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The Scottish Health Survey 2013: Volume 1: Main Report

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1 General Health, Mental Wellbeing and Caring

Linsay Gray and Alastair H Leyland

SUMMARY

Self-assessed general health

  • In 2013, as in previous years, three quarters (74%) of adults (aged 16 and over) assessed their health in general as either 'good' or 'very good,' while 8% assessed their heath as being either 'bad' or 'very bad'.
  • Most children (95%) aged 0-15, in 2013, had general health that was described as either 'good' or 'very good,' while for just 1% it was described as 'bad' or 'very bad'. General health assessments of children have not changed significantly since 2008.
  • Self-assessed general health remained significantly associated with age for both adults and children. For example, while 0% of men and 3% of women aged 16-24 described their health as 'bad' or 'very bad,' the equivalent figures for those aged 75 and over were 18% and 14%, respectively.

Mental wellbeing, depression and anxiety

  • The mean score for adults on the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) in 2013 was 50.0. Mean wellbeing scores have not changed significantly since the scale was introduced in 2008.
  • In 2012/2013, around one in ten (9%) adults had two or more symptoms of depression, indicating moderate to high severity. Prevalence of two or more symptoms of anxiety was also 9%.
  • There has been significant increase in the percentage of adults displaying 1 symptom of depression (from 5% in 2010/2011 to 8% in 2012/2013) coupled with a small drop in the percentage displaying no symptoms (from 86% in 2008/2009 to 83% in 2012/2013). A similar pattern was observed for symptoms of anxiety (11% had one symptom in 2012/2013).

Suicide attempts and self-harm

  • In 2012/2013, 5% of adults reported having attempted suicide at some point in their life, with women (6%) more likely than men (3%) to report having made an attempt.
  • The percentage of adults reporting that they had deliberately self-harmed without suicidal intent at some point in their life was 5% in 2012/2013. Although this represents a significant increase from 2% in 2010/2011 and 3% in 2008/2009, some of this increase may be due to a change in the way the questions have been asked since 2012.

Stress at work

  • In 2013, 14% of adults (aged 16 and over) in paid employment or on government training reported that their job was 'very' or 'extremely stressful'. This has not changed significantly over time.

Unpaid care provision

  • In 2013, 16% of adults aged 16 and over were regular providers of unpaid care to a family member, friend or someone else.
  • Women were more likely than men to provide unpaid care (19% and 13%, respectively), with the gap between men and women most notable for the 35 to 64 age group.
  • Children aged 4-15 were less likely than adults to be unpaid carers, with 4% reporting providing unpaid care in 2013. Caring levels were similar for boys and girls (3% and 4%, respectively), however, children aged 12-15 were much more likely to be carers than those aged 4-11 (8% and 2%, respectively).
  • In 2012/2013, 30% of adult carers provided up to 4 hours of care per week, 36% provided 5-19 hours, while 28% cared for 20 hours or more each week (including 15% who cared for 50 hours or more). The duration of unpaid care provided increased with carers' age.

1.1 INTRODUCTION

This chapter covers two interrelated topics. The first is self-assessