Mental Health and Emotional Wellbeing Among Adults

This topic area covers statistics and information relating to mental health, emotional wellbeing and loneliness among adults in Hull including local strategic need and service provision. Further information relating to Mental Health and Emotional Wellbeing Among Children and Young People and Children with Special Educational Needs or Disabilities is given under Health Factors within Children and Young People. Further information on Learning Disabilities and Mental Ill Health is provided under Vulnerable Groups. Information relating to self-harm can be found within Suicide and Self-Harm under Health Factors under Adults. Information relating to hospital admissions for self-harm, alcohol and substance abuse can be found within A&E Attendances and Hospital Admissions under Health Factors under Children and Young People. Emotional health and wellbeing information has been collected within Hull’s Health and Wellbeing Surveys and full reports are available under Surveys within Tools and Resources.

This page contains information from the Office for Health Improvement & Disparities’ Fingertips. Information is taken ‘live’ from the site so uses the latest available data from Fingertips and displays it on this page. As a result, some comments on this page may relate to an earlier period of time until this page is next updated (see review dates at the end of this page).

In July 2022, Clinical Commissioning Groups (CCGs) ceased to exist and were replaced by the Integrated Care System. Data will still be available at CCG level for some time after July 2022 so this page continues to refer to CCGs and Hull CCG, and continues to present data at the CCG geographical level. Six local CCGs were also combined to form the Humber, Coast and Vale geographical area, which has also ceased to exist. It has been replaced by the Humber and North Yorkshire ICS. However, data will still be available at Humber, Coast and Vale geographical level, and will be presented within our JSNA.

Headlines

• Mental health is an integral and essential component of health.
• From Hull’s Adult Health and Lifestyle Survey 2019, 13.8% people had low levels of satisfaction with their lives, 12.0% had low levels of feeling their life was worthwhile, 15.9% had low levels of happiness yesterday and 31.0% had high levels of anxiety yesterday. The wellbeing measures were the worst among those aged 16-24 years and generally next highest among those aged 55-64 years. People living in the most deprived two-fifths of areas were twice as likely to report poor outcomes compared to people living in the least deprived fifth of areas of Hull. People who were unemployed and who were aged under 65 years who lived alone also had the among the highest prevalence of poor outcomes, but the highest prevalence was among those who were not working due to long-term illness or disability where around 50% had poor levels of satisfaction with life, feeling life was worthwhile and happiness (40% for high anxiety). In addition to the groups mentioned above, students and lone parents also had among the highest levels of anxiety.
• In 2007, it was estimated that 20.5% of the patient population registered with Hull GPs have a common mental health disorder which is higher than England (16.9%). In 2020/21, there were 28,697 patients (12.0%) registered with Hull GPs who had a record of unresolved depression within their patient record that had been diagnosed on or after 1st April 2006 (slightly lower than England at 12.3%), although the number of new cases was higher in Hull (1.6% versus 1.4%) with 3,898 new diagnoses in 2020/21 among Hull patients.
• In the GP Patient Survey, 11.3% reported a long-term mental health problem and 15.9% reported depression and anxiety (both higher than England – 9.9% and 13.7% respectively).
• From Hull’s Adult Health and Lifestyle Survey 2019, around one in ten people stated that they often lacked companionship, often felt left out, often felt isolated from others, and often felt lonely with 18% stating ‘often’ to one or more of these four questions. People aged 16-24 years, living in the most deprived areas of Hull, who were unemployed, who were not working due to long-term illness or disability, or were aged under 65 years and lived alone were the most likely to report that they often lacked companionship, often felt left out, often felt isolated from others, or often felt lonely.
• It is estimated that around 30,000 people aged 18-64 years in Hull have common mental disorders, around 4,000 borderline personality disorders, over 5,500 antisocial personality disorders, around 1,150 psychotic disorders, and 11,800 two or more psychiatric disorders.
• It is recognised the mental and emotional wellbeing has been detrimentally affected for many adults and children due to COVID-19 and lockdowns. Furthermore, the effect has not been felt evenly across society and the most vulnerable have generally been affected the worst, increasing the inequalities gap between both Hull and England, and within Hull. Recognition is not sufficient and increased resources need to be made available to improve mental health and emotional wellbeing particularly among those most affected.

