Did you know? Information
Briefing on Levels of mental disorder and treatment in
This briefing hightlights that while mental
disorders are common, only a minority of people receive any
intervention. This treatment gap is relevant, as it has
widespread impact on services and costs. This information is
therefore important for commissioners, health and public health
professionals, shawdow health and wellbeing boards, local health
and wellbeing strategies, as well as the general public. At a local
level, this needs to be incorporated into the Joint Strategic Needs
- More than a fifth of the population in
England experiences a mental disorder at any one
time 10 although in Europe, 38% of the population
have experienced at least one mental disorder in the previous year
- An even larger proportion experience mental
distress which impairs functioning, but does not formally meet any
diagnostic criteria (sub-threshold mental disorder).
- Almost half of adults experience at least one
episode of depression during their lifetime.
- Only a minority of those with mental disorder
in England receive any intervention, except those with psychosis of
whom two thirds receive some intervention. In comparison, almost
all of those with cancer receive some intervention, with almost
half having surgical
Levels of mental disorder across England
In England, the most recent national surveys
of psychiatric morbidity find that at any one time:
- 10% of 5-16 year olds have a clinically
recognised mental disorder; conduct disorder (6%) and emotional
disorder (4%) are the most common disorders 5.
- 17.6% (21.0% of women and 11.9% of men)
experience a common mental disorder which includes anxiety or
depressive illness 10.
- 0.4% of adults have psychosis in the previous
- 5.9% of adults have alcohol dependence
- 3.4% of adults have drug dependence mainly in
those aged 16–24 years 10.
- 21% of adults have nicotine dependence,
although 42% of tobacco consumption in England is by those with
mental disorder 9.
- 5.4% of men and 3.4% of women have a
diagnosable personality disorder 13, while 0.3% have
antisocial personality disorder 10.
- 25% of older people have depressive symptoms
requiring intervention, 11% have minor depression and 2% major
depression rising to 40% of people aged over 85 4.
- Dementia affects 5% of people aged over 65
and 20% of those over 80 8.
Furthermore, almost half of all adults will
experience at least one episode of depression during their
Levels of sub-threshold disorder
This includes mental distress not reaching
diagnostic criteria for mental disorder and results in significant
- 18% of 5-16 year olds have sub-threshold
conduct disorder 3.
- 17% of adults experience sub-threshold common
mental disorder 10.
- 6% have sub-threshold psychosis
- 24% have hazardous drinking
Furthermore, people with sub-threshold mental disorder are at
much higher risk of going on to develop mental disorder.
Proportion of children and adolescents receiving any
intervention for mental disorder
- 30–40% of children and adolescents who
experience clinically significant mental disorder have been offered
evidence-based interventions at the earliest opportunity for
maximal lifetime benefits 5,11.
- 64% of parents with
children with emotional disorder had contacted a professional
source usually a teacher (47%) 5.
- For parents with conduct
- 81% sought some form
of advice or help.
- 76% approached a
professional source most commonly a teacher (60%).
- 28% sought advice
from a mental health specialist.
- 24% sought advice
from special educational services such as psychologists.
- Levels of impairment
or symptoms are undetected in 55% of children with autism and 57%
of those with Asperger’s syndrome 12.
Proportion of adults receive any intervention for mental
- 24% with a common mental
disorder - mostly in the form of medication 10.
- 28% screening positive for
Post-Traumatic Stress Disorder (PTSD) 10.
- 65% with ‘psychotic disorder’
treated in the past year 10.
- 81% with probable psychosis
received some form of treatment (85% in 2000) 10.
- 20% screening positive for
Attention Deficit Hyperactivity Disorder
- 14% with alcohol dependence
- 14% with cannabis dependence
- 36% with dependence on other
- One in six of older people with
depression discuss their symptoms with a GP and less than half of
these receive adequate treatment 2.
In Europe, the situation is event
worse with only 10% with mental disorder receiving notionally
adequate treatment 15.
Level of mental disorder and treatment informs Joint
Strategic Needs Assessments (JSNAs) and commissioning
JSNAs determine the level of unmet need
including for mental disorder (JCP, in press). Local estimates of
prevalence and treatment of levels for mental disorder are required
by health and wellbeing strategies. Such information should
determine level of interventions to be commissioned.
© Royal College of
Psychiatrists. August 2012. This leaflet reflects the best
available evidence available at the time of writing.
Dr Jonathan Campion, consultant
pychiatrist at South London and Maudsley NHS Foundation Trust and
Professor Kam Bhui, Professor of Cultural Psychiatry and
Epidemiology and Hon Consultant Psychiatrist, Queen Mary,
University of London.
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