Work Package 7: Mental Health Inequalities Work Package Investigators: Ann McNeill, King's College London; Leonie Brose, King's College London; Deborah Robson, King's College London and Sarah Hill, University of Edinburgh Aim: To understand the relation between unhealthy commodities, mental ill-health, and stigma, and to explore how these relationships can be disrupted over time. Objectives: Investigate the relationship between unhealthy commodities and mental ill-health, and the impact of initiatives by producers of unhealthy commodities, governmental and non-governmental organisations on these relationships; Understand how people with mental ill-health who smoke and/or use alcohol perceive government mass media campaigns and marketing campaigns and how these affect their behaviour and influence norms/stigmatization. To co-design and evaluate new health communication strategies; Examine how producers of unhealthy commodities position their products in relation to social norms and mental health. Methods and Data Sources: We will use several different data sources and approaches to address our aims. We have previously asked smokers in England about their mental health in the Smoking Toolkit Study. For this project, we will extend questions about mental health to all adults and to Scotland and Wales. We will explore whether respondents have ever being diagnosed with, and a mental health problem, and their experience of past-month distress (using the K6, a screening instrument for severe and moderate mental illness). With more data over time we will be able to explore the impact of policies such as tax changes, and marketing campaigns on smoking and drinking behaviours and mental ill-health as well as track population-level distress contemporaneously Since international evidence indicates that mass media campaigns and other recognised tobacco control policies are ineffective among smokers with mental health problems, we will use qualitative and experimental research methods to explore how current tobacco and alcohol policies and mass media campaigns (e.g. Stoptober and marketing) are perceived by those with mental health problems and how they affect perceptions of stigma. We will also explore, with a newly established panel of people with mental health problems, whether and how population-wide campaigns can be made more effective in promoting and protecting the health of those with mental ill-health. Finally, we will use publicly-available data to explore whether producers of unhealthy commodities exacerbate stigma, mental ill-health and inequalities in relation to their products. Data sources will include submissions to public consultations, marketing materials, and industry reports produced for shareholders and investors. Using qualitative approaches (e.g. critical discourse analysis) we will examine the framings and strategies used by producers and explore their potential implications for public understanding, social norms and policy approaches concerning the relationship between mental ill-health, health behaviours and non-communicable diseases. We will work closely with the Mental Health & Smoking Partnership and our mental health service user panel throughout.