Using data from the Attitudes to Mental Illness (AMI) survey, we previously reported positive change in mental health stigma in England between 2008 and 2019. However, following the conclusion of the Time to Change campaign in 2021, 2023 data revealed a deterioration in several stigma-related attitudes. This report presents AMI survey 2024 results, examining changes over the past year. Regression analyses assessed stigma-related knowledge (Mental Health Knowledge Schedule (MAKS)), attitudes (Community Attitudes toward the Mentally Ill scale (CAMI)) and behavioural intent (Reported and Intended Behaviour Scale (RIBS-IB)), along with willingness to interact based on vignettes of depression and schizophrenia. The proportion of respondents achieving 2023-level MAKS and CAMI scores declined significantly (by 3.5% (p = 0.028) and 7.0% (p < 0.001), respectively), whereas RIBS-IB scores showed a non-significant decrease. Vignette responses remained stable, but there are signs of increasing desire for social distance. This report explores potential drivers of these trends.

Hyperprolactinaemia is a common adverse effect of antipsychotic medication, primarily resulting from dopamine D2 receptor blockade. It is characterised by menstrual irregularities, gynaecomastia, galactorrhoea and, with prolonged exposure, an increased risk of osteoporosis and breast cancer. When switching towards a prolactin-sparing antipsychotic is not feasible, adjunctive use of aripiprazole – a dopamine D2 partial agonist – has emerged as a validated strategy to mitigate hyperprolactinaemia without compromising antipsychotic efficacy. However, alternative options are needed for patients who cannot tolerate aripiprazole. Here we report the use of brexpiprazole, a dopamine D2 partial agonist structurally related to aripiprazole, to counteract paliperidone-induced hyperprolactinaemia effectively in a patient who developed a cutaneous reaction to aripiprazole. During the follow-up period with adjunctive brexpiprazole in combination with paliperidone, neither a recurrence of psychotic symptoms nor a reappearance of the skin reaction previously experienced with aripiprazole was observed.