Mental Health: Deprivation

Major risk factors for mental ill health are poverty, poor education, unemployment, social isolation and major life events; socially excluded and deprived people are at a higher risk of developing mental health problems. A recent review of large scale studies, of mental health problems undertaken by Social Exclusion Unit of the Cabinet Office, reported that such problems are more common among people who are unemployed, have fewer educational qualifications, have been looked after or accommodated, are on a low income or have a low standard of living (Mental Health and Social Exclusion 2004 (1.11MB)).

Research carried out by McLaren and Bain in 1998 (Deprivation and Health in Scotland), demonstrated a clear gradient in first admission rates for specialist psychiatric care by deprivation category of residence for schizophrenia. Mortality from suicide and undetermined causes was also shown to have a clear correlation with deprivation, especially in the younger age groups

More recently the study by Boyle et al 2005 study found that between 1980-2 and 1999-2001, the gap between the number of deaths from suicides in the most and least deprived areas of Scotland had widened, particularly for young adults. The suicide gap between the most and least deprived areas widened more for young women.

In Scotland, Practice Team Information data provides further evidence of the link between deprivation and psychiatric morbidity:

• For female and male patients seen with depression and anxiety between 2004and 2005, the ratio between the most deprived and least deprived areas widened: for males from 51 per 1000 population to 93 per 1000 and for females from 111 per  1000 to 187 per 1000. (Table 1)

 

Table 1. Depression and Anxiety - PTI annual prevalence rates per 1000 population for Scotland(1); years ending 31 March 2004 and 2005 (2)(3); by sex and quntile, standardised for age.

		2003-2004		2004-2005
Sex	Quintile	Patients seen per 1,000 population	Estimated patients for Scotland (2)	Patients seen per 1,000 population	Estimated patients for Scotland (2)
Male	1	54.8	28,750	50.7	26700
	2	60.3	31,350	57.9	30500
	3	73.4	38,250	70.6	37100
	4	83.3	43,700	86.5	45600
	5	98.2	53,400	92.7	50,300
	All categories	74.2	195,350	71.8	190,150
Female	1	118.4	63,600	111.1	59,850
	2	133.5	71,600	119.2	64,600
	3	155.5	83,300	145.8	78,700
	4	174.0	94,100	176.8	95,800
	5	192.6	105,350	187.4	102,100
	All categories	155.0	417,950	148.2	401,100
Total		115.1	613,300	110.4	591,250

Source: ISD Practice Team Information.

Population source: Community Health Index (CHI) record, ISD Scotland, as at September 2003 and September 2004

notes:

 1. Prior to April 2003 data were collected only from GPs (Continuous Morbidity Recording (CMR)). From 1 April 2003 data collection was extended to encompass patient contacts with practice nurses, district nurses and health visitors (Practice Team Information (PTI))

2.Based on 45 and 44 practices which collected and submitted PTI data, years ending March 2004 and 2005 respectively.

3.Based on ISD's revised Standard Morbidity Groupings (SMG) for both ‘Depression & other affective disorders’ and 'Anxiety & other neurotic, stress-related, & somatoform disorders' .

4.Figures have been rounded to the nearest 50.  Totals do not equal the sum of the estimated numbers for each age group due to rounding.