Abstract
BackgroundReliance on national figures may be underestimating the extent of mental ill health in urban communities. This study demonstrates the necessity for local information on common mental disorder (CMD) and substance use by comparing data from the South East London Community Health (SELCoH) study with those from a national study, the 2007 English Adult Psychiatric Morbidity Study (APMS).Methodology/Principal FindingsData were used from two cross-sectional surveys, 1698 men and women residing in south London and 7403 men and women in England. The main outcome, CMD, was indicated by a score of 12 or above on the Revised Clinical Interview Schedule. Secondary outcomes included hazardous alcohol use and illicit drug use. SELCoH sample prevalence estimates of CMD were nearly twice that of the APMS England sample estimates. There was a four-fold greater proportion of depressive episode in the SELCoH sample than the APMS sample. The prevalence of hazardous alcohol use was higher in the national sample. Illicit drug use in the past year was higher in the SELCoH sample, with cannabis and cocaine the illicit drugs reported most frequently in both samples. In comparisons of the SELCoH sample with the APMS England sample and the APMS sample from the Greater London area in combined datasets, these differences remained after adjusting for socio-demographic and socioeconomic indicators for all outcomes.Conclusions/SignificanceLocal information for estimating the prevalence of CMD and substance use is essential for surveillance and service planning. There were similarities in the demographic and socioeconomic factors related to CMD and substance use across samples.
Highlights
While national psychiatric epidemiological surveys are useful in setting macro-level policy agendas, combating inequalities in mental health requires knowledge generated from local data [1]
We aimed to demonstrate the necessity for this level of information by comparing our data on the symptoms of common mental disorder (CMD) and the prevalence of common mental disorder (CMD) and substance use with those from a national study – the 2007 English Adult Psychiatric Morbidity Study (APMS)
We hypothesise that the prevalence of CMD and substance use, including alcohol use, will be higher in the South East London Community Health (SELCoH) sample in comparison to the APMS sample, and these differences will be explained by socio-demographic attributes and the socioeconomic status of the individual sample members
Summary
While national psychiatric epidemiological surveys are useful in setting macro-level policy agendas, combating inequalities in mental health requires knowledge generated from local data [1]. Reliance on national figures may underestimate the extent of mental ill health in certain communities – for example in those with high levels of deprivation [2,3] In this context, variations in the characteristics both of individual members of the population and of the area as a whole may engender concomitant variation in morbidity. Health planners need access to detailed local information in order to develop public mental health strategies For this reason, we established the South East London Community Health Survey (SELCoH), which covers an inner-city population. This study demonstrates the necessity for local information on common mental disorder (CMD) and substance use by comparing data from the South East London Community Health (SELCoH) study with those from a national study, the 2007 English Adult Psychiatric Morbidity Study (APMS)
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