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Mental health

Mental health is an issue of national and local concern.  In the UK one in four adults will experience a mental health problem each year[1] and 11% of children and young people aged between five and fifteen have a clinically diagnosable a mental health issue. [2] Mental ill-health is the largest cause of disability in the UK. [3]

Improving mental health and wellbeing is associated with a range of better outcomes for people of all ages and backgrounds, including:

Improved:

  • physical health and life expectancy
  • educational achievement, employability and productivity
  • social interaction and participation

Less:

  • risky behaviours such as smoking and alcohol misuse
  • anti-social behaviour and criminality
  • risk of suicide

Parental mental illness is one of most common reasons for children to need social services involvement.  Around 4,900 under 18s in Herefordshire are living with a parent with severe mental health issues.

Recent research has highlighted the issue of mental health in farming communities where people can be more reluctant to seek help and access to services can be an issue.   Farm workers are one of the occupational groups most at risk of suicide.  The fact that mental ill-health is often hidden is apparent from variation in the recorded prevalence of mental illness; e.g. diagnosed depression rates vary across GP practices (from 4% of adult patients in Kington to 15% in Belmont (Hereford)).

Loneliness and involuntary social isolation can have a negative impact on mental health, but this is an area where local communities can play a critical role.

In 2016/17, the hospital admission rate for mental health disorders in children and young people aged 0 to 17 years was 166.8 per 100,000 population in Herefordshire; significantly higher than in England as a whole (81.5 per 100,000) and in the West Midlands region (84.3 per 100,000).  The rate has been increasing since 2012/13 and the gap between Herefordshire and England is widening. [4]

Figure 1:  Hospital admissions for mental health conditions in child and young people aged 0 to 17 years.

Graph showing hospital admissions for mental health conditions in Herefordshire compared to England between 2012/13 and 2016/17.

Source:  Public Health England

Hospital admissions for self-harm in children have increased in recent years, with admissions for young women being much higher than admissions for young men.

In Herefordshire, the rate of hospital admissions as a result of self-harm in persons aged 10 to 24 years was 365.6 per 100,000 in 2016/17; lower than nationally (404.6 per 100,000) and regionally (413.9 per 100,000).

Mental health problems are common among those needing treatment for alcohol misuse and alcohol misuse is common among those with a mental health problem.

In 2016/17, the rate of admissions to hospital for mental and behavioural disorders due to alcohol in Herefordshire was 31.5 per 100,000; much lower than in England as a whole (72.3 per 100,000) and the West Midlands region (76.6 per 100,000).

In 2014/15, the excess under 75 mortality rate in adults with serious mental illness, measured as a ratio of observed to expected mortalities and expressed as a percentage was 247.6% in Herefordshire; significantly lower than nationally (370.0%) and regionally (400.7%).

Suicide

Suicide is a significant cause of death in young adults, and is seen as an indicator of underlying rates of mental ill-health. Suicide is a major issue for society and a leading cause of years of life lost.  Between 2003 and 2013 in the UK over 18,000 people with mental health problems took their own life.  

In Herefordshire between 2014 and 2016 there were 56 lives lost to suicide.   The age-standardised mortality rate from suicide and injury of undetermined intent in Herefordshire was 11 per 100,000 population; higher than nationally (9.9 per 100,000) and regionally (10.0 per 100,000), but not significantly so.

The suicide rate among men is much higher than among women.  In 2014/16, the male suicide rate in Herefordshire was 17.5 per 100,000; the highest it has been since 2004/06 and higher than nationally (15.3 per 100,000) and regionally (15.9 per 100,000), but not significantly so. Residents of the most deprived areas of Herefordshire are approximately 19% more likely to die as a result of suicide than the county population in general.

Figure 2: Age-standardised mortality rate from suicide and injury of undetermined intent per 100,000 population (males).

Graph showing the age-standarised mortality rate from suicide and injury of undetermined intent per 100,000 males in Herefordshire compared to England between 2001/3 and 2013/15.

Source:  Public Health England, Mental Health and Wellbeing JSNA

In 2014/16, the female suicide rate in Herefordshire was 4.6 per 100,000; the lowest it has been since 2003/05 and similar to nationally (4.8 per 100,000) and regionally (4.4 per 100,000).

Figure 3:  Age-standardised mortality rate from suicide and injury of undetermined intent per 100,000 population (females).

Graph showing the age-standarised mortality rate from suicide and injury of undetermined intent per 100,000 females in Herefordshire compared to England between 2001/3 and 2013/15.

Source:  Public Health England, Mental Health and Wellbeing JSNA

[1] Adult psychiatric morbidity in England, 2007: results of a household survey. S. McManus et al, The NHS Information Centre for health and social care, 2009.

[2] Mental Health of Children and Young People in England, 2017:  Summary of Key Findings, NHS Digital, 2018.

[3] Policy paper: 2010 to 2015 government policy: mental health service reform, Department of Health & Social Care

[4] Note: Comparisons between areas must be made with caution for this indicator. Local protocols are known to result in children and young people being counted as a hospital admission where similar hospital presentation and care in other areas would not be counted as such. It is likely that these figures reflect different protocols rather than differences in underlying health.