Director of Public Health Annual Report 2023: Mental health matters
10. Who is most at risk of poor mental health?
While the factors listed in the previous sections can affect everyone, some people are more likely to experience poorer mental health than others. This includes people who live in more deprived areas and those who belong to particular groups.
This section considers the national research and local Buckinghamshire data in order to identify who is most at risk of poor mental health.
Poverty and deprivation
National research has demonstrated a link between poverty and mental health. For example, a large national study showed that children in the poorest fifth of households in the UK were four times more likely to have serious mental health difficulties by the age of 11 than those in the wealthiest fifth.
This link between poverty and mental health is evident in Buckinghamshire. Data from before the pandemic found that people living in the most deprived fifth of areas in Buckinghamshire were more than twice as likely to have an emergency admission for mental health or self-harm compared with those living in the least deprived fifth of the county. Emergency admissions for mental health are significantly higher for residents living in the Aylesbury and High Wycombe Community Board areas which are both areas with higher levels of deprivation.
The figure below illustrates this pattern, mapping data on mental health from multiple sources such as mental health related hospital attendances and prescribing of antidepressants.This creates an index which can be compared against England – the figure is colour coded so that the darkest blue areas have the best mental health (i.e. are in the best tenth of areas nationally) and red areas have worse mental health than the national average. The majority of areas in Buckinghamshire score significantly “better” compared with England. The areas with poorer mental health are primarily clustered in the Aylesbury Community Board area.
Buckinghamshire Small Area Mental Health Index (SAMHI) for each Lower Super Output Area and Community Board, 2019
Gender differences
Mental health risk varies by gender. National data shows that women in England are three times more likely than men to experience common mental health problems, post-traumatic stress disorder and eating disorders. However, men have a much higher risk of dying by suicide and are three times more likely than women to end their own lives.
Poorer mental health in particular groups
Mental health is also linked to gender identity and sexual orientation. Research shows that people who are lesbian, gay, bisexual and transgender have a higher risk of mental health conditions linked to emotional distress, discrimination and barriers to accessing healthcare and support.
The risk of poor mental health is higher in people with physical health problems. About 30% of people in England in 2012 who had a long-term physical health condition also had a mental health problem, primarily depression or anxiety.
There is evidence that people from many other groups may have higher risk of poor mental health. This includes people who are neurodiverse, and people from some ethnic groups.
Migrants may have an increased likelihood of mental health disorders linked to their experiences before, during or after migration.
As outlined above, children and adults who act as carers for others are also at risk of having poorer mental health if they do not get the right support. In 2021, around 8% of Buckinghamshire residents aged five and over provided some level of unpaid care.