The biggest national survey of mental health among adults living in England reported its first set of results in June. With historical data going back to 2000, the Adult Psychiatric Morbidity Survey (APMS) provides the most accurate and widely used source of reliable data on the mental health of people aged over 16. And as there was almost a decade between this year’s data (for 2023/24) and the last time the survey was carried out (2014), these results provide the first comprehensive picture of our mental health in a very long time.
The picture is one of a decline in the public’s mental health. And whereas the 2007 and 2014 surveys suggested gradual increases in levels of mental ill health since the millennium, the data for 2023/24 tells a stark story of deterioration for many, and deep and entrenched inequalities.
The headline figure is that one in five of us (aged over 16) has a common mental health problem, including depression, anxiety or post-traumatic stress disorder (PTSD). Rates of severe mental illness, eating disorder, and problem substance use are among figures that will be published later this year.
For adults aged 16-64, rates of common mental health conditions rose at every interval between surveys (including 1993 to 2000), except 2000-2007, when they remained stable. But the biggest increase was between 2014 and 2023/24, rising from 18.9% to 22.6%. In the last decade, young adults (16-24) have had both the highest rates (reaching 25.8%) and the biggest increase. The lowest rate was among over-75s, at 10.2%, which has also been the most stable over time. This is yet more evidence that young people’s mental health has been declining more steeply than for other age groups. It provides solid evidence to refute baseless claims from some politicians and commentators that the observed increase in mental distress among this age group isn’t real. And it raises the question of what legacy this will leave for young people as they progress in their adult lives over the next few decades.
Women are much more likely to have a common mental health problem than men – at 24.2% compared with 15.4%. This in itself is a stark inequality that frequently gets overlooked. Women have lower suicide death rates than men, but in 2023/24 women were more likely to have had suicidal thoughts and to have attempted to take their own life during their lifetime, as well as having higher rates of trauma, of PTSD, and of self-harm. It’s therefore vital that suicide prevention efforts focus on women as well as men, and that women and girls’ needs are better addressed by mental health services across the board.
It’s no surprise that people living in more deprived areas, those who are unemployed, and those who have problem debts have higher rates of mental distress than the rest of the population. But the extent of the difference is stark. Some 40% of unemployed people had a common mental health problem in 2023/24, more than twice the rate among those in work. Rates of PTSD among those out of work are almost four times the average. With government plans to restrict benefits for disabled people, this is a timely reminder of the connections between unemployment and mental ill health and the urgency of effective support.
Some of the biggest disparities in mental health are faced by those with long-term life-limiting physical conditions. Some 39% of those with a long-term condition also have a mental health problem. A very similar number had had suicidal thoughts during their lifetimes, and 14.4% had attempted to take their own lives. One in ten with a long-term condition screened positive for PTSD: a reminder of the traumatic nature of physical illness and the urgency of mental health support for people living with it.
One of the biggest, and more welcome, findings of the survey is that many more people with common mental health problems are getting some kind of treatment for them. This continues a trend that began in 2007, the year before the Improving Access to Psychological Therapies (later renamed NHS Talking Therapies) programme started work. Almost half of people with a mental health condition (47.7%, or 15.7% of the entire adult population of England: some 7.3 million people) have had treatment for it – up from one-third in 2014 and only a quarter in 2007. (Another 2.8% of people had tried to get mental health treatment and not been able to receive it.)
The overall picture from the survey is clear enough. Our mental health is indeed getting worse. And younger generations are being especially hard hit. What we now need to understand is why, and what can be done to reverse it.
But it’s not talking therapies that predominate. In total, 12.8% of the population is using medication for a mental health difficulty, while 5.1% are having talking therapies. And despite the growth in NHS talking therapy provision over the last two decades, use of medication has grown more quickly. The proportion of those with a common mental health problem using medication for it doubled between 2007 and 2023/24 from 19.6% to 38.4%, while talking therapy use grew from 10.4% to 17.9% during that period.
The fact that the NHS has made great strides in closing the treatment gap among people with common mental health problems is rarely recognised for the achievement that it is. But a huge gap remains, and it is clear that the job is only, at best, half done so far.
Rates of mental health treatment are similar for men and women, perhaps dispelling the idea that men are less help-seeking for their mental health. Among age groups, younger people are far more likely to receive treatment than older adults. Treatment rates are also lower for all racialised communities compared with white British people. Some 18.4% of the latter are receiving treatment, compared with 16.7% of Other white people, 4.1% of Asian or Asian British, 8.1% of Black or Black British, and 9.5% of those with Mixed ethnicity (according to the categorisations used in the survey). By contrast, the report notes that prevalence rates of common mental health conditions were similar between ethnic groups: though as with other surveys of this kind, low sample sizes have limited its value in this regard. Nonetheless, this strongly suggests that the provision of support for common mental health problems is still inadequate for all racialised groups.
The overall picture from the survey is clear enough. Our mental health is indeed getting worse. And younger generations are being especially hard hit. What we now need to understand is why, and what can be done to reverse it. It’s encouraging that more people are getting mental health treatment, but that can’t stop people becoming unwell in the first place. For that, we have to see the determinants and drivers of common mental health problems for what they are. It’s no coincidence that women face a far higher risk than men of depression, anxiety and PTSD. That the most deprived, those who are unemployed, those facing problem debts, and those with long-term physical illnesses face dramatically higher risks to their mental health. These are structural inequalities that harm people’s mental health. So the solutions lie in tackling them, head on, preventing them where possible, and acting quickly when necessary.
Finally, the results of this survey point to its enduring value. With the equivalent survey for children and young people, this is an essential data set for policymakers, commissioners and providers of public health, social services and health care. We urge the Government to ensure that it continues to report regularly, with sufficient funding for enhanced sample sizes for groups of people including racialised communities, LGBTQ+ people and others whose needs are otherwise hidden within a general household survey.
