Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan;50(2):293-302.
doi: 10.1017/S0033291719000023. Epub 2019 Feb 12.

Prevalence of mental illness in primary care and its association with deprivation and social fragmentation at the small-area level in England

Christos Grigoroglou  1   2 , Luke Munford  2   3 , Roger T Webb  2   4   5 , Nav Kapur  2   5   6   7 , Darren M Ashcroft  2   5   8 , Evangelos Kontopantelis  1   2
Affiliations

Prevalence of mental illness in primary care and its association with deprivation and social fragmentation at the small-area level in England

Christos Grigoroglou et al. Psychol Med. 2020 Jan.

Abstract

Background: We aimed to spatially describe mental illness prevalence in England at small-area geographical level, as measured by prevalence of depression, severe mental illness (SMI) and antidepressant prescription volume in primary care records, and how much of their variation was explained by deprivation, social fragmentation and sociodemographic characteristics.

Methods: Information on prevalence of depression and SMI was obtained from the Quality and Outcomes Framework (QOF) administrative dataset for 2015/16 and the national dispensing dataset for 2015/16. Linear regression models were fitted to examine ecological associations between deprivation, social fragmentation, other sociodemographic characteristics and mental illness prevalence.

Results: Mental illness prevalence varied within and between regions, with clusters of high prevalence identified across England. Our models explained 33.4-68.2% of variability in prevalence, but substantial variability between regions remained after adjusting for covariates. People in socially cohesive and socially deprived areas were more likely to be diagnosed with depression, while people in more socially fragmented and more socially deprived areas were more likely to be diagnosed with SMI.

Conclusions: Our findings suggest that to tackle mental health inequalities, attention needs to be targeted at more socially deprived localities. The role of social fragmentation warrants further investigation, and it is possible that depression remains undiagnosed in more socially fragmented areas. The wealth of routinely collected data can provide robust evidence to aid optimal resource allocation. If comparable data are available in other countries, similar methods could be deployed to identify high prevalence clusters and target funding to areas of greater need.

Keywords: Antidepressant prescribing; depression; deprivation; mental illness; severe mental illness; social fragmentation.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Prevalence of depression in England (2015/16 LSOA level).
Fig. 2.
Fig. 2.
Prevalence of severe mental illness in England (2015/16 LSOA level).
See this image and copyright information in PMC

References

    1. Allardyce J and Boydell J (2006) Environment and schizophrenia: review: the wider social environment and schizophrenia. Schizophrenia Bulletin 32, 592–598. - PMC - PubMed
    1. Allardyce J, Gilmour H, Atkinson J, Rapson T, Bishop J and McCreadie RG (2005) Social fragmentation, deprivation and urbanicity: relation to first-admission rates for psychoses. British Journal of Psychiatry 187, 401–406. - PubMed
    1. Barr B, Taylor-Robinson D, Scott-Samuel A, McKee M and Stuckler D (2012) Suicides associated with the 2008–10 economic recession in England: time trend analysis. BMJ 345, e5142. - PMC - PubMed
    1. Barr B, Kinderman P and Whitehead M (2015) Trends in mental health inequalities in England during a period of recession, austerity and welfare reform 2004 to 2013. Social Science & Medicine 147, 324–331. - PubMed
    1. Barr B, Taylor-Robinson D, Stuckler D, Loopstra R, Reeves A and Whitehead M (2016) ‘First, do no harm’: are disability assessments associated with adverse trends in mental health? A longitudinal ecological study. Journal of Epidemiology and Community Health 70, 339–345. - PMC - PubMed

Publication types

LinkOut - more resources