When we get ill: mental ill health 2022

Page last updated: 2022 - due to be refreshed in 2024.

 

Five key points       

  1. Mental ill health conditions affect around one in four people in any given year, ranging from common problems, such as depression and anxiety, to more severe problems such as schizophrenia and bipolar disorder. (Why is mental health important?)
     
  2. In Suffolk, it is estimated that over 106,000 residents experienced a common mental ill health condition in 2020, with the most common conditions being anxiety, depression and phobias. (Estimated prevalence using survey responses)  
     
  3. Mental ill health problems are more common in areas of higher deprivation and poor mental health is consistently associated with unemployment, less education and low income. In Suffolk, people living in more deprived areas are more likely to experience severe mental illness, and to be admitted to hospital for self-harm. (Why is mental health important?
     
  4. 7,235 people registered with a GP in Suffolk had a GP registered diagnosis of severe mental illness in 2020/21. Generally, the lives of people with severe mental illness are 15-20 years shorter than the rest of the population. (Severe mental illness
     
  5. The number of people admitted to hospital because of intentional self-harm has increased in Suffolk in recent years; in 2019/20 the rate in Suffolk was significantly higher than England (213.7 admissions per 100,000 residents compared to 192.6 admissions per 100,000 residents). (Self-harm)

Why is mental health important in Suffolk?      

Good mental health is defined as a state of wellbeing in which every individual realises their own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. Like physical health, people can experience both temporary and long-term mental ill-health. Mental ill-health conditions affect around one in four people in any given year, ranging from common problems, such as depression and anxiety, to rarer problems such as schizophrenia and bipolar disorder.

Physical health and mental health are closely linked. People with long-term conditions, including diabetes and heart disease, are two to three times more likely to have depression. The more physical ill health problems a person has, the more likely they are to have a mental ill health problem. People with more than four physical health conditions are nearly seven times more likely to experience mental ill health than people in good physical health.

People can experience mental ill health at any age and the implications are wide-ranging. For children and young people, educational outcomes may be negatively affected, which can result in more limited job opportunities. For people of working age, they may be less productive at work and more likely to be unemployed. Among elderly people, they are more likely to be isolated and less active in their community. For people of all ages with mental ill health, it can be challenging to carry out everyday tasks.

Mental ill health can be both a cause and a consequence of social, economic and environmental inequalities. Mental ill health problems are more common in areas of higher deprivation and poor mental health is consistently associated with unemployment, less education and low income. In Suffolk, people living in more deprived areas are more likely to experience severe mental illness, and to be admitted to hospital for self-harm.

What is the local picture?       

A Mental Health Needs Assessment for Suffolk was published in 2018, and will be updated from 2022. The Needs Assessment includes more than twenty separate sections covering topics related to mental ill-health. For more detail about mental ill-health in Suffolk, please refer to the Mental Health Needs Assessment.

Note that Suffolk is covered by three Clinical Commissioning Groups (CCGs):

  • Ipswich and East Suffolk (within the County borders)
  • Norfolk and Waveney (covering the north-east corner of Suffolk as well as the whole of Norfolk)
  • West Suffolk (within the County borders) 

Wellbeing

Research shows that many factors influence our quality of life and well-being. At a national level, how people view their health is the most important factor related to personal well-being, followed by employment status and relationship status.

The Office for National Statistics publishes survey responses to four personal well-being questions. Respondents gave scores out of 10 to questions relating to life satisfaction, feeling that the things done in life are worthwhile, happiness, and anxiety (based on the previous day). Responses to questions had been showing a trend towards more positive answers both locally and nationally until 2019/20 when scores worsened. In 2020/21, respondents in Suffolk gave answers which were in line with England (Table 1).  Within Suffolk, 1 in 4 (24.5%) residents reported high anxiety and 1 in 10 (9.0%) residents reported a low happiness score  

Table 1: Average score out of 10 given by survey respondents for life satisfaction, feeling that the things done in life are worthwhile, happiness yesterday, and anxiety yesterday, Suffolk, East of England, England, 2020/21

 

Life satisfaction

Worthwhile

Happiness

Anxiety

Suffolk

7.59

7.79

7.39

3.19

East of England

7.47

7.75

7.37

3.22

England

7.38

7.71

7.31

3.31

Common mental ill health

Common mental ill health problems include depression and anxiety disorders such as generalised anxiety disorder, panic disorder, obsessive-compulsive disorder (called OCD for short) and post-traumatic stress disorder (called PTSD for short). Other common mental health problems include phobias about a specific thing (such as spiders) or situations (such as being embarrassed in front of other people).

