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Map of the Week: A depressing picture

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Mark Easton | 16:19 UK time, Monday, 6 April 2009

New figures I have obtained under freedom of information paint a troubling picture of the mental well-being of people in part of Wales and northern England.

It may be the recession, but I suspect the statistics showing very high levels of anti-depressant use in those regions have more complex origins.

The new numbers also show yet another increase in prescribing pills like Prozac, despite national guidance advocating alternative treatments - up 3.15% in Wales and 3.64% in England during 2008.

The previously unpublished data, given to me by the Prescription Pricing Authority in England and the Prescribing Services Unit in Wales, focus on January this year. If one looks at the number of prescriptions for anti-depressants issued in that month per thousand patients, a startling story emerges.

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The top seven are all Welsh Local Health Boards (LHBs) in a small area in the south of the country. Of the top thirty prescribers, 12 are in Wales and 10 are Primary Care Trusts (PCTs) in the north-east of England.

We even see a local health authority prescribing at a rate greater than one prescription for 10 patients. In Torfaen, the area around Pontypool in south Wales, GPs handed out 104 prescriptions per 1,000 patients during January. This appears to be an astonishing level of anti-depressant use. GPs we have contacted blame a shortage of counselling for the high prescribing levels.

prescriptions_top30.png

Both south Wales and the north-east of England are areas with high levels of people not in work, but deprivation cannot explain what one sees as the other end of the table. Of the 30 PCTs which have the lowest levels of anti-depressant prescribing, all but two are in Greater London. And these areas include some of the most deprived in England.

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The figures also show how January 2009 compares with January 2008, and I wondered whether this might reveal the effects of the recession. The map shows a less obvious regional picture.

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The biggest year-on-year increases in prescribing are both in south Wales: Torfaen has seen a rise of over eight prescriptions per 1,000 patients in twelve months, consolidating its position at the top of the table.

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Blaenau Gwent, Bridgend and Neath/Port Talbot have also seen very large rises. Six of the top 20 places ranked by the increase in prescribing anti-depressants are in Wales. Have free prescriptions made a difference? If so, why do figures for the Vale of Glamorgan and Wrexham show falls in anti-depressant use?

In England, Swindon and Sunderland, which have both recently seen big job losses and lay-offs as a result of the economic downturn, have seen anti-depressant prescriptions rise by more than five prescriptions per 1,000 patients.

Tameside and Glossop sees the largest increase in the past 12 months in England with at least one local doctor saying that the recession is having a serious effect on the area's mental health.

Dr Kailash Chand, a GP in the area told his local paper:

Job insecurity, redundancy, debt and financial problems are all proven to contribute to mental distress. For the last few months I've seen at least one or two more patients per week who are unable to cope with financial difficulties.

I have no doubt that the threat and impact of recession is having a psychological effect upon many people in the UK - but anti-depressant prescribing has been rising for years and, in fact, the rate of increase is falling. Comparing Jan 2007 with Jan 2008, the increase in England was 8.3%, and it was 9% in Wales.

Do let me know what conclusions you draw from the data.

Comments

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  • 1. At 4:56pm on 06 Apr 2009, newsjock wrote:

    The blue map of anti-depressant use is interesting. The elderly are a population sector that is requiring more anti-depressant than average (look at Cornwall and the Isle of Wight for instance).

    What is less accountable is the differing increases in anti-depressant use over the past year (red map).

    Only one reason for the increase stands out. British folk becoming more self-centred and consumer orientated, encouraged by relentless advertising and gambling opportunities. Materialistic peer pressure is a grievous cause of stress and depression.

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  • 2. At 5:01pm on 06 Apr 2009, Jan wrote:

    I have no doubt financial problems cause acute anxiety leading to depression and in the South Wales valleys things have been bad for a long time. Since the 80s in fact and the closure of the pits. Generations have now lived with the general air of depression and it only takes a little further push to tip people over the edge and to lose all hope.

    One thing which may have an impact on the level of prescribing is that prescriptions are free in Wales. This does make a difference to those who are in work but on a low wage as the prescription charge in England is now £7.20 which is expensive to those with low incomes. I'm not sure about Wrexham but the Vale of Glamorgan is generally a better off area although I can't see why rates of prescibing for anti-depressants should be lower than last year.

