmet mental health needs at their last GP appointment, representing a lack of gender-sensitive and specialist care.

In fact, 70% of transgender individuals reported experiencing transphobia from their primary healthcare provider, with 14% being refused care because of their gender identity. Furthermore, looking through an intersectional lens, disabled transgender people are more likely to experience mental health issues, economic hardship and mistreatment by healthcare providers, compared to transgender people without disabilities.

What can organisations learn from this?

In workplaces where vulnerability is still stigmatised, employees often struggle in silence. Workplaces should be mindful of gender-biased language, which discourages a culture of vulnerability. Phrases like “man up” or “toughen up” stigmatise emotional vulnerability and perpetuate harmful stereotypes around mental health and masculinity. Likewise, referring to women as being “emotional” or “hormonal” downplay the impact that mental-ill health can have on an individual, discouraging those who need support from seeking it.

In support of maternity returners experiencing postpartum depression, organisations can offer phased and flexible return-to-work schemes to help ease the transition back into work. Managers should be trained in recognising the signs of postpartum depression and how to respond with empathy in a bid to foster a supportive environment. For more information, read our article, ‘Pregnancy and maternity leave at work: 6 essential things all employers should know’.

To create a culture of belonging, organisations should champion positive role models, encouraging leaders from all genders to show vulnerability or advocate for better mental health awareness. Workplaces should offer mental health training for better understanding, as well as training on inclusive workplace practices.

Mental health first-aiders can be deployed to act as advocates for those needing support and help to break down barriers around discussing mental health in the workplace. Managers should regularly have wellbeing check-ins with their teams to challenge the taboo around discussing mental health and create open lines of communication.

To support transgender employees in the workplace, employee resource groups can be utilised to offer safe spaces for gender-minority groups to receive support, but it is important that allies are also a part of this initiative to help enact cultural change and raise awareness. The April 2025 Supreme Court ruling on the definition of ‘woman’ and ‘sex’ brings further challenges for transgender employees. Read our article on the importance of inclusive leadership, humility and empathy during this time.

Sexuality and mental health inequalities

Sexual identity is a key variable at interplay with mental health conditions, with gay, lesbian and bisexual individuals facing heightened mental health challenges. These disparities often stem from discrimination, family rejection, poor access to inclusive care, and the damaging practice of conversion (or reparative) therapy.

In fact, one in five LGBTQ+ individuals have undergone conversion therapy – the practice of trying to change or suppress one’s sexual orientation or gender identity. The effect of these practices has a direct impact on mental health, as such experiences can lead to depression, anxiety, drug use, homelessness, and suicide, according to Human Rights Campaign.

Over half of LGBTQ+ people have experienced depression, and almost 60% have struggled with anxiety, according to Stonewall. These challenges are intensified by discrimination, with two thirds of LGBTQ+ people experiencing violence or abuse due to their identity.

Looking at the workplace, figures indicate that organisations have a long way to go in terms of being inclusive, as over one third of LGBTQ+ employees hide their identity at work for fear of discrimination.

These challenges directly impact feelings of belonging, psychological safety and wellbeing. When individuals feel unable to express their authentic selves, it leads to covering, increased stress and feeling socially excluded.

What can organisations learn from this?

Organisations need to be proactive about creating an inclusive environment where people of all sexual identities feel valued and respected. This includes implementing anti-discrimination policies that explicitly reference sexual orientation (among the other protected characteristics under the Equality Act 2010), providing LGBTQ-sensitive support, and role-modelling authenticity to encourage others to be themselves at work.

Organisations should train managers on identifying the signs of psychological distress, such as appearing tired, anxious or withdrawn, or increased sickness absence. Workplaces should also offer training on unconscious bias to help unveil hidden prejudices, and leadership teams should undergo inclusive leadership training, which teaches how to build effective communication and practice empathy for different perspectives.

By practicing these initiatives, workplaces can move towards building inclusive cultures that support employees with different identities, without judgement or bias.

The connection between age and mental health problems

Mental health problems in the UK present differently across age groups, due to a variety of factors, such as socioeconomic and biological factors. For example, NHS data shows that one in five children and young people (under 25) had a “probable mental health disorder”, often attributed to media influences, pressure to perform and quality of home life. 93% of younger people have experienced negative treatment at work because of their age, often feeling patronised, undervalued and being seen as overly sensitive.

On the other hand, one in four older people are living with mental health conditions, with the World Health Organization linking some of these cases to a decline in functional ability, a drop in income due to retirement, and being subjected to ageism.

In fact, almost half of people aged over 50 report experiencing ageism, with higher levels reported among people from ethnic minority backgrounds (58%) and those with disabilities (up to 73%), illustrating the compounding effect of intersectionality. Over a quarter of workers over the age of 50 have been put off applying for jobs because the job descriptions appear to be aimed at younger candidates.

For women, the added factor of menopause can bring further challenges to mental health. Hormonal changes during (peri)menopause can cause unpleasant physical symptoms, as well as mental symptoms, such as depression, anxiety and overwhelm.

