By Sarah Jowett, Research Officer
More than one in five adults (22.6%) in England are now living with a common mental health condition, a 20% increase since 2014. 1 At the same time, services are struggling to keep pace with rising demand, and the mental health waiting list has grown to an estimated 1.7 million people.2
The growing burden of poor mental health is not shared equally. People living in the most deprived areas of England are 64% more likely to experience a common mental disorder than those in the least deprived.1 Similar inequalities exist across the UK, with people in the most deprived areas of Scotland, Wales, and Northern Ireland also experiencing significantly worse mental health outcomes.3
These inequalities are not random. They reflect deep-rooted structural issues that shape our mental health. Without targeted action, mental health inequalities are likely to widen, with serious consequences for individuals, communities, and the economy.
The good news? We can change this. By focusing on prevention and addressing the root causes of mental health inequality, we can build a fairer, healthier society.
Understanding the causes, shaping the solutions
To tackle mental health inequalities, we first need to understand them.
We know that mental health is shaped by the conditions in which people are born, grow, live, work and age (these social, physical and economic environments are known as the social determinants of mental health). Yet, with a vast body of research pointing to a wide range of contributing factors, it can be difficult to know where to begin.
That’s where our Delphi study comes in.
A Delphi study is a structured research method that gathers expert consensus through multiple rounds of consultation.
Recognising that all social determinants matter for mental health, we convened a diverse panel of experts from across the UK, including people with lived experience, researchers, and policymakers, to identify the most impactful areas for action.
Six priority determinants identified by the Delphi panel
Using a structured Delphi process, the panel reached consensus on six key social determinants driving mental health inequalities in the UK:
- Household financial situation
- Housing and household conditions
- Employment
- Loneliness and social connection
- Access to mental and physical health support
- Identity-based mistreatment
A key insight from the panel was that these determinants are deeply interconnected. Tackling them in isolation won’t work. We need coordinated, cross-sector approaches that reflect how these issues compound and reinforce one another.
The Foundation Reports: building a picture of mental health inequality
The Delphi study is the first step in The Foundation Reports, the Mental Health Foundation’s ambitious multi-year research project investigating the state of mental health inequalities across the UK.
In this initial phase, the Delphi brings together expert insights to helps us understand why mental health inequalities exist, highlighting where decision makers should focus their efforts to reduce avoidable differences in mental health outcomes.
The wider Foundation Reports research will map mental health inequalities across the four nations, identifying who is most affected across different regions and communities. The project will track changes over time, allowing us to measure progress toward a fairer, more mentally healthy society.
By building a robust evidence base, we aim to support meaningful change and ensure that mental health is treated as a matter of social justice.
Looking ahead: a fairer future for mental health
In 2026, we’ll publish the first findings from our Foundation Reports inequality mapping research. We’ll also begin a series of deep dives into specific social determinants. The first will focus on employment and workplace mental health, a priority area identified by the Delphi panel which was also recognised for intersecting powerfully with other forms of inequality.
We know that good work can support good mental health. But insecure, low-quality, or unsafe work can do the opposite. Our upcoming research will explore how employment conditions shape mental health outcomes, and what can be done to ensure that work is a source of wellbeing, not harm.
Mental health inequalities are not inevitable, they are shaped by the conditions in which we live, and they can be changed. Through The Foundation Reports, we’re building the evidence needed to drive that change, starting with the Delphi study. By identifying the most impactful social determinants of mental health and mapping where inequalities are widest, we aim to support targeted, effective action across sectors. This is part of our long-term commitment to building a society that is fairer and supports better mental health for all.
- Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2023/24. NHS England; June 26, 2025. Accessed October 30, 2025. https://digital.nhs.uk/data-and-information/publications/statistical/adult-psychiatric-morbidity-survey
- Mental health pressures in England, data analysis. British Medical Association; 2025. Accessed October 30, 2025. https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/mental-health-pressures-data-analysis
- Poverty of ambition: why we need bold action to tackle poverty and improve mental health. Mental Health Foundation; 2025. Accessed October 16, 2025. https://www.mentalhealth.org.uk/our-work/policy-and-advocacy/poverty-ambition-why-we-need-bold-action-tackle-poverty-and-improve-mental-health