Key Health Data for the West Midlands 2001

Chapter 6: Progress on Targets set by "Our Healthier Nation"

Contacts

Preface

Contents

List of Tables
List of Figures

Abbreviations

Main Body

1: West Midlands Geography

2: Our Healthier Nation

3: Winter Health

4: Accident and Emergency

5: Environment and Health

6: Mental Health

7: Communicable Disease

8: Perinatal Mortality

9: Crime

10: Sports Facilities

11: Housing Quality

12: Inequalities, Focusing on the early years

6.1 Introduction

At any one time one adult in six suffers from one or other form of mental illness making it as common as asthma. They range from more common conditions such as deep depression to schizophrenia, which affects less than one person in a hundred. In 1999, the Government introduced a National Service Framework for Mental Health, that will lays down models of treatment and care which people will be entitled to expect in every part of the country. It spells out national standards for mental health, what they aim to achieve, how they should be developed and delivered and how to measure performance in every part of the country. For further information see http://www.doh.gov.uk/nsf/mentalhealth.htm.

Monitoring performance for mental health remains difficult, as there are few good indicators of mental health service provision and effectiveness. The NSF identified a variety of outcome indicators for severe mental illness; however, the most relevant measures were only available via periodic local survey that restricts comparisons across areas such as the type of measures presented elsewhere in this document. Therefore, we have brought together a range of measures that can illustrate the situation across the West Midlands. These are:

1. Deaths from suicide,
2. Admissions for suicide,
3. Admission to a psychiatric specialty as an emergency,
4. Admission for a depressive illness,
5. Consultation with a GP in regard to either
1. Suicidal intent
2. Or a depressive illness

These reflect the Government's specified target measure for "Our Healthier Nation", that is deaths from suicide (see Chapter 3), alongside are more general measures of the psychological health of the population as measured by GP consultations, and hospital admissions.
The measures are based on resident rather than responsible population.

6.2. Suicide

	Table 6.1 Admissions for intentional self-harm and suicides by StHA, Rate per 10,000
	Figure 6.1. Suicides per 10,000
	Figure 6.2. Admission after intentional self-harm by PCT, rate per 10,000,1999/00
	Table 6.4. Key for figures 6.1 to 6.2

6.3. Inpatient Mental Health Activity

Suicide and intentional self-harm are one end of the spectrum of mental illness, described here are another set of measures that are based on admissions to hospital for treatment under the care of a psychiatric consultant. Figure 6.3 shows the age-sex standardised admission rate to a psychiatric specialty whether as part of a planned treatment or as an emergency, and Figure 6.4 shows the admission rate for those admitted solely as emergencies.

	Figure 6.3. All cause admissions to a psychiatric specialty by PCT, rate per 10,000, 1999/00
	Figure 6.4. Emergency admissions to a psychiatric specialty by PCT, rate per 10,000, 1999/00
	Table 6.4. Key for figures 6.1 to 6.2

6.4. Primary Care Mental Health Activity

The treatment of Mental Illness is predominantly undertaken in a primary care setting. However, this is not true of those with suicidal intent, where consultation rates are half of those admitted to hospital. Consultations peak in spring (weeks 9-16) (see Figure 6.5) and the most common group is females aged 15-24 (see Figure 6.6). This demographic pattern is reflected in those admitted to hospital (see Table 6.2), where the female rate is over 50% higher than in males of the same age group (49.1 per 10,000 compared to 31.0 per 10,000).

	Figure 6.5. Temporal GP consultation for suicidal Intent, Rate per 10,000 in four weekly periods starting 1 January
	Figure 6.6. Age sex differences in GP consultation for Suicidal Intent, Rate per 10,000
	Table 6.2. Age Sex profile of intentional self-harm admissions by PCT, 1999/00, Age specific rates per 10,000

The most common reason for patients with mild mental illness to consult their GP is with a depressive disorder. Consultations for this condition is constant throughout the year, although for women there appears to be a seasonal element, with rates higher in the winter months (see Figure 6.7). Again women consult more frequently than men; however the age profile is very different to suicidal intent, the patients being generally much older (see Figure 6.8). This consultation pattern is reflected in the admission rates with the overall female rate being twice that of males (1.5 per 10,000 compared to 0.7 per 10,000).

	Figure 6.7. Temporal GP consultation for Depressive Disorder, Rate per 10,000 in four weekly periods starting 1 January
	Figure 6.8. Age sex differences in GP consultation for Depressive Disorders, Rate per 10,000
	Table 6.3. Age Sex profile of admissions to hospital for depressive disorder, rate per 10,000

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For more information please contact Carol Richards on 0121 414 3368
© Department of Public Health and Epidemiology, University of Birmingham