    Another factor which I think is currently underestimated in any analysis of peoples' sense of well-being is housing. There is nothing more depressing than being stuck in overcrowded or damp housing and having no means of doing anything about it. If you have bought a property with a high mortgage which needs improvements and you don't have the money to do them because you have lost your job or because all your other bills have gone up then that is a recipe for depression. There is a lot of old Victorian substandard housing in the Welsh valleys.

    A lot of people are really struggling at the moment. I don't think the political class has any idea of the reality of most peoples' lives. The more we read of their cloud-cuckoo expense account lives the more people despair about their own inability to just keep their heads above water. The day in day out struggle just to make ends meet is commonplace for many. New Labour just don't get it and no wonder GPs dish out antidepressants like sweeties. There's nothing else they can do in the face of conditions they can do nothing to alleviate.

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  • 3. At 5:46pm on 06 Apr 2009, ByeByeBritain wrote:

    The data doesn't surprise me at all. Figures have shown an increase in stress, depression and mental health disorders in Western countries for years. Also, data from the ONS has show year after year that although "standard of living" (roughly related to GDP) as increased quite markedly, "Happiness" has remained relatively flat. Which to my mind demonstrates something the politicians don't want you to know - standard of living is not the same as quality of life. An increase in the latter almost certainly leads to increased happiness and a reduction in a wide range of mental disorders.

    I don't see this changing in the short term in Western economies. Our current leader's obsession with "growth" is same-old, same-old thinking - lots of debt-fueled consumerism will fix things. Gordon (Gekko) Brown has the mantra "Growth is Good". No. Happiness and quality of life is good. Growth generally means buying loads of tat we don't need on credit cards to keep up with the Joneses. That's bad and leads to too much work and not enough play, stress, depression, over consumption and waste. Quite frankly "Growth" is a dead-end - literally!

    There are a ton of books out there on this topic "Is the American Dream Killing You" by Paul Stiles is a great read and very well researched.

    Having said all of that I think the credit crunch is definitely a factor, and there are obviously some localized issues. The weather doesn't help, although it probably isn't a factor in this data as it's always blown.

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  • 4. At 6:32pm on 06 Apr 2009, Hilary Curtis wrote:

    I'm not querying your broad conclusions, but is this data controlled for duration of prescriptions? Anti-depressants are usually taken long term, so the number of prescriptions per patient per month will depend quite significantly on whether each lasts 28 days, 30 days, 42 days, or longer.

    I'm pretty sure rules on this differ between primary care trusts, which could influence the maps.

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  • 5. At 6:41pm on 06 Apr 2009, Jenny F wrote:

    This comment was removed because the moderators found it broke the House Rules.

  • 6. At 7:21pm on 06 Apr 2009, stwl wrote:

    While I wouldn't wish to interfere with jennysue's treatment regime, Google searching "Xocai" and "scam" does make me wonder whether she would be as well-served by some less aggressively-marketed product...

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  • 7. At 7:35pm on 06 Apr 2009, almost witty wrote:

    Could the conclusions be that awareness of alternatives to pills is higher in the areas that don't have high prescription levels ie London? Where counselling is generally accepted to be a good way of trying to combat depression? Whereas in other areas, the temptation is just to prescribe medication as a way out of the problem in a part of the UK where counselling isn't seen as a good-enough option?

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  • 8. At 7:48pm on 06 Apr 2009, delminister wrote:

    thinking are anti-depressant drugs being over prescribed in this country ?
    in my younger years if i was feeling depressed the doctor would say have a cigarette and relax but today its heres a months tablets dont worry about any side affects.
    the news today is depressing but in the words of monty python always look on the bright side of life.

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  • 9. At 9:07pm on 06 Apr 2009, alexandercurzon wrote:

    DEPRESSION??

    WHAT DO YOU EXPECT WHEN AVERAGE HOUSE PRICE ARE 7 TIMES AVERAGE INCOMES

    MILLIONS OF PEOPLE CANNOT AFORD TO LIVE! ITS SIMPLE: NO HOPE NO FUTURE!

    WELL DONE GORDY & THE GANG!

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  • 10. At 9:39pm on 06 Apr 2009, Astillsmallvoice wrote:

    A sad picture but a totally unsurprising one. The highest prescribing areas are also among the most depressed in the UK. Many people there are unemployed and on benefit. In the UK the benefit system for anyone unfortunate enough to need it is nothing more than ritual brutalisation in exchange for bare subsistence while the wealthy largely escape being taxed.

    Housing benefit is calculated for the number of occupants, woe betide those who don't rent their properties with a foreknowledge of this insane rule. They will end up homeless

    It is a wonder the levels of anti-depressants isn't much higher. The credit crunch hasn't made that huge an impact in such areas. Years of policies under which the rich get richer and the poor get poorer did.

    To combat this will need not only a new government but a fundamental change in policy. The only good news is that the credit crunch will expose the gods of the financial firmament for what they are and bring about that fundamental change. Maybe...

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  • 11. At 10:09pm on 06 Apr 2009, Robert Shaw wrote:

    This analysis is a bit below your usual standard. Did you not think about trying to age-standardise the data? The lower rates in the london area almost certainly reflect the higher proportion of young people (who are less likely to be presctibed antidpressents (or most drugs for that matter).

    Similarly, if you showed your 'increase' maps as percentages rater than absolute numbers you might see something rather different.

    Moreover, I suspect it is the variation _within_ PCTs rather than between them that is most interesting. For any given level of need (age, deprivation etc) there will be a huge variation between different GPs. Exploring the reasons for this and making insights into how there could be improvements would be interesting. Being told that older and/or deprived people are more likely to be ill and/or depressed is (sadly) not new or news.

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  • 12. At 10:39pm on 06 Apr 2009, MK_Steve wrote:

    Really interesting Mark, particularly your finding that deprivation itself cannot explain the figures (although I suppose that change in circumstances is more likely to trigger depression than continued poverty).

    Be interesting to know the total numbers of prescriptions (for everything) to see whether actually it's just a reflection of the proportion of 'patients' who go to the doctors in each area, or how many prescriptions are given. The darker blue areas are generally less populated than the paler blue areas (could there be budget issues, or more people qualifying for free prescriptions (a good point made earlier). please excuse my ignorance of the subject area. The red map shows expected increases (proportional to the high and low areas) ans so adds less I think, except to show that usage seems to be increasing across the country overall (fewer jobs means more free prescriptions, as well as more depression perhaps).

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  • 13. At 11:08pm on 06 Apr 2009, danbealec wrote:

    Do low rates of anti-depressant prescribing co-incide with high rates of available talking therapies? Or with high rates of completed suicide? Or how about rates of prescription of levo-thyroxine for men, which would indicate better detection of stuff that looks like depression but is not depression.

    Also: Gloucestershire has a high number of people at risk of suicide: farmers, isolated people, older women, and so on. It also has weird budgetary stuff; it gets *less* per head because it's a rural area. But modern services (home treatment, telehone treatment, etc) are harder to provide in rural areas.

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  • 14. At 11:25pm on 06 Apr 2009, threnodio wrote:

    #1 - newsjock

    One of the effects of having concentrations of elderly people in particular areas is an increased incidence of bereavement which - I am reliably informed - is a common cause of depression amongst the elderly.

    I am interested in why the Isle of Wight is coloured dark blue but does not appear in the corresponding list. Is this another example - a bit like unemployment - where the IOW conveniently gets counted in with Hampshire if the figures are particularly nasty?

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  • 15. At 00:01am on 07 Apr 2009, DrFrankRant wrote:

    Interesting discussion, but your 'prescription' data is meaningless.

    Unfortunately, the NHS does not publish data on DURATION of treatment contained in each prescription.

    Duration of repeat medication scripts varies from practice to practice and advice on the duration of each prescription varies from PCT to PCT.

    In many areas each prescription is issued for 3 months, whereas in other areas the advice is to issue only one or two months at a time.

    That alone could explain differences of up to 3x more prescriptions in an area even though the same amount of actual drug is being dispensed by pharmacies.



    Secondly, you have not adjusted the figures for either depression prevalence in an area or age of the population - both of which vary dramatically from region to region.



    A little knowledge....

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  • 16. At 07:26am on 07 Apr 2009, polyurethane wrote:

    It appears to me that there has been a wave of anti-depressant prescribing - for problems other than depression. For pain relief. For effects of thyroid disease (on top of levothyroxine) - and being fully aware of the previous poster's comment about hypothyroidism itself causing a form of depression that is *NOT* helped by anti-depressants. For erythromelalgia. For numerous other problems.

    Not sure if the statistics divide by actual ingredient, but the old-style anti-Ds are now regarded as not very good so when they are prescribed it is probably for things other than depression.

    Of course, none of this disproves anything, just throws into question the whole dataset.

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  • 17. At 08:16am on 07 Apr 2009, jon112uk wrote:

    One factor may be the availability of the currently fashionable alternative to anti-depressants - cognitive behavioural therapy. Have the more rural areas made adequate provision for this?

    For mild-moderate depression the CBT required can be effective when delivered by nurses, computers or even using a book - not just by psychologists who are in short supply. So not much excuse for health providers who are still lagging behind on this.

    DrFrankRant (#15) above talks of three month prescriptions. It would be interesting to see how many of those patients come back for a second prescription: an interesting issue with anti-depressants in primary care is 'non-compliance.' A surprising number of patients given their first prescription will not be physically taking them after three weeks, let alone three months.



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  • 18. At 08:55am on 07 Apr 2009, Simon Attwood wrote:

    Hardly surprising, and I think similar maps could be drawn for rises in violence as a result of the current financial environment.

    When the populations stress levels rise, it is going to have a serious knock on effect for society in general. The country may be filling up with ticking time bombs.

    GPs also have a role to play, one of mine recently tried to prescribe me Diazepam (valium) for whiplash!!!

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  • 19. At 09:16am on 07 Apr 2009, stanilic wrote:

    Work is good for people as it gives them purpose, focus, a life outside themselves and often a sense of fulfilment. So why do we allow people to rot? Even the word `redundancy' which started as a nicer alternative word for the political class than `unemployment' implies that as a person you are unnecessary.

    I can understand people becoming depressed as they find that despite however hard they struggle they still find themselves where they started out. There has to be a future, a hope, a dream.

    Yet, having said that, the answer lies not in the doctor's surgery and more supplies of mother's little helper. The answer lies in combining together in solidarity and setting out to change the society and the environment in which you find yourself. What you may not be able to achieve individually you might be able to achieve through collective action.

    All the doctors are doing in prescribing their drugs is controlling the development of social dissent. In this way the welfare state protects itself from criticism and change: the two things its elite fears most of all. This is social control at its most hypocritical.

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  • 20. At 09:49am on 07 Apr 2009, lorentz1 wrote:

    Rates of around 1 in 10 patients on antidepressants seem rather high to me. One reason why the rates may be lower in London may be that mental health services are very well developed here with a range of psychological treatments reasonably readily available.

    Many trusts in London also have psychiatrists working in the primary care setting which helps to clarify the diagnosis of depression in people who may not be depressed in a truly psychiatric sense (ie the distress caused by coping with a difficult life is not necessarily the same as depression). It must also be remembered that antidepressant prescriptions are not an very accurate measure of depression given that they are used for a number of other indications such as OCD, pre-menstrual syndrome, anxiety/panic disorder, Tourette's, PTSD, migraine, pain syndromes.

    Regarding the point about the elderly, in my view it is quite rare that you can put depression down merely to old age related factors. It does however occur qute commonly in other disorders that occur in this patient group such as Parkinson's disease, cerebrovascular disease etc.

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  • 21. At 10:12am on 07 Apr 2009, laurencecrutchlow wrote:

    As a GP I try hard to avoid prescribing anti-depressants, although undoubtedly they are sometimes both necessary and effective. I've certainly seen a number of patients where their mental health problems would appear to be a direct result of the financial crisis - but must note that all the other common underlying causes of mental health problems (which often seem to relate to family breakdowns) are still just as common - and seem to relentlessly increase.
    On an further point of analysis not yet looked at, I wonder how much the above figures reflect availability of non-drug methods of treatment (ie counselling, psychotherapy etc)? Even with equal funding across different areas (and indeed many might say London is underfunded relative to how deprived much of it is), it is a lot easier to provide an accesible counselling service in an urban borough where everything is close together and transport links are good. Perhaps this is why London seems to have lower prescribing.
    I've worked in several different PCTs, and find that easier it is to access "talking treatments", the less need there often is to prescribe antidepressants.

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  • 22. At 11:23am on 07 Apr 2009, CarolineOfBrunswick wrote:

    Mark,
    Did you speak to anyone in NHSBA Prescribing Services, or a Prescribing Advisor? Already there are comments (particularly 4,11 and 15) saying that number of prescriptions per 1,000 population isn't a good measure. It isn't my field, but you might want to try "ADQs per STAR-PU".

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  • 23. At 1:31pm on 07 Apr 2009, chrisk50 wrote:

    Wales and Scotland appear high - probably free prescription, cheaper than drinking, not a fault of the people as most are in need of treatment due to the state of the economy.

    I notice London boroughs are very low - is this because they can afford other drugs and no need to go to the doctors.

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  • 24. At 3:22pm on 07 Apr 2009, PeterDE wrote:

    Taking a patient's temperature with a thermometer taped on the end of a long bamboo stick comes to mind.
    Prescribing [anything] lay with the prescriber, the supplier, the funder, the authorities, the politicians not just the needs of the recipient alone. So, can someone explain to me how the number of prescriptions of an anti-depressant drug is a measure of social difficulties in that area? If we need to know that then let's try asking those that are hurt by it!

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  • 25. At 8:00pm on 07 Apr 2009, Clive Harris wrote:

    Well, the rather obvious explanation comes to mind. Affluent London, plus the posh bits of Birmingham plus a slightly unhappier but albeit wealthy Cheshire all register as the lowest.
    What else is there to say? I used to live in Port Talbot, one of the highest areas in which these drugs are used. It's a symptom of social problems that a London-obsessed society brings on its own people.
    We need to think about the psychology of the built environment and the hope we can provide to everyone.
    Sad.

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  • 26. At 8:43pm on 07 Apr 2009, John Ellis wrote:

    i had 2 major addictions to anti depressants thanks to my doctor and psychiatrist. they didn't fix me though made me ill in a lot more ways through adverse affects. So I use cipralex and CBD's now Had enough of people who think they know how i feel.

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  • 27. At 3:00pm on 08 Apr 2009, NewHorizonsRAPgroup wrote:

    We the members of Research Action and Policy group (R.A.P) from New Horizons Mental Health and Emotional Well-being Resource Centre a service user led charity would like to make this comment in relation to your article:

    After reading your recent article it has come to our attention that Rhondda Cynon Taff (where we are based) are the second highest “authority in England and the prescribing services in Wales” for prescribing anti depressant drugs. It has made our group realise that from the stats and figures it is the poorer counties that seem to be suffering. With the economic surroundings as they are, in these deprived areas from personal experience we feel there will not be much progress not only in the way of treatment and lessening prescription of anti depressant drugs but also less likeliness of a full recovery from mental illness.
    Services in Rhondda Cynon Taff are completely over stretched in ways of alternative medicine and therapies with waiting lists of up to 18 months and sometimes over. GPs in the area are also stretched to their resources of referral to mental health services unless patients reach a certain criteria in their illness enabling them to use alternative treatments such as psychological services etc and even when these treatments are available to people there is often considerable waiting lists.
    Voluntary sectors have become an alternative to treatment but these services are also becoming over stretched. New Horizons takes on many new service users from both self referral and statutory service referral. The problem is in these areas is that funding is extremely limited and over the recent years services have had to be cut, although the demand for these alternative services has dramatically risen especially due to the present social and economic climate. Therefore in conclusion prescribed medications could be reduced if statutory and voluntary services were made more readily available and better funded for the use of everyone with mental illness.
    Counselling services in this current climate are totally over stretched as are all health services and with the current economic situation this is only the beginning. Therefore before we address the medication issues we need to address the funding for appropriate services in the voluntary sectors.

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  • 28. At 3:58pm on 08 Apr 2009, danbealec wrote:

    Did you need to use the FOI stuff? In my experience health providers are happy to provide information when asked. They're very careful not to break patient confidentiality, but I've received information about precribing rates before without having to make use of any special powers.

    There's a whole bunch of interesting stats that could be looked at. For example - has the number of prescriptions for valproate (and similar meds) dropped rapidly in the light of recent findings that it might be linked to PCOS? How are doctors explaining the risk of PCOS, and do patients understand that explanation? Gerd Gigerenzer has an interesting book about explaining risk, and the perils of using percentages.

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  • 29. At 4:27pm on 08 Apr 2009, Rapedwife wrote:

    The NHS estimates that one half of all women with mental health ailments, including depression, have been victims of violence. A comparison of the use of anti-depressants map with recession trend maps yields some sporadic correlation. But if you compare the Maps of Gaps report map for Violence Against Women support services in Britain with Mark's anti-depressant prescription map you get some much more persuasive and interesting overlaps. For example, low rates of anti-depressant prescription are reported in many boroughs of Greater London, despite recession worries hitting the financial services sector hard there. But Greater London also has pockets of the highest numbers of counselling and other services for female victims of violence. The same is true for the Leeds-Manchester connurbation - not exactly a trouble free area for unemployment, but scrips for depressants are down and hey presto, provision of support services for female victims of violence is amongst the highest in the country. Or take East Anglia and Nottinghamshire, black spots for high anti-depressant prescription and also black spots for the paucity of violence against women support services.
    Women victims of domestic violence go to their GP for support. In the absence of other support services, GPs write scrips for anti-depressants. Women think the domestic violence is all their fault for being depressed and the cycle happens all over again.
    Mark, PLEASE can you look at this correlation and point it out to the Home Office in their current consultation.

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  • 30. At 1:49pm on 09 Apr 2009, Taff224 wrote:

    I'm not so surprised. My Wife went to the doctors to discuss workplace stress and the effects on her sleep, she specifically went to discuss the options of counselling and therapy. she comes out after 5 minutes with the doctor and he's prescribed Anti-depressants.
    After reading the side-effects of the drugs he recommended the box has been left unopened, some of them are shocking.
    Since then we have resorted to paying for private stress counselling which is working fine.
    Whether it is the GP's fault or just the situation they find themselves in, I was shocked that a doctor would prescribe some pretty powerful drugs, with some quite extreme side-effects, after a 5 minutes conversation.

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  • 31. At 3:01pm on 09 Apr 2009, danj180 wrote:

    I think you'll see there is a close correlation between the high anti-depressant prescriptions and the number of white people living in deprivation within the area.

    You can see that the areas of the low prescriptions have higher ethnic minority populations.

    I think there is also a factor of how transient the population - plus an urban/rural factor - it may be harder to see a GP in the city.

    My hypothesis would be a close correlation between deprivation factors (unemployment etc) and the average length most residents have lived in the area with the number of anti-depressants prescribed. If you are depressed and new to London - maybe you'll just leave - that may not be possible for other people in other areas.

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  • 32. At 7:19pm on 09 Apr 2009, sparklingwelshgem wrote:

    I live in Cwmbran which is in Torfaen. I've suffered from depression for years but have avoided taking pills for it. Previously I lived in Blackburn where I went to my doctor and was offered extensive help with both counselling and mild short term medication and felt really well. I moved back to Cwmbran and sought the same. No chance! I was only offered medication without any assessment of the extent of my problem. I insisted on having counselling. I was referred to a 'fast track' team based at Panteg hospital. I got a badly photcopied letter saying my case was being considered. Six months later I got another badly written letter saying that my case had been considered and it was being referred to a counsellor at my surgery!! By the time I had an appointment my condition had improved and I declined the offer. NOT ONCE throughout this process did anyone talk to me or see me so how could my case be assessed? How did they not know the extent of my condition? I could've been suicidal and ended myself or done something stupid during the time it took them to do absolutely nothing! The treatment of me here is exactly the same as the treatment of the elderly (the system treated my mother appallingly) - they don't want to know and if you insist something is done they don't have the skills or ability to deliver. I'm from this area originally and having been away, I can say services are a shambles here compared to the other parts of UK I have lived in. They're way behind on a number of fronts, not just on health. The Assembly keep saying they're investing time and money in issues of major concern such as this but they're not .... the proof of the pudding is in the eating and I'm afraid WAG think if they keep saying things are good, people will eventually believe it.

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  • 33. At 00:16am on 10 Apr 2009, danbealec wrote:

    People know that talking therapy is supposed to be the first option for many depressive illnesses, but they've had a hard time getting that therapy.

    They may be interested to know that IAPT (Improved Access to Psychological Therapy) comes in April 2009, so talking therapies *should* be much easier to get hold of, especially for people with mild to moderate problems who'd only need a 12 week course of CBT.

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  • 34. At 02:54am on 11 Apr 2009, lionThorburn wrote:

    The map showing anti-depressant use, especially in Wales where prescribing is the most generous, correlates well with maps showing the annual rainfall.

