Publication
Health Education Population Survey (HEPS): Update from 2004 Survey - Final Report
| Contents: | Summary 1. Introduction 2. Attitudes to own health 3. Physical activity 4. Diet 5. Smoking 6. Alcohol 7. Mental Health 8. Oral health 9. Sexual health 10. Cannabis legislation Appendix |
7. Mental Health
Mental health is an integral part of health as defined by the World Health Organization. The most common problems presented to GPs are linked to mental health and it is one of the top priorities for the NHS in Scotland. As life expectancy increases and treatment or prevention of the main causes of mortality improves, issues such as mental health and well-being become increasingly salient on the health agenda. In addition, material and social disadvantage can affect health through indirect psychosocial pathways, thus contributing to the added burden of morbidity and mortality attributable to behavioural factors5.
For health education, mental health has been a broad underlying theme of much public communications activity, especially those concerning young people’s decision-making. Stress in the workplace has been a more specific focus of preventive actions. In 2001, a new national programme was launched in Scotland to promote mental health and well-being which will attempt to reduce the rising levels of suicide among young people, particularly young men, and which features a public education campaign (See Me) to reduce the stigma associated with mental illness. A separate national survey of public attitudes to mental health, well-being and mental health problems was carried out by the Scottish Executive in 2002 (and was repeated in 2004) to provide population level information on a broad spectrum of mental health issues6.
5Marmot, M. and Wilkinson, R.G. (eds) (1999) Social Determinants of Health. Oxford University Press, Oxford.
6Scottish Executive (2002) Well? What do you think? Scottish Executive, Edinburgh.
7.1 Stress
There were no changes in the levels of reported stress in 2004. One in four (24%) reported large amounts of stress and four in ten (41%) reported harmful stress. As in previous years, women and those aged 35-54 were most likely to report stress.
7.2 Mental health status (GHQ12)
As in the Scottish Health Survey, the mental health indicator used in HEPS is the twelve-item version of the General Health Questionnaire (GHQ12) which consists of a list of symptoms of mental distress and is scored on a scale from zero to twelve, with higher scores reflecting the reporting of more symptoms. This questionnaire has been widely used in general population surveys in order to assess levels of potential psychological morbidity. The generally recommended threshold score for detecting potential psychiatric morbidity is two 7. For the purposes of this survey, a score greater than two is taken as an indicator of potential mental health distress. Consideration is also given to those with a score of four or more as an indicator of potential psychological disorder. The GHQ12 was part of the self-completion section of the questionnaire which approximately 5% of respondents refused to complete. The data in this section are based on those who completed the section.
Figure 7.1 Time trends GHQ12 scores (1996-2004)
|
Base: all answering self-completion section (2004:1523)
Despite an apparent increase in the proportion with higher scores in 2003, 2004 has seen a return to previous levels, showing no change in overall levels since 1996. The mean GHQ12 score in 2004 was 1.7, compared with 1.8 in 1996.
As in previous years, women were more likely than men to show signs of potential mental health distress on this measure (27% of women scoring over 2). Those in social grade E were again more likely than average to have a score over 2 (34%).
Main points
- Women were more likely than men to report symptoms of potential mental distress.
- There was a marked social gradient in symptoms of mental distress and disorder, with those living in more deprived areas and in social grade E reporting more symptoms.
- There were no discernible changes over time, and the apparent increase in mental health disorder in 2003 appears to have been a random fluctuation.
7Goldberg, D.P. and Williams, P. (1988) A User’s Guide to the General Health Questionnaire. NFER-Nelson, Windsor