Introduction and key points
The World Health Organisation defines mental health as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. The Thrive Edinburgh mental health and wellbeing strategy emphasises the importance of supporting and promoting mental health in addition to addressing mental illness.
Mental illness is one of the major health challenges in Scotland. It is estimated that more than 1 in 3 people are affected by mental health problems each year (Scottish Government). The most common mental illnesses are depression and anxiety and together they were estimated to account for a total of 9,733 years of healthy life lost across the City of Edinburgh in 2019 (Scottish Burden of Disease study).
Mental illness is often linked to other long-term conditions and alcohol and substance misuse, which themselves can exacerbate mental health challenges. Higher rates of mental illness are observed in areas of multiple deprivation, and studies have shown that Mental Health is a contributing factor to multimorbidity (Barnett et al., 2012) . As understanding of mental health conditions grows and the stigma attached to them reduces, the number of people being treated for mental health issues will rise.
Additionally, the aging population has led to an increase in the number of people living with dementia, and more people are treated at home shifting care into the community. This often leads to added complexity of care required in the community, putting additional pressure on social care resources. Data in relation to Dementia is covered in our separate Dementia topic paper.
Changes in the broader determinants of population mental health at individual, community and structural levels will influence levels of mental wellbeing and illness in the population. This includes factors such as the proportion living in poverty or in substandard housing, levels of exposure to stigma, discrimination and harassment or poor-quality employment.
This paper contains data on Mental Health indicators, primarily sourced from the Office of National Statistics (ONS) population survey and the Public Health Scotland (PHS) ScotPHO dataset. This includes data sourced from hospital discharge records (SMR01, SMR04), National Record of Scotland (NRS) deaths data, PHS Prescribing data, and the Scottish Health Survey). Throughout this paper we have compared the City of Edinburgh with the Scotland rates and over time.
This paper is intended to provide a high-level overview of mental health in Edinburgh, covering a wide range of data related to mental health. It does not dive deeply into any particular issues but provides an introduction to this topic that can be used to inform and guide the commissioning and delivery of wider health, wellbeing and social care services.
Much of the data on this subject is on service/outcome indicators, which is therefore the focus of this paper. However, it is recognised that, as mentioned above, there are many socio-economic and environmental factors which will be drivers of the state of mental health in any population. Further papers on some of these topics, such as Housing, may be carried out in future, as has already been done for Poverty and Dementia.
The impact of COVID-19 on the data included here is hard to gauge at this time, however should be kept in mind when interpreting recent data. A 2022 publication on the early impacts of the COVID-19 pandemic on Scotland’s mental health (Public Health Scotland), based on survey data and qualitative studies, stated:
“What the evidence also underlines is not just the extent and nature of the mental health impacts of the pandemic, but also the uneven distribution of those impacts, with the potential to worsen and widen mental health inequalities across society. Where people started from, and their social and economic position, may well influence the impacts of the pandemic on their mental health and wellbeing. It may also influence the emotional and financial resources people are able to draw on to recover from the pandemic”.
Key points to note:
- Overall, data on the levels of mental health and wellbeing in Edinburgh, when compared to Scotland as a whole, show a mixed picture
- Mental health prescribing in Edinburgh is lower than the Scottish average, although this could be attributed to differences in access/availability as well as prescribing rates themselves
- In general, rates of mental health related hospitalisations and deaths in Edinburgh, including those that are alcohol and drug related, do not differ greatly from those in the rest of Scotland
- Edinburgh North East is the locality with the highest rates of mental health related hospitalisations and deaths, as well as drug and alcohol related hospitalisations. It is also the locality with the highest levels of deprivation in the city.