These mental ill health problems are called 'common' because when combined they affect more people than other mental health problems (up to 15% of people at any one time in the UK). Some people may have more than one mental health problem (such as depression and anxiety).

Prevalence estimates

The prevalence of common mental ill health problems can be estimated by looking at GP registered prevalence (the number of people with a diagnosis). However, this is likely to underestimate the true prevalence because some people living with mental ill health will not have been diagnosed. An estimate of the true number of people with a mental ill health problem (those with a diagnosis plus those without a diagnosis) can be calculated using survey responses.

GP registered prevalence of depression

Within the three CCG areas that cover Suffolk (and including Great Yarmouth), a total of 87,374 people (aged 18 and over) had a GP registered diagnosis of depression in 2019/20 (Figure 1). Prevalence was higher than East of England in all Suffolk CCGs. West Suffolk and Great Yarmouth and Waveney have higher prevalence than England as a whole, while Ipswich and East Suffolk prevalence is similar to England. Prevalence of depression may be higher in some Suffolk CCGs or those CCGs may be more successful at identifying, diagnosing and recording depression.

Figure 1: GP registered prevalence of depression among individuals aged 18 and over, CCGs, East of England, England, 2019/20 

Chart illustrating the text: higher prevalence of depression in  Great Yarmouth and Waveney, and West Suffolk

Some people with a common mental health disorder (CMD) will be referred (or self-refer) to IAPT (Improving Access to Psychological Therapies) services (Table 2), which aim to see around 25% of all people with anxiety and depression by 2020/21

Table 2: IAPT services: key activity in the year 2020/21 for CCGs covering Suffolk

CCG Referrals received Entered treatment Finished course treatment
Ipswich & East Suffolk 14,085  10,065  3,850 
Norfolk & Waveney 25,370  18,140  8,775 
West Suffolk 7,540  5,350  1,975 

Estimated prevalence using survey responses

Based on responses to the Adult Psychiatric Morbidity Survey 2014, researchers have generated prevalence estimates for a range of common mental ill health conditions. These prevalence estimates have been applied to Office for National Statistics population estimates to give an estimated number of people within Suffolk, and the CCG areas covering Suffolk, who suffer from common mental ill health conditions. More detailed estimates for Suffolk districts and boroughs can be found in the Mental Health Needs Assessment.

In Suffolk, it is estimated that 106,250 residents (aged 16 or over) experienced at least one common mental ill health condition in 2020 (Table 3). The most commonly occurring conditions were generalised anxiety disorder, depressive episode and phobias.  

Table 3: Estimated prevalence of common mental ill health conditions among people aged 16 and over, Suffolk CCGs (2020 population estimates), 2020

 

Population (16 & over 2022 est)

Generalised anxiety disorder

Depressive episode

Phobias

Obsessive compulsive disorder

Panic disorder

Any CMD

Rate (all, aged 16 and over) not applicable 5.9% 3.3% 2.4% 1.3% 0.6% 17.0%

 Ipswich & East Suffolk CCG 

338,327

19,961

11,165

8,120

4,398

2,030

57,516

 Norfolk & Waveney CCG 

858,436

5-,648

28,328

20,602

11,160

5,151

145,934

 West Suffolk CCG 

188,047

11,095

6,206

4,513

2,445

1,128

31,968

 Suffolk

625,000

36,875

20,625

15,000

8,125

3,750

106,250


Note: Estimates are for prevalence identified in the week before interview unless otherwise specified.

Severe mental illness

Severe (sometimes called serious) mental illness (SMI) covers schizophrenia, bipolar affective disorder and other psychosesPeople with severe mental illness experience poor outcomes in terms of physical health and mortality rates, and they have an increased likelihood of unhealthy lifestyles including alcohol or substance misuse and smoking. Generally, the lives of people with severe mental illness are 15-20 years shorter than the rest of the population.

More detailed discussion about severe mental illness can be found in the State of Suffolk's groups at risk of disadvantage section and the Mental Health Needs Assessment for Suffolk.

In 2020/21, 7,235 people registered with a GP in Suffolk were on the mental health register (i.e. had a diagnosis of severe mental illness) (Figure 2). This equates to a prevalence of 0.90% among the GP registered population, significantly lower than England as a whole (0.95). 