The Population Affected – Why Is It Important?

The World Health Organisation (WHO) defines mental health, examines determinants of mental health, looks at mental health promotion and protection as well as treatment and care in relation to mental health.

WHO state that mental health is an integral and essential component of health. The WHO constitution states: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” An important implication of this definition is that mental health is more than just the absence of mental disorders or disabilities.

WHO state mental health is a state of well-being in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community. Mental health is fundamental to our collective and individual ability as humans to think, emote, interact with each other, earn a living and enjoy life. On this basis, the promotion, protection and restoration of mental health can be regarded as a vital concern of individuals, communities and societies throughout the world.

They go on to say that multiple social, psychological, and biological factors determine the level of mental health of a person at any point of time. For example, violence and persistent socio-economic pressures are recognized risks to mental health. The clearest evidence is associated with sexual violence. Poor mental health is also associated with rapid social change, stressful work conditions, gender discrimination, social exclusion, unhealthy lifestyle, physical ill-health and human rights violations. There are specific psychological and personality factors that make people vulnerable to mental health problems. Biological risks include genetic factors.

Thus poor mental health can have a detrimental effect on all aspects of life undermining self-esteem, confidence and enthusiasm for life. Social and emotional well-being in children creates the foundations for healthy behaviours and educational attainment. It also helps prevent behavioural problems (including substance misuse) and mental health problems. Social and emotional well-being provides personal competencies (such as emotional resilience, self-esteem and interpersonal skills) that help to protect against risks relating to social disadvantage, family disruption and other adversity in life. Such competencies provide building blocks for personal development which will enable children and young people to take advantage of life chances. 

Evidence shows that poor social and emotional wellbeing predicts a range of negative outcomes in adolescence and adulthood. The National Institute for Health and Care Excellence state that negative parenting and poor quality family or school relationships place children at risk of poor mental health. Early intervention in childhood can help reduce physical and mental health problems and prevent social dysfunction being passed from one generation to the next. 

A general low mood can include sadness, anxiety, worry, tiredness, low self-esteem, frustration and anger and people with poor mental health sometimes can deal with this by smoking more, eating excessively and unhealthy diets and not exercising. Depression can involve continuous low mood, feelings of hopelessness and helplessness, low self-esteem, feeling tearful, feeling irritable and intolerant of others, having no motivation of interest in things, finding it difficult to make decisions, not getting any enjoyment out of life, having suicidal thoughts or thoughts of self-harming, and feeling anxious or worried. As a consequence, poor mental health influences all aspects of life, a person’s physical health, their family, their education and training, their workplace and employment, and their involvement in their community.

The diagnosed prevalence of depression and severe mental illness can be examined from data collected as part of the Quality and Outcomes Framework within primary care. Quality of care indicators are also included, and it means that high percentage of the patients diagnosed with depression and severe mental illness have annual reviews which gives medical staff the opportunity to provide information and encourage their patients to improve their lifestyle behaviours to improve their health, and lower their risk of morbidity and mortality from their condition. Information relating to Mental Ill Health is given within Vulnerable Groups. Local analysis of the QOF data has been completed with prevalence calculated for each GP practice and Primary Care Network group.

The Hull Picture

Incidence and Prevalence

Common Mental Disorders (Modelled Estimates)

The Office for Health Improvement & Disparities’ Fingertips presents information at Clinical Commissioning Group (CCG) level – based on patients registered with Hull GPs – in relation to modelled estimates of the prevalence of common mental disorders. The estimates of common mental disorders are based on applying the prevalence estimates from the national Adult Psychiatric Morbidity Survey completed in 2014 and applied to Hull’s population structure. Specific prevalence estimates have been used for each age group and for different levels of deprivation for males and females separately.

In their models estimated for 2017, the prevalence of common mental disorders was considerably higher in Hull compared to England being 21% higher among those aged 16+ years and 25% for those aged 65+ years.

Fingertips also presents modelled estimates in relation to depressive episodes, generalised anxiety disorders, and mixed anxiety and depressive disorders for 16-74 year olds. The estimates are also based on applying the prevalence estimates from a national survey completed in 2012 and applied to Hull’s population structure. The estimates take into account age, sex, area type and some socio-demographic factors in the local population.

For 2021, the percentage of Hull’s population aged 16-74 years estimated to have depressive episodes, generalised anxiety disorders, and mixed anxiety and depressive disorders is considerably higher than England being 39%, 19% and 8% higher respectively.

In Hull, there has been relatively small changes in the modelled estimated prevalence estimates for depressive episodes, generalised anxiety disorders, and mixed anxiety and depressive disorders among those aged 16-74 years.

Unresolved Record of Depression on GP Register

Fingertips also presents information at CCG level based on patients registered with Hull GPs from information from the Quality and Outcomes Framework so represents the percentage of patients aged 18+ years diagnosed on or after 1st April 2006 who have an unresolved record of depression in their patient record.

For 2020/21, the percentage in Hull is only marginally lower than England (12.0% versus 12.3%), but given the relationship between depression and deprivation, this suggests that there is a higher rate of undiagnosed depression in Hull.

Between 2009/10 and 2020/21, the prevalence of an unresolved record of deprivation among patients aged 18+ years has tripled, although some of the increase will be due to increased case finding (since the indicator was first introduced) and possibly better recording. Therefore, it is difficult to ascertain the true extent of the increase. There has been similar increases both for England and across Humber, Coast and Vale.

In 2020/21, there were 28,697 patients aged 18+ years registered with Hull GPs who had a record of unresolved depression within their patient notes who had been diagnosed on or after 1st April 2006. This represented 12.0% of the patient population registered with Hull GPs, although the prevalence was similar to Humber, Coast and Vale (11.9%) and only slightly lower than for England (12.3%).

From a local analysis, it was found that there was no difference in the prevalence of unresolved record of deprivation among patients aged 18+ years in relation to either average patient age or average deprivation score (based on Index of Multiple Deprivation) for the 32 GP practices in Hull for 2020/21. The prevalence of mental health issues does tend to be higher among people living in more deprived areas, so it could be that people in more deprived areas are not visiting their GP about this and there are more cases that are undiagnosed.

New Cases of Depression on GP Registers

As part of the Quality and Outcomes Framework, the number of new diagnoses are also recorded so it is possible to examine incidence of (newly) diagnosed depression as well as prevalence above. For 2020/21, there was a higher incidence of newly diagnosed depression among those aged 18+ years who were registered with Hull GPs (1.6%) compared to England (1.4%) and across the Humber, Coast and Vale (1.4%).

There has been a gradual increase in the incidence of depression in Hull although there has been year-on-year variability, and the percentages have fallen the last two years to 2020/21.

Self-Reported Long-Term Mental Health Problems

From the GP patient survey in 2018/19, 11.3% of patients aged 16+ years registered with Hull GPs reported that they had a long-term mental health problem which was higher than England (9.9%). From the same survey but for 2016/17, the percentage of patients aged 18+ years reporting depression and anxiety was also higher in Hull (15.9%) compared to England (13.7%).

Information on the trends over time is available for depression and anxiety, and the prevalence has been increasing over time. This is self-reported so could relate to an increase in the prevalence over time, or a greater willingness to report mental health issues, or both.

The percentage in Hull has been consistently higher than England. This does not necessarily relate to diagnosed depression, and it is possible that people state that they have depression or anxiety when completing the survey but are not recorded as having depression on the patient records.

Measures of Wellbeing

An Adult Health and Wellbeing Survey was conducted in Hull during 2019 involving over 4,000 adults aged 16+ years. Further information and the full reports are available under Surveys within Tools and Resources. The survey asked four questions relating to mental wellbeing that have also been used nationally, and as a result the prevalence estimates from the local survey can be compared with the prevalence in Hull from the national survey. The numbers involved in the local survey were considerably higher than the numbers surveyed in Hull for the national survey, and due to the way the local survey was conducted, it is likely that the survey responders in the local survey are more representative of Hull’s overall population. In general, the prevalence estimates from the local survey were higher than the national survey.