In fact, women are 40% more likely to experience depression during the perimenopause, compared to women who are not experiencing menopausal symptoms. According to Mind, the menopause can also make women feel self-conscious at work, affecting confidence and stress levels, thus undermining mental health.

What can organisations learn from this?

Organisations must acknowledge that mental health challenges can vary across age groups, thus support should be tailored accordingly. For younger employees who may be impacted by the pressures of early career advancement or media expectations, employers can support by providing mentoring programmes, networking opportunities and ensuring that communication and feedback is open and transparent. Additionally, working with employees to set personal goals is a useful way to demonstrate commitment to their career progression.

To help older employees feel more supported at work, organisations should offer flexible working options to help support employees who are managing caring responsibilities or their own health needs. Organisations should review employee data, segmented by groups, such as age, to establish what the biggest challenges are for those groups.

Additionally, employers should review policies, job descriptions, and be mindful of ageist language and assumptions that can exclude certain employees. For example, a CIPD report found that older workers participate less in training, and cautions managers from assuming that these workers do not want development opportunities. It is therefore important that organisations involve all employees in training opportunities, regardless of age, and invest in unconscious bias training to help mitigate prejudices.

Lastly, employers have an important role in supporting women who are experiencing menopausal symptoms, which can greatly affect physical and mental health. Managers should be trained to understand the effect of the menopause and how to approach conversations around it. It is also important to note that it is against the law to discriminate against any employee because of menopausal symptoms, if it is related to a protected characteristic, such as age, sex or disability.

Disability and mental health challenges

Mental health challenges among people with disabilities is an area of growing concern. Almost a quarter (24%) of Britons now identify as disabled, with mental health conditions being one of the most common disabilities, making up 34% of all reported disabilities.

According to The Office of National Statistics, a significant rise in reported mental health conditions can be seen in people of working age. In fact, 47% of working-age disabled people have mental health challenges. A House of Commons Library report attributes this rise to an increase in mental health conditions being reported among working-age adults.

In addition, people with disabilities are more likely to experience physical and digital exclusion, resulting in difficulties in accessing health services. These barriers to accessible support can exacerbate health inequalities and contribute to feelings of isolation. In fact, people with disabilities are 72% more likely to experience exclusion, compared to people without disabilities, which negatively impacts mental wellbeing.

Again, these societal barriers bleed into the workplace. Despite legal obligations for reasonable adjustments (under the Equality Act 2010), 56% of disabled employees report that there are still disability related barriers in the workplace, even after adjustments have been made.

These adjustments can include assistive technology, adapted ergonomic equipment or communications support. A lack of effective adjustments excludes those who need it, works against building an inclusive, fair environment, and does not support wellbeing in the workplace.

Finally, the employment rate for disabled people (53.4%) remains considerably lower compared to people without disabilities (81.8%). This disability employment gap adds to economic inequality, as well as impacting mental health, as meaningful work is closely linked to life satisfaction. This disparity, coupled with the fact that 40% of disabled employees experience discrimination, contributes to higher levels of stress, thus intensifying existing mental health conditions.

What can organisations learn from this?

To help address these inequalities, promote accessibility and cultivate a culture of inclusion, employers need to move beyond compliance and box-ticking, into embedding disability inclusion into workplace culture. To ensure employees with disabilities feel heard and valued, employers should include them when revising the policies and procedures than affect them.

Additionally, organisations should ensure that workplaces are set up with accessibility from the start, before any employee needs to request it. Other meaningful adjustments, like quiet zones and sensory-friendly environments, help to create safe and inclusive spaces for the employees that need them.

Staff training around disability and unconscious bias is crucial to raising awareness and understanding, and demonstrates to your staff network that your workplace is committed to being inclusive and equitable for all.

At the core of mental health inequalities lies exclusion

Mental health cannot be viewed through one single lens. Our identities overlap, and so do the barriers we face. A lesbian Asian woman will face different challenges to a gay black man, who will yet again face different challenges to a disabled transgender woman.

In fact, 72% of employees who identify with two or more protected characteristics have faced exclusionary or discriminatory behaviour. This figure increases to 86% for employees with three or more protected characteristics. It is therefore imperative that organisations develop systems and strategies that acknowledge the complexities of intersectionality.

At the core of mental health inequalities lies a deeper issue of exclusion, where people feel underrepresented, misunderstood, marginalised or rejected. Whether through racial prejudice, gender bias, ageism, sexuality-based discrimination or inaccessibility, many people feel unable to be their authentic selves at work. This lack of psychological safety and belonging directly contributes to stress and deteriorating mental health.

Let us help you

At FAIRER Consulting, it is our mission to create more equitable and inclusive workplaces. We support organisations to build psychologically safe environments and foster a sense of belonging through our various training programmes, including unconscious bias training and inclusive leadership training.

We also work with businesses to design inclusive DEI strategies that focus on embedding equity, inclusion, accessibility and belonging into practices and policies.

Download our free directory of inclusive mental health resources, which contains a list of tools and services, designed to help workplaces better support mental wellbeing. Additionally, we’ve put together a free checklist of actionable steps for employers to take towards mental health inclusivity.

Alternatively, book a complimentary call with us to discuss how we can take your DEI efforts one step further.