Figure 2: Prevalence of severe mental illness in Suffolk CCGs 2020/21

Figure 3: Prevalence of severe mental illness by Suffolk GP, 2020/21

Patients who live in more deprived areas have a higher prevalence of SMI, and patients with SMI living in more deprived areas have a higher prevalence of physical health conditions. Six of the 10 GP practices with the highest percentage of mental health QOF prevalence are also in the ten practices with the highest levels of deprivation in Suffolk (Public Health Suffolk analysis). Socio-economic deprivation is recognised as both a cause and consequence of SMI, with sufferers experiencing an increased risk of “social withdrawal” such as unemployment. 

Self-harm and suicide

Self-harm

The number of people admitted to hospital because of intentional self-harm has increased in Suffolk in recent years: in 2019/20 the rate in Suffolk was significantly higher than England (213.7 admissions per 100,000 residents compared to 192.6 admissions per 100,000 residents) (Figure 3). 

More recent data (Figure 4, 2020-21) shows that the highest levels of self-harm in Suffolk are seen in Ipswich (266.9 per 100,000), and East Suffolk (217.7 per 100,000).  

When broken down by age (five year age bands for 10 to 24 year olds), each age group in Suffolk has significantly higher emergency admission rates than England as a whole (Figure 5).

Figure 3: Emergency hospital admissions for intentional self-harm, directly standardised rate per 100,000, Suffolk compared to England, 2010/11 to 2019/20

Suffolk trends for self-harm showing significantly higher than England

Figure 4: Emergency hospital admissions for intentional self-harm (all ages), Suffolk lower tier local authorities, 2020-21

Chart showing Ipswich and East Suffolk districts have significantly higher rates of emergency hospital admissions for self-harm than England, while the other Suffolk lower tier local authorities are similar to England.

Figure 5: Hospital admissions as a result of self-harm, people aged 10-24 by five year age band, Suffolk, 2019-20

Table showing for each age band Suffolk has significantly higher levels of hospital admissions as a result of self-harm than England

Suicide

Among people of all ages in Suffolk, the number of deaths by suicide has increased from 174 deaths in 2015-17 to 208 in 2018-20. Rates of death by suicide (10.4 per 100,000) are similar to England (10.4) and to the East of England (10.8). The rate is higher for males (15.4) than females (5.7).

Impact of COVID-19 

The Covid-19 pandemic, and the unprecedented measures required to reduce the spread of the virus, have placed extraordinary pressures and demands on everyone. Perhaps unsurprisingly, around 1 in 5 adults in Britain experienced some form of depression in the first 3 months of 2021 - that’s over double the figure prior to the pandemic.

Suffolk Public Health focused on ‘public mental health’ for the 2021 Annual Public Health Report (Better Together) to understand what everyone can do to support mental wellbeing – as individuals and families, in communities, workplaces and groups, and across Suffolk as a whole. Even at the height of the pandemic, many individuals and organisations in Suffolk did things that supported our collective mental wellbeing.  This is a concept known as ‘public mental health’: "The focused actions taken to improve mental health and wellbeing, and prevent mental ill-health, by individuals, communities and organisations".

National studies show deteriorations in mental health and wellbeing between March and May 2020, followed by a period of improvement through July, August and September 2020, and then a second deterioration between October 2020 and February 2021, followed by another period of recovery but not to pre-pandemic levels. Some groups have been more likely to experience poor or deteriorating mental health: women, young adults (aged between 18 and 34), adults with pre-existing mental or physical health conditions, adults experiencing loss of income or employment, adults in deprived neighbourhoods, some ethnic minority populations and those who experienced local lockdowns. Suffolk Mind’s COVID-19 impact report (published November 2021) suggests “the number of people susceptible to stress or mental ill health has doubled since March 2020”. Their research confirms that “those who are not working or are younger are less likely to be well”, while older people and the retired are least affected overall.

Some children and young people’s mental health and wellbeing has been substantially impacted due to and during the pandemic (particularly children with special educational needs (SEND), girls, children in care or disadvantaged financially, with pre-existing mental health needs, from Black Asian and Minority ethnic backgrounds, and LGBTQ+ young people). In England, there was an 81% increase in referrals to children and young people’s mental health services (April to September 2021 compared to the same period in 2019), compared to an 11% increase for adults. Healthwatch Suffolk reported in My Health, Our Future Phase 5 (2021) that “young people are now less resilient and more likely to have poorer wellbeing compared to 2019, revealing the negative impact of the pandemic on their mental health… some groups (e.g., young people from multi-ethnic communities, students with disabilities and LGBT*Q+ young people) [were] disproportionately impacted by mental health and emotional wellbeing concerns.”

Further information