Common mental disorders (CMD), like anxiety and depression, are modifiable mental health conditions that affect around one in ten people in the UK. Rates of CMD and self-harm are higher in groups who experience unemployment or poverty. Further, those facing a crisis like job loss, housing insecurity, or debt may be more likely to develop CMD and self-harm.
The economic recession of 2007/2008, subsequent decades of austerity policies, and recently, the COVID-19 pandemic have highlighted how psychosocial crises may be caused by regional, national, and global events. These global disruptions have not impacted on all groups equally, and there is growing evidence these events have an exaggerated impact on some sociodemographic groups, revealing regional, ethnic, and gendered patterns.
Thus, it is a public mental health priority to understand how changes in broad factors may influence the rates of developing CMD and self-harm. This may guide interventions which aim to reduce the impact of psychosocial crises on mental health problems.
This research aims to measure the incidence (new episodes) of CMD in general practice for population subgroups over the last 20 years.
We will explore how the incidence of CMD has changed over time and explore which sociodemographic groups are at highest risk of developing CMD, including age, sex, region, ethnicity, comorbidity, and deprivation.
Using the results of this study, we will explore how these patterns relate to regional, national, and global events, policies, and interventions, with the overall aim of guiding public mental health practice and policy.
Common mental disorders (CMD) are highly prevalent mental health conditions, affecting 10% of the UK population. Research has shown that rates of CMD are linked to socioeconomic difficulty, including unemployment, poverty, and housing insecurity. The last decades have been characterised by dramatic changes in spending in social services, housing, welfare, and the public sector. The financial crisis of 2007-2008 was followed by strict austerity policies, which have differentially affected the most vulnerable people in the UK, entrenching poverty, and contributing to growing inequality.
While poverty and inequality have been consistently linked to poor health outcomes, the impact of austerity policies on mental health has not been specifically determined. Before we are able to examine the impact that austerity policies have on mental health outcomes, we must first establish a better understanding of the incidence of common mental disorders over the past 20 years, with a particular focus on the population subgroups that may be differentially impacted by these changes.
The aim of this research is to estimate the annual incidence of common mental disorders (CMD) from 2000-2020 and to generate age, sex, region, ethnicity, comorbidity, and deprivation-specific incidence estimates, which will allow us to explore inequalities in rates of CMD by sociodemographic factors. We will use CPRD diagnoses and drug prescriptions for anxiety, depression, and self-harm as our primary outcomes. Where possible, we will then use stratum-specific estimates to explore how changes in CMD incidence over time may be linked to macrosocial changes and policy interventions.
Incidence and prevalence of recorded depression, anxiety, and self-harm and related treatment (including pharmacotherapy):
anxiety diagnosis; anxiety symptoms; depression diagnosis; depressive symptoms; self-harm behaviours; receipt of drug treatment for mental disorders (e.g. antidepressants); receipt of psychological therapy; referral to psychotherapy
David Osborn - Chief Investigator - University College London ( UCL )
Jennifer Dykxhoorn - Corresponding Applicant - University College London ( UCL )
Annie Jeffery - Collaborator - University College London ( UCL )
Antonio Lazzarino - Collaborator - University College London ( UCL )
Francesca Solmi - Collaborator - University College London ( UCL )
Kate Walters - Collaborator - University College London ( UCL )
Shamini Gnani - Collaborator - Imperial College London
ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation