Is England a nation on anti-depressants?

 
Blackpool Blackpool - where approximately one adult in six is prescribed anti-depressants

Each month in Blackpool, one adult in every six picks up a prescription for anti-depressants.

A seaside resort promising fun and excitement to visitors, emerges as the place in England with the highest proportion of its population regularly taking medication for depression and anxiety.

Analysis of prescribing statistics reveals a number of English towns and cities where approximately one adult in six is now prescribed anti-depressants in an average month. They include Barnsley, Redcar, Durham, Middlesbrough, Salford and Sunderland.

The Health and Social Care Information Centre this week published data showing that more than 50 million prescriptions for anti-depressants were issued last year, the highest ever number and 7.5% up on the year before.

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In Lincolnshire some 75,500 anti-depressant prescriptions are issued each month”

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One is tempted to ask why we are seeing such huge and rising numbers of people regularly taking anti-depressants when GPs are advised to prescribe them only for more seriously ill patients.

In some places the number of patients prescribed anti-depressants exceeds the number of people in that area estimated to suffer from depression and anxiety by the NHS England's Psychiatric Morbidity Survey (PMS).

For example, in Lincolnshire some 75,500 anti-depressant prescriptions are issued each month and yet the PMS suggests there are only 58,700 people suffering from depression and anxiety in the area.

It is a similar story in County Durham where there were 63,700 prescriptions and 55,300 people identified by the survey.

Doctor writing out a prescription London boroughs have fewest prescriptions per head of adult population

Official guidance from the National Institute for Health and Care Excellence (NICE) urges doctors in England to treat patients suffering mild to moderate depression with psychological therapies. Medication is recommended for more severe depressive illness in conjunction with therapy.

However, access to psychological therapies is patchy. Figures published this week show that in Swindon, for example, 25% of people estimated to be suffering from depression or anxiety received therapy treatment last year. In Hillingdon in north London, it was under 2%.

In a statement, the Chair of Hillingdon Clinical Commissioning Group, Dr Ian Goodman, said: "We recognise that the number of patients in Hillingdon with anxiety or depression who are getting treatment through the IAPT (Improving Access to Psychological Therapies) service is low."

"Our patients who do get IAPT treatment have high recovery rates, so we are committed to improving access so that more patients can receive this high quality care."

What are they doing right in Swindon? The commissioning group there says the results "demonstrate the outstanding achievements" of their psychology team. "One of the reasons this service is different is that it runs and open access opt-in service, which is available to anyone and has at least one therapist based in each GP practice."

While communities, largely in the north of England, have very high levels of anti-depressant prescribing, the areas with the lowest rates are in London. The 20 places with fewest prescriptions per head of adult population are all boroughs in the capital.

Graph showing ratio of adults receiving anti-depressant prescriptions (monthly)

In Brent, for example, anti-depressants are issued to one adult in 23 each month. In Kensington & Chelsea and Redbridge it is one in 21. This means that the prescribing rate even in some of the poorest in London is less than a third what it is in Blackpool.

The proportion of estimated depression and anxiety sufferers prescribed anti-depressants is lowest in London too. While in Blackpool the figure is 92%, in Kensington & Chelsea it is 23% and in Brent 28%.

However, London boroughs do not have particularly impressive figures for getting patients with depression or anxiety into therapy. Hillingdon and Croydon have among the worst figures in England.

Indeed, there is little correlation between anti-depressant prescribing and access to psychological therapies. While in Blackpool (the highest prescribing rate) 7.3% of those estimated to need therapy treatment are receiving it, in Brent (the lowest prescribing rate) the figures is 7.4%.

This suggests it is not as simple as doctors offering tablets because therapy is not available.

Trust Highest prescription rate*

*ADULTS/ANTI-DEPRESSANT PRESCRIPTION A CALENDAR MONTH

Blackpool Primary Care Trust (PCT)

5.53

Barnsley PCT

6.30

Redcar and Cleveland PCT

6.37

County Durham PCT

6.38

Middlesborough PCT

6.47

Salford PCT

6.49

Sunderland Teaching PCT

6.49

Knowlsey PCT

6.53

Gateshead PCT

6.53

North Tyneside PCT

6.75

Trust Lowest prescription rate*

*ADULTS/ANTI-DEPRESSANT PRESCRIPTION A CALENDAR MONTH

Waltham Forest PCT

17.90

Southwark PCT

18.11

Newham PCT

18.74

Hammersmith & Fulham PCT

19.16

Ealing PCT

19.38

City & Hackney Teaching PCT

19.86

Harrow PCT

20.10

Redbridge PCT

20.65

Kensington & Chelsea PCT

20.93

Brent Teaching PCT

22.96

Trust % in therapy*

*Estimated % DEPRESSION/ANXIETY SUFFERERS RECEIVING THERAPY (LOWEST)

Hillingdon PCT

1.9

Croydon PCT

2.9

Stockton on Tees Teaching PCT

3.0

Heywood Middleton & Rochdale PCT

3.3

Luton PCT

3.5

Trust % in therapy*

*Estimated % DEPRESSION/ANXIETY SUFFERERS RECEIVING THERAPY (HIGHEST)

Walsall Teaching PCT

21.0

Northumberland Care Trust

21.5

North Lincolnshire PCT

22.5

Wiltshire PCT

22.9

Swindon PCT

25.0

All data sourced to HSCIC

 
Mark Easton, Home editor Article written by Mark Easton Mark Easton Home editor

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  • rate this
    0

    Comment number 364.

