joint strategic needs assessment foundation profile - JSNA

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10.9.3.6 General Practitioner Consultations for Mental Health
This section uses information given within the Mental Health Equity Audit (for full report
see www.hullpublichealth.org). Whilst the information could have been updated for
more recent population estimates, the majority of the prevalence estimates are national
surveys have not been updated, so this will make relatively little difference to the
estimates of the number of people within Hull with different mental illnesses.
The fourth national study carried out by the Royal College of General Practitioners, the
Office of Population Censuses and Surveys, and the Department of Health examined
morbidity statistics in General Practice (McCormick, Fleming et al. 1995). This survey
was conducted during 1991-1992 and provides the most up-to-date reasons why people
consult their GP. The survey found that over 7% of people consulted for a mental illness
which was 649 per 10,000 people. The prevalence was lowest among older children
and increased with age. Among every age group in adults, the rate was higher for
women than men. It is not stated specifically what conditions are classified as mental
illness. However, from the tables and appendices it appears that mental illness was
classified as organic psychotic conditions (ICD 9: 290-294), other psychoses (295-299),
neurotic disorders, personality disorders and other non-psychotic mental disorders (300-
316) and mental retardation (317-319). However, an acute reaction to stress or an
adjustment reaction may be recorded by another doctor as a neurotic disorder or
depression. Depression not elsewhere classified had a prevalence rate of 110 per
10,000 persons, and special syndromes or syndromes not elsewhere classified a rate of
97 per 10,000 persons. These were mainly disorders of sleep, and pains of mental
origin (psychalgia). In addition, 26 per 10,000 consulted for acute reaction to stress, and
36 for adjustment reaction. It is not entirely clear if these are classifications are included
in the mental illness definition or whether they are additional conditions. However, it
appears they are additional and the total consultation rate would increase from 649 to
908 per 100,000 (40% increase). This would increase the consultation rate from 7% to
9.8%. However, this is considerably lower than the 25% figure quoted by others for
consultations related to mental health problems (Goldberg and Bridges 1987). It is likely
that this is due to differing definitions and that reports indicate that only about 30% to
50% of depression in primary care is recognised by GPs (Goldberg and Bridges 1987;
Doherty 1997; Vazquez-Barquero and al 1997; Dixon, Raymond et al. 2006).
Based on the prevalence calculated from the number of consultations from the 1991-
1992 Survey, the estimated number of people in different geographical areas can be
estimated in Hull (using resident population estimates for October 2005 64 ) assuming that
the prevalence estimated above applies to the area for the current year. This
assumption may be incorrect as there might have been an increase in the prevalence for
various reasons, more people may be willing to see their GP about such problems as
acceptance and attitudes towards mental illness may have changed over time, the
64 It would be possible to update this using a more recent population file, but with the potential problems
with the prevalence estimates, the tables only provide a guide only, and for this reason, the population
figures for October 2005 will be sufficient, i.e. the estimates should be treated with caution.
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