Trends in psychological distress in Great Britain, 1991–2019: evidence from three representative surveys

• Published in: Journal of epidemiology and community health (1979) Vol. 77; no. 7; pp. 468 - 473
• Main Authors: Zhang, Anwen, Gagné, Thierry, Walsh, David, Ciancio, Alberto, Proto, Eugenio, McCartney, Gerry
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.07.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Adult; Age groups; Breakpoints; Coronaviruses; COVID-19; COVID-19 - epidemiology; Datasets; Economic policy; epidemiology; Female; health inequalities; Health surveys; Humans; Inequality; Life expectancy; Mental disorders; Mental health; Mortality; Original Research; Pandemics; Polls & surveys; Psychological Distress; Questionnaires; Surveys; Surveys and Questionnaires; Time series; Trends; United Kingdom - epidemiology; United Kingdom; United Kingdom > UK; England; Scotland; epidemiology; health inequalities; mental health
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech-2022-219660

BackgroundPreviously improving UK mortality trends stalled around 2012, with evidence implicating economic policy as the cause. This paper examines whether trends in psychological distress across three population surveys show similar trends.MethodsWe report the percentages reporting psychological distress (4+ in the 12-item General Health Questionnaire) from Understanding Society (Great Britain, 1991–2019), Scottish Health Survey (SHeS, 1995–2019) and Health Survey for England (HSE, 2003–2018) for the population overall, and stratified by sex, age and area deprivation. Summary inequality indices were calculated and segmented regressions fitted to identify breakpoints after 2010.ResultsPsychological distress was higher in Understanding Society than in SHeS or HSE. There was slight improvement between 1992 and 2015 in Understanding Society (with prevalence declining from 20.6% to 18.6%) with some fluctuations. After 2015 there is some evidence of a worsening in psychological distress across surveys. Prevalence worsened notably among those aged 16–34 years after 2010 (all three surveys), and aged 35–64 years in Understanding Society and SHeS after 2015. In contrast, the prevalence declined in those aged 65+ years in Understanding Society after around 2008, with less clear trends in the other surveys. The prevalence was around twice as high in the most deprived compared with the least deprived areas, and higher in women, with trends by deprivation and sex similar to the populations overall.ConclusionPsychological distress worsened among working-age adults after around 2015 across British population surveys, mirroring the mortality trends. This indicates a widespread mental health crisis that predates the COVID-19 pandemic.