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Q&A with Sally McManus

Last month, the results of The Adult Psychiatric Morbidity Survey hit the headlines, setting out the current state of mental health in England. The news heralded improvements in treatment rates but also showed worrying increases in mental illness among at risk groups, like young women. 

The Adult Psychiatric Morbidity Survey is the only data source providing rates of treated and untreated mental illness in England. Since 1993, this invaluable resource has been uncovering how many people are affected by mental health conditions in England, which conditions people struggle with, and whether or not they are receiving treatment. 

We wanted to find out more about this vital tool for research, so we spoke to Sally McManus from NatCen Social Research, who ran the survey. Sally shared with us her views on the key findings, important emerging trends and why work in this area is so important.

Which findings do you think were the most unexpected?

I didn’t expect to see treatment use increase as much as it did. In the 2000 and 2007 surveys, about one person in four with anxiety or depression was getting treatment, now that figure is closer to one in three.

We also found pronounced inequality in who gets treatment. Among people with anxiety or depression, those who are young are only half as likely to get treatment as those in midlife. Black people with anxiety or depression are also much less likely to receive treatment than those who are White British.

Interestingly, since 1993 we have seen a very gradual increase in levels of severe anxiety or depression, mainly in women.

Were you surprised by the findings around young people, specifically young women?

Yes, I was surprised. The survey showed high rates of anxiety and depression in young women, previously this used to peak around midlife. Particularly high rates of bipolar disorder, posttraumatic stress disorder, and self-harming also emerged for this group. While I considered this could be a statistical blip, given this profile is somewhat different to what we’ve seen in the past, other recent data sources also suggest that young women have become a high risk group. I hope these results prompt more research of this data, to understand this changing profile.

You have mentioned that social media is an area to focus on - can you tell us more?

I wish we had included more about social media in the 2014 survey as it is a key way in which the context of people lives has changed since the 2007 survey was carried out.

Social media can be a positive and a negative for mental health, in my opinion. There is scope for greater peer support and access to information about help and services, but there is also the potential for greater exposure to self-scrutiny and bullying.

Increased awareness and reduced stigma about mental health may mean that people now feel able to be more honest about sensitive experiences. This could have impacted on trends to some extent. The interview included some questions asked face-to-face and some also asked in a self-completion. Exploring this data could give us some insight on reporting behaviour. 

What areas do you think we should be exploring, moving forward?

The questionnaire covered so many different topics, so there is a lot of scope for the data to be explored further by researchers. I would like to look at whether the factors that predict mental illness has changed over time, and what role this may have in explaining trends in mental disorder. Understanding key triggers can help us to develop targeted prevention.

In the early 90s the government commissioned surveys of vulnerable groups such as homeless people, offenders and looked after children. These have not been repeated since, despite major changes in these populations. It would be great to see mental health surveys like those being carried out again.

Why is measurement of mental health and wellbeing so important?

We need to understand trends and target action where inequality is happening.

I think survey data needs to be at the heart of exploring and understanding inequalities. This dataset allows us to establish who does - and who doesn’t - get treatment, and who does and who doesn’t get diagnosed.

The data gives us a really comprehensive picture of people’s personal lives including difficult to discuss issues, such as abuse and debt.

We have the opportunity to examine the links between physical and mental health and to identify which groups in society would most benefit from targeted support. For example, the data shows strong links between receipt of Employment and Support Allowance and mental illness. This link is important to acknowledge when looking at unemployment and economic activity. The data has the potential to inform many aspects of wider social policy.

What inspired you to explore mental health? 

I hadn’t done much research on mental health before working on the 2007 Adult Psychiatric Morbidity Survey. But since becoming involved with the study I fell in love it and been so impressed with what a phenomenal resource it is. The datasets in the series are all made publically available and they have opened up a lot of opportunities for research. I really want to encourage more analysis of the data.

Last updated: 26 July 2017

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