The four questions were “Overall, how satisfied are you with your life nowadays?”, “Overall, to what extent do you feel the things that you do in your life are worthwhile?”, “Overall, how happy did you feel yesterday?” and “Overall, how anxious did you feel yesterday?”. Each of the four questions had a response scale from 0 “not at all” to 10 “completely”. Poor or low levels of satisfaction, of feeling worthwhile, and of happiness were recorded as having a score of 0-4 and poor or high levels of anxiety were recorded as having a score of 6-10.

Satisfaction With Life

In relation to age, the lowest levels of satisfaction with life occurred for those aged 45-64 years and 16-24 years. There was a marked association with deprivation with low levels of satisfaction twice as high among people living in the most deprived fifth compared to the least deprived fifth of areas of Hull. The most marked difference occurred in relation to working status where over half of people who were not working due to long-term illness and disability reported low levels of satisfaction with their life, and 22% of those who were unemployed or not allowed to work (asylum seekers etc). Almost one-quarter of people who were aged under 65 years and who lived alone also had low levels of satisfaction with their lives. Among survey responders aged under 65 years, the single person households had a higher percentage of males aged 35-64 years (42% versus 24% for all other households type where the survey responder was aged under 65 years) and females aged 55-64 years (19% versus 8% for all other households types where the survey responder was aged under 65 years). So it appears that this group could include people who are separated or divorced as well as single individuals.

The percentage of people who had low levels of satisfaction with their lives was highest in St Andrew’s & Docklands wards at 22% with the next highest wards around 18% (North Carr, Orchard Park, Longhill & Bilton Grange, Newington & Gipsyville, Pickering, and Central).

The Office for Health Improvement & Disparities’ Fingertips presents information from the national survey, although for the latest year 2020/21 the numbers surveyed are not sufficiently large in Hull and the results have not been presented.

For 2019/20, the percentage of people with a low satisfaction with life was lower in Hull (6.3%) compared to England (4.7%).

As mentioned above the rates are dramatically lower in the national survey for Hull (6.3% in 2019/20) compared to the local survey (13.8% in 2019). The time periods of the two surveys differ, however, it does not make much difference as regardless of the survey year of the national survey, the prevalence from the national survey is consistently lower than the local survey. In Hull, from the national survey, the percentage of people aged 16+ years with a low level of satisfaction with their life has ranged from 5.0% in 2017/18 to 8.5% in 2012/13, which are all considerably lower than 13.8% from the local survey.

Feeling Life is Worthwhile

Examining to what extent people felt the things people they do in their lives were worthwhile showed a similar pattern to satisfaction with life. People aged 16-24 years had the highest percentages of low levels of feeling their life was worthwhile followed by those aged 55-64 years and 45-54 years. There was also a very strong association with deprivation with more than twice as many people living in the most deprived fifth of areas of Hull having low levels of feeling their life was worthwhile compared to people living in the least deprived fifth of areas of Hull. Again, people who were not working due to long-term illness and disability, and who were unemployed had the worst responses. Overall, 23% of people who were aged under 65 years and lived alone had low levels of feeling their life was worthwhile as did 16% of people who lived in households with three or more adults and child(ren).

One in five survey responders who lived in St Andrew’s & Docklands ward had a low level of feeling their life was worthwhile, and the percentage was next highest for people living in Newington & Gipsyville, and Central wards (both 17%).

The percentage of people with a low worthwhile score is missing for Hull for both 2019/20 and 2020/21 due to small numbers. In 2018/19, they estimate that 5.2% of Hull residents had low levels of feeling life was worthwhile compared to 3.6% for England.

However, the percentage from the national survey has been relatively consistent for Hull over time ranging from 4.7% in both 2013/14 and 2017/18 to 5.8% in 2016/17.

As mentioned above the rates are dramatically lower in the national survey for Hull (5.2% in 2018/19) compared to the local survey (12.0% in 2019). Again, it does not really matter what time period is used for the national survey, it is consistently lower than than the local survey regardless of the time period.

Happiness

Overall, 15.9% had low levels of happiness, and there was a very similar pattern for the percentages with a low level of happiness yesterday in relation to age, deprivation and employment status as noted in relation to satisfaction with life and feeling life was worthwhile. Almost half of people who were not working due to long-term illness or disability had a low level of happiness yesterday and one-fifth or more of those who were aged 16-24 years, 55-64 years, living in the most deprived two-fifths of areas of Hull, were students, unemployed or not working due to long-term illness or disability, who were aged under 65 years and lived alone, and those who lived in households with three or more adults with child(ren).

One-quarter of people living in Newington & Gipsyville ward had low levels of happiness, 24% of people living in Central ward, 23% of people living in St Andrew’s & Docklands ward and 21% of people living in Orchard Park ward.

In 2020/21, a higher percentage of people in Hull had a low happiness score (11.0%) compared to England (9.2%).

However, as mentioned above, the percentages differed markedly between the local survey (15.9% in 2019) and the national survey (13.2% in 2019/20), but regardless of the time period of the national survey this would have been the case.

The percentages reporting low levels of happiness nationally and regionally both increased between 2019/20 and 2020/21, and it might be anticipated due to the COVID-19 pandemic. However, not such increase occurred in Hull which is surprising.

Anxiety

Almost one third of survey responders had had high levels of anxiety yesterday with the highest levels among women, younger people particularly those aged 16-24 years, people living in the most deprived areas of Hull, students, people who were not working due to unemployment or long-term illness or disability, lone parents and people aged under 65 years who lived alone.

In University and Newington & Gipsyville wards, 38% of survey responders had high levels of anxiety yesterday, and it was also over two-thirds among people living in St Andrew’s & Docklands and Central wards.

In 2020/21, the percentage from the national survey was only slightly lower in Hull at 24.8% compared to England (24.2%).

However, as for the other wellbeing measures, the percentage was considerably higher in the local survey (31.0%) compared to the national survey which ranged from 18.4% in 2018/19 to 24.8% in 2020/21.

There has been a considerable increase nationally and across the region between 2019/20 and 2020/21 which might be expected due to the COVID-19 pandemic, but the increase in Hull was smaller. Nevertheless, the percentage in Hull, estimated nationally, is the highest it has been since 2011/12.

Mental Health Index

In addition, survey respondents in Hull’s Health and Wellbeing Survey 2019 were asked five questions from the Mental Health Index to how they felt over the past four weeks in relation to nervousness, feelings of being down in the dumps, calm and peaceful, downhearted, or happy. They were asked if they felt like this all of the time, most of the time, some of the time, a little of the time or none of the time.

Between 10% and 15% felt nervous, felt so down in the dumps nothing could cheer them up or felt downhearted and low all or most of the time in the last four weeks.

Over four in ten felt calm and peaceful all or most of the time, and over half (55%) felt happy all or most of the time in the last four weeks.

Frequency (‘…of the time’) over last four weeks	Number	All	Most	Some	A little	None
Have you been nervous?	4,059	2.4	10.0	32.7	29.7	25.5
Have you felt so down in the dumps nothing could cheer you up?	4,051	2.7	9.1	22.9	25.7	39.6
Have you felt calm and peaceful?	4,017	5.8	36.1	29.9	20.5	7.7
Have you felt downhearted and low?	4,019	3.1	11.0	28.4	32.5	25.0
Have you been happy?	4,038	9.3	46.0	27.7	13.0	4.0

Lacking Companionship and Loneliness

In the local survey conducted during 2019, people were asked questions as to how often they felt a lack of companionship, left out, isolated from others, or lonely.

Overall, around one in ten stated that they often lack companionship. There was not a great deal of difference between men and women, or among the age groups although highest in those aged 16-24 followed by those aged 45-64 then those aged 65+ and lowest among those aged 25-44 years. People living in the most deprived two-fifths of areas of Hull were twice as likely to state they often lacked companionship compared to those living in the least deprived fifth of areas of Hull. There was also a significant difference in the percentages depending on working status being lowest for those working or who were looking after the home and family (both around 7%), 9% among people who were retired, 11% among students, but 19% among those who were unemployed and 27% for people who were not working due to long-term illness or disability. There was also a significant difference among people by households composition with 22% of people who lived alone who were aged under 65 years often feeling they lacked companionship compared to 14% among those who lived alone who were aged 65+ years. Lone parents also had relatively high levels of lacking companionship (13%). The percentage who often lacked companionship was lowest among people aged 65+ years who lived with another person at 5%.

Among survey responders aged under 65 years, the single person households had a higher percentage of males aged 35-64 years (42% versus 24% for all other households type where the survey responder was aged under 65 years) and females aged 55-64 years (19% versus 8% for all other households types where the survey responder was aged under 65 years). So it appears that this group could include people who are separated or divorced as well as single individuals.

The highest percentages who often lacked companionship occurred among survey responders living in Central (16%) and Newington & Gipsyville (15%) wards.

One in eleven survey responders often felt left out, but this was higher among women (10%) compared to men (7%) and considerably higher among those aged 16-24 years at 13% compared to 9% for the next highest group (aged 75+ years). There was also a strong association with deprivation with twice as many people stating they often felt left out compared to those living in the least deprived fifth of areas of Hull. Similar to lacking companionship, there was also a strong association with working status with almost one-third of people who were not working due to long-term illness and disability often feeling left out and 17% of those who were unemployed. People who were aged under 65 years and lived alone were the most likely to often feel left out at 18%.

In Central ward, 15% of survey responders often felt left out, and this was also more than one in ten for survey responders living in North Carr (13%), Newington & Gipsyville (13%), Orchard Park (12%), Longhill & Bilton Grange (12%), Southcoates (11%), Pickering (10%) and University (10%).

Around one in ten often felt isolated from others, and this was highest among those aged 16-24 years at 14% and lowest among those aged 65-74 years (7%). As for lacking companionship and feeling left out, people living in the most deprived two-fifths of areas of Hull were twice as likely to often feel isolated from others than those who lived in the least deprived fifth of areas of Hull. Almost one in five people who were unemployed felt isolated from others as did over one-third of people who were not working due to long-term illness and disability. One-fifth of people aged under 65 years who lived alone often felt isolated from others.

In Central ward, 17% of survey responders stated they often felt isolated from other and it was almost 15% for people living in Newington & Gipsyville, Longhill & Bilton Grange, and Pickering wards.

There was a similar pattern in relation to often feeling lonely although the percentages were considerably higher among those aged 16-24 years and among students.

Around 18% of survey responders living in Pickering, Newington & Gipsyville and Central wards often felt lonely.

There were stark differences between different groups of people when examining the percentages who stated ‘often’ to at least one of these four questions. Overall, 18% had stated they often felt they lacked companionship, often felt left out, often felt isolated from others and/or often felt lonely. The percentage was higher among women compared to men, and considerably higher among those aged 16-24 years at 28%. More than one in five of people living in the most deprived two-fifths of areas of Hull had stated ‘often’ for at least one of the four questions which was considerably higher than the 13% among people living in the least deprived fifth of areas of Hull (although not twice as high as it had been for the four individual questions). Almost one-quarter of students, almost one-third of people who were unemployed and over half of people who were not working due to long-term illness or disability had answered ‘often’ for one or more of the four questions, as had almost one-third of people who were aged under 65 years who lived alone.

More then one-quarter of survey responders living in Longhill & Bilton Grange had stated ‘often’ for one or more of the four questions, and this was also more than one-fifth for survey responders living in Newington & Gipsyville, Central, Pickering, Orchard Park, St Andrew’s & Docklands, North Carr, Boothferry, and University wards.

A further question in a slightly different format asked about the frequency of feeling lonely or isolated from others. Young people, people living in the most deprived areas of Hull, students, people who were not working due to unemployment or long-term illness or disability, people living alone aged under 65 years, and lone parents had the highest levels of feeling lonely or isolated from others all or most of the time.

Around 16% of more of survey responders living in Central, Newington & Gipsyville, Longhill & Bilton Grange, and St Andrew’s & Docklands wards stated that they felt lonely or isolated from others all or most of the time.

The local adult Black and Minority Ethnic Health and Lifestyle Survey 2007 indicated worse mental health for failed asylum seekers, almost one-third of whom stated that they were ‘so unhappy that life is not worthwhile’ compared to 13% of those whose asylum had been granted and less than 4% for all other groups.

Treatment

Information relating to treatment for alcohol and substance abuse can be found within Alcohol and Drugs and Substance Abuse under Lifestyle Factors under Adults.

Hospital Admissions

Information relating to self-harm can be found within Suicide and Self-Harm under Health Factors under Adults, and information relating to hospital admissions for mental health, self-harm, alcohol and substance abuse can be found within Hospital Admissions under Health Factors under Children and Young People.

Projected Numbers of People with Mental Health Issues

The Projecting Adult Needs and Service Information (PANSI) and the Projecting Older People Population Information Service (POPPI) provide current estimates and future projections at local authority level of the number of people with different health needs for those aged 18-64 and 65+ years respectively.

They use estimates for the estimated prevalence from different surveys and research which have generally been derived at a national level (generally different prevalence estimates for different age groups for men and women separately). They then apply these prevalence figures to Hull’s population. For instance, if the prevalence among males in England in a specific age group is 5% and there are an estimated 500 men living in Hull in that age groups, they would estimate there were 25 men in that age group living in Hull with that condition. For many conditions, there is an increased prevalence in populations with higher levels of deprivation, and in most cases, deprivation is not taken into consideration. Thus in many cases, these estimates for Hull are likely to underestimate the numbers in Hull due to the high levels of deprivation in Hull.

Further definitions are available from www.pansi.org.uk and www.poppi.org.uk.

It is estimated that just over 30,000 people aged 18-64 years in Hull have a common mental health disorder, just under 4,000 have a borderline personality disorder, around 5,600 have an antisocial personality disorder, over 1,100 have a psychotic disorder and that almost 12,000 have two or more psychiatric disorders. The numbers are not anticipated to change much between 2020 and 2040 as the population aged 18-64 years is projected to remain relatively stable in terms of total numbers.

“Common mental disorders comprise different types of depression and anxiety, including obsessive compulsive disorders. They cause marked emotional distress and interfere with daily function, but do not usually affect insight or cognition.

Personality disorders are long-standing ingrained distortions of personality that interfere with the ability to make and sustain relationships. Antisocial personality disorder and borderline personality disorder are two types with particular public and mental health relevance.

Borderline personality disorder is characterised by high levels of personal and emotional instability associated with significant impairment.

Antisocial personality disorder is characterised by disregard and violation of the rights of others. People with antisocial personality disorder have a pattern of aggressive and irresponsible behaviour with emerges in childhood or early adolescence.

Psychotic disorders produce disturbances in thinking and perception severe enough to distort perception of reality. Psychoses can be serious and debilitating conditions.

Psychiatric comorbidity – or meeting the diagnostic criteria for two or more psychiatric disorders – is known to be associated with increased severity of symptoms, longer duration, greater functional disability and increased use of health services. Disorders include the most common mental disorders (anxiety and depression) as well as: psychotic disorder; antisocial and borderline personality disorders; eating disorder; post-traumatic stress disorder (PTSD); attention deficit hyperactivity disorder (ADHD); alcohol and drug dependency; and problem behaviours such as problem gambling and suicide attempts.

Mental health disorder	2020	2025	2030	2035	2040
Common mental disorder	30,914	30,351	30,137	30,022	29,763
Borderline personality disorder	3,927	3,856	3,829	3,814	3,781
Antisocial personality disorder	5,555	5,474	5,450	5,441	5,402
Psychotic disorder	1,150	1,131	1,124	1,120	1,111
Two or more psychiatric disorders	11,820	11,616	11,542	11,504	11,410

It is estimated that there are around 5,900 men and 12,900 women aged 18-64 years who are survivors of sexual abuse in Hull.

Gender	2020	2025	2030	2035	2040
Males	5,866	5,796	5,782	5,782	5,747
Females	12,880	12,592	12,464	12,384	12,256
Persons	18,746	18,388	18,246	18,166	18,003

The number of people aged 65+ years with depression is estimated to be around 3,400 in 2020, but anticipated to increase to over 4,200 by 2040 due to the ageing population.

Age	2020	2025	2030	2035	2040
65-69	980	1,073	1,185	1,118	1,024
70-74	898	849	926	1,048	989
75-79	595	778	734	822	922
80-84	509	500	670	642	726
85+	409	408	413	521	559
Total 65+	3,390	3,607	3,928	4,151	4,219

The number of people aged 65+ years with severe depression is estimated to be just over 1,000 in 2020 but anticipated to increase to around 1,400 by 2040, again because of increasing to the number of people aged 65+ years in Hull.

Age	2020	2025	2030	2035	2040
65-69	290	318	353	333	305
70-74	174	165	181	202	192
75-79	245	322	305	340	382
80-84	165	159	213	204	228
85+	179	183	187	238	257
Total 65+	1,054	1,147	1,238	1,316	1,364

Strategic Need and Service Provision

The World Health Organization state that mental health promotion involves actions that improve psychological well-being which may involve creating an environment that supports mental health. An environment that respects and protects basic civil, political, socio-economic and cultural rights is fundamental to mental health. Without the security and freedom provided by these rights, it is difficult to maintain a high level of mental health. National mental health policies should be concerned both with mental disorders and, with broader issues that promote mental health. Mental health promotion should be mainstreamed into governmental and nongovernmental policies and programmes. In addition to the health sector, it is essential to involve the education, labour, justice, transport, environment, housing, and welfare sectors.

WHO go on to state in terms of treatment and care that in the context of national efforts to develop and implement mental health policy, it is vital to not only protect and promote the mental well-being of its citizens, but also address the needs of persons with defined mental disorders. Knowledge of what to do about the escalating burden of mental disorders has improved substantially over the past decade. There is a growing body of evidence demonstrating both the efficacy and cost-effectiveness of key interventions for priority mental disorders in countries at different levels of economic development.

People with general mental health issues need to be identified early and encouraged to seek help early so that the consequences in terms of the effects on family and employment are minimised, issues are not escalated so reduce the levels of need for crisis and/or medical interventions. It should be recognised that specific groups of people may be more likely to have mental health issues due to their circumstances, such as poverty, asylum seekers, social isolation, etc. There is a need to improve and expand early help and targeted interventions to improve young people’s emotional health and wellbeing and build resilience to enable them to cope with challenging life events.

Hull’s Early Help and Prevention Strategy 2021-2025 aims to identify individuals and families with problems and brings together different services and agencies to collectively look at what support is needed and then work together to deliver the required support in an coordinated way. The framework outlines the approach to ensure that collaboration and alignment of services, and that early help may be ‘early in life or at the earliest opportunity’ which is also part of the day job, helpful, non-stigmatising, preventative, targeted and tailored. There are four thresholds of need: (i) no additional needs which is the universal response to build resilience in children and young people; (ii) additional needs involving prevention and early help; (iii) complex needs involving a targeted response of early help and interventions; and (iv) risk of significant harm which includes child protection procedures and safeguarding services.

In order to improve mental health, other non-medical approaches might be necessary such as talking therapies, helping solve practical problems that are causing stress and anxiety such as housing problems and debt, and improving social networks and support through community involvement, for example, befriending. Hull’s Connect Well social prescribing service aims to bridge a gap helping Hull’s residents access support and guidance on a range of issues, helping people feel more linked in with their communities, helping with issues such as money, benefits and housing, helping with physical or emotional difficulties, and helping get active and feeling better.

It is recognised the mental and emotional wellbeing has been detrimentally affected for many adults and children due to COVID-19 and lockdowns. Furthermore, the effect has not been felt evenly across society and the most vulnerable have generally been affected the worst, increasing the inequalities gap both between Hull and England, and within Hull. Recognition is not sufficient and increased resources need to be made available to improve mental health and emotional wellbeing particularly among those most affected.

Resources

National Institute for Health and Care Excellence, Social and emotional wellbeing for children and young people: Local government briefing.  www.nice.org.uk. 2013, National Institute for Health and Care Excellence: London.

World Health Organization. Mental health: strengthening our response: https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response

NHS Digital. Quality and Outcomes Framework. https://qof.digital.nhs.uk/

The Office for Health Improvement & Disparities’ Fingertips: https://fingertips.phe.org.uk/

Hull’s Health and Wellbeing Surveys

Hull’s Early Help and Prevention Strategy 2021-25. https://www.hull.gov.uk/sites/hull/files/media/Hull%20Early%20Help%20and%20Prevention%20Strategy%202021-25.pdf

Updates

This page was last updated on 12 July 2022.

This page is due to be updated / checked in March 2023.