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  • 35. At 3:32pm on 11 Apr 2009, rogertheterrible wrote:

    I believe anti-depressants are the most immoral thing to have been given out by our medical profession since they stopped locking women up for 'hyseria'. Sorry if I'm inaccurate there, but there are alot of practises in the past that should fit. Plenty of people know it's a quick fix by GPs. I've been on it a couple of times in my lifetime when I've lost all confidence and direction, but due to my own belief and my love for others (and myself) I've clawed myself out of the black hole, looked the world in the face and remembered Elliot 'Lord though pluckest me out, burning.'

    Now, my family orginated in those south Wales valleys and I know some of their history. They worked and lived in hell, but kept their nobilty against all that was thrown against them. What was their secret, for I'm sure they suffered. I know they had religeon instead of alcohol (though there are alot of pubs in Brynmawr). Well, you can't replace the religeon, but you shouldn't tranquilise people up so they can endure to watch day time TV either.

    People need hope, a goal no matter how trivial it seems to the rich and powerful. These mainly former heavy industrial/mining areas have had it taken away. Generations have been left on the perithery of society for too long. My grand parents and their siblings left there in the early thirties for London and brought their parents when they settled. They thrived during and after the war.

    Thoses left there have had to suffer the destruction of their culture and community through unemployment. They watch the world of so called success and consumerism go on, some get out some stay. Those that stay won't all have the same opportunity or luck and are dragged down and often through no fault of their own. They are not feckless, immoral, or lazy, they're just there. What would I proscibe - well stop giving continuously safe seats to so called Labour politicians who have long deserted you and forgotten you. Nothing will change for you otherwise. Maybe then they'll stop giving you the cocktail of drugs and community projects which make your lives pointless; maybe then with employment and the power and respect that money earnt through the sweat of your brow gives you will once again regain your noble spirits and only then will this depressing map might change.

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  • 36. At 4:30pm on 11 Apr 2009, DeniseCullum222 wrote:

    ere these Welsh places into anti depressants before they had their mining communities smashed by Thatcher? no I would think not Wales like Scotland and Ireland do not get what those in England gets and then only the South which is jobs and housing even through London does have more drug problem than anywhere else and homelessness is a disgrace. The huge pharmaceutical companies do what they have always done which is to try out their drugs in poor communities then if anything goes wrong they can say its to do with age colour sex of these places, the unpeople can suffer so that the rich do not I was told to take Vioxx and I looked it up and did not take it now its been withdrawn as the USA is being sued as it kills but in the country they do not believe this and can not sue so there is nothing wrong with these places except the Govenment likes to give the opinion that it give a toss especially when its looking for votes well we have been ruled by Tories since Thatcher so there is no chose really so people will have to rule themselves which they have done for years. The Depression may life when people are give the rights back and are give respect and not killer drugs.

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  • 37. At 12:33pm on 12 Apr 2009, phoenixarisenq wrote:

    It starts very early. Baby cannot sleep, so a sedative is prescribed. Later, whether from lack of parental control or plain naughtiness, the child is restless. Doctor diagnoses "lack of attention syndrome" or some such nonsense, and stronger sedatives given. These fail to work, so experts finally state it is autism and really strong drugs are introduced. By the time the wretched child is an adolescent, even more problems emerge. If the child is female, she may become pregnant and produce offspring which will be poisoned by NHS medicine, in the same way as she was. So the cycle continues. Result, an adult who never really has a proper work record, unskilled, unhealthy and drugged to the eyeballs. A perfect citizen for Nu Labour to rely on for continuing their dictatorship. Together with the need of benefits, social housing, and free drugs, the poor citizen is caught by the cleverest "dealer" on the street! No way, will he/she be able to free themselves from complete dependence.

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  • 38. At 10:59am on 16 Apr 2009, U13889990 wrote:

    ByeByeBritain touches on this in passing, but bearing in mind your theory of weather and knife crime, have you thought about a correlation between weather and depression?

    The areas with the highest rates of anti-depressant use seem also to be the areas with the highest levels of rainfall in the UK. And constant drizzle is enough to tip anyone over the edge. Just a thought...

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  • 39. At 4:45pm on 16 Apr 2009, Woolfbane wrote:

    I wonder if the areas of low prescribing are the same areas where it is hard to get registered with a GP? And who is to say that the apparently "under-prescribed" areas aren't simply self-medicating with drugs bought over the internet?

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  • 40. At 03:25am on 19 Apr 2009, dennisjunior1 wrote:

    Mark:
    It is a pretty depressing looking picture in your graphs...
    ~Dennis Junior~

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