Director of Public Health Annual Report 2023: Mental health matters

While the factors listed above can promote good mental health in adults, there are many things that can have a negative effect. These include drinking too much alcohol, gambling and living in poor quality homes or neighbourhoods. Worrying about money and debt can also lead to poorer mental health.

Drinking too much alcohol is bad for both our physical and mental health. Indeed, alcohol has been identified as contributing to or causing more than 200 different medical conditions. Some people drink in order to relieve the symptoms of mental ill-health such as anxiety or depression. However, evidence suggests that regularly drinking too much alcohol – including binge drinking – actually has the opposite effect, causing feelings of depression.

Harmful gambling (where people continue to gamble despite harmful consequences or the desire to stop) is linked to poor health, low wellbeing and psychological health issues.

People with a gambling disorder have a higher risk of dying from any cause and are at higher risk of self-harm and suicide.

Gambling also increases the risk of other experiences that can negatively affect our mental health, including the risk of debt, loss of employment, harm to our relationships and reduced social support.

Gambling is generally more common in less deprived groups and people in employment. However, harmful gambling is more prevalent in people living in deprived areas and amongst people who are unemployed.

Stable, good quality housing protects mental health but poor quality, overcrowded and insecure housing can cause or worsen existing mental health disorders.

Adults living in overcrowded housing are more likely to experience psychological distress. Living in a home that is cold is also linked to poorer mental health. For example, a government scheme to support improvements in home energy efficiency found this improved people’s mental health in both the short and medium term.

The neighbourhoods we live in equally influence our health. Neighbourhood deprivation is associated with poorer mental health, suicide and needing longer treatment for mental health problems. Meanwhile, people who feel safe in their community tend to suffer less psychological distress and depression. Research has found that acts of neighbourliness and the existence of community hubs (such as sports clubs and activity groups) can foster feelings of togetherness and offer informal sources of support.

Worrying about money – due to either debt or low income – often has a negative impact on our mental health. Indeed, surveys have found that recent rises in the cost of living are affecting people’s mental health with over half of adults in England reporting that their mental health has deteriorated.

In Buckinghamshire, 90% of participants in research undertaken by the charity Buckinghamshire MIND in partnership with Citizen’s Advice Bucks in 2022, reported that worrying about their finances – particularly heating and health – impacted negatively on their mental health. The sample size for this study was, however, small (81 participants).

Acting as a carer to a family member or close friend can be positive and rewarding. However, worry for the person being cared for can have a negative effect on the carer’s mental health. The time needed to care can also mean giving up other activities. As many as 1 in 10 adult carers give up work or reduce their working hours in order to fulfil their role as a carer and many give up hobbies and social activities, leading to greater isolation.

As with children, many adults who deliver unpaid care do not see themselves as carers: it is important to identify people with caring responsibilities in order to ensure they get information and support for their physical and mental wellbeing.