    In a word...no. The most widely prescribed drugs are mainly for cardiovascular disease , pain killers and drugs for asthma and indigestion. There are no anti depressants in the top 10.

  • Comment number 363.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    +1

    Comment number 362.

    Maybe the media should take responsibility for the state of the country?
    After all media outlets now seem to delight in gloom and doom news.
    Mental health is definitely the poor relation of the NHS.
    Maybe some "good news" stories to counteract the gloomy ones?

  • rate this
    +1

    Comment number 361.

    10 years ago I had undiagnosed post natal depression. I ran away to kill myself. Initially I refused anti-d but stayed suicidal. I was persuaded to take them by a wonderful CPN who pointed out that a clinically depressed brain needs serotonin like a diabetic body needs insulin.
    Like many women I now take them to control menopausal symptoms as an alternative to HRT. They can be lifesavers.

  • rate this
    +1

    Comment number 360.

    Ugly as sin, personality of a mouse, yes I've nothing to be depressed about. And don't tell me to cheer up.

  • rate this
    +1

    Comment number 359.

    I think people need to understand the difference between actual clinical depression and feeling a bit low.

    The effects of anti depressants for those with clinical depression are very noticeable in my experience. Like food for the person who has been starved for a week. I don't think those prescribed these drugs that don't need them will notice the benefit.

  • rate this
    +1

    Comment number 358.

    I hope the BBC and Mark Easton in particular look at these responses, they highlight that the stigma and misunderstanding of depression and its treatment is as high as ever. Thank you BBC for providing a platform for these nasty views. I'm on anti depressants and have got back to work full time, it's been 15yrs back and forth and it seems I need to be on pills no end in sight this made me despair

  • rate this
    0

    Comment number 357.

    Hey, soon be Monday !
    I owe, I owe its off to work I go..........
    With apologies to Disney for misuse of lyrics........

  • rate this
    0

    Comment number 356.

    @351 "Fortunately I discovered the reason for my daily bouts of
    gloominess and have switched away from the BBC News programs altogether"

    I think you might be lost - this is the BBC NEWS website.

  • rate this
    0

    Comment number 355.

    The problem with anti-depression medication is the often accompanying tendency to reduce all the persons problems to variables of brain chemistry. This can lead to amplified expectations of the drug and its possible effects with regards to patients lives. The bigger picture reveals a complex network of cause and effect relations interacting to instigate neurochemical changes in time (change)...

  • rate this
    -2

    Comment number 354.

    Sorry to ask a silly question but who takes Anti-depressents?

    Our countryside is incredibly beautiful, life is wonderful (everyone's really) why don't people get out of their homes and stop watching sh*te on the tv??

    Get out of the house! live!!

  • rate this
    0

    Comment number 353.

    Maybe these pills work for some people, but my guess is that they cause other issues?

  • rate this
    +1

    Comment number 352.

    They helped me get through a bad time a decade ago (sudden marriage break-up). I came off them too soon and had to start again, but I later came them off them completely so I could think clearly, to complete my degree as a mature student (after a necessary sabbatical). When you need them you need them, but try to get off them when you're ready. In my case I quit them finally after 15 months.

  • rate this
    -1

    Comment number 351.

    I suffered depression for a number of years but managed to stay off medication. Fortunately I discovered the reason for my daily bouts of
    gloominess and have switched away from the BBC News programs altogether. I now see green shoots everywhere.

  • rate this
    +1

    Comment number 350.

    @ 316. Steve J "I take a medicine that is classed as an anti depressant but it used to treat the nerve damage in my spine."

    Good point. My mother is on antidepressants for pain as she cannot take conventional pain killers. They do the trick so score for the GP.

    I suspect these exceptions wouldn't be a huge percentage but they highlight a problem with the assumptions of this survey.

  • rate this
    +1

    Comment number 349.

    Depressed areas = depressed people, no a surprise really.

  • rate this
    0

    Comment number 348.

    @stepee - Anti-depressants are not handed out easily. There are a series of tests you need to do prior to them being prescribed, and if they are deemed to be unlikely to work, you won't get them. This is then reviewed regularly to make sure they work. They aren't a fix-all, don't work quickly, and have a massive stigma still attached to them. They aren't something people enter into lightly.

  • rate this
    0

    Comment number 347.

    343 - I think you're absolutely right. Having worked in both Blackpool (highest) and North West London (lowest), I believe this reflects the differences in job opportunity. When criticising others for being out of work, too often people forget the depressed job market in areas outside of London. Those in whitehall don't think/care about the disproportionate pressures for those even in work.

  • rate this
    +1

    Comment number 346.

    @ShatnersBasoon - Six years in local government, 4 of which I've been on anti-depressants. I have not taken a single day off due to depression, and only turned to tablets when CBT etc did not work. Anti-depressants are to make you stable while you deal with the problem, not to cover it completely. Depression is a serious illness - would you complain about someone taking time off for chemotherapy?

  • rate this
    -1

    Comment number 345.

    Well there is quite a lot to be depressed about! However the main cause would I believe be the G.P. s obsession for ignoring the patients words and diagnosing "depression" or "anxiety" instead of sending people for expensive investigation that may prove them wrong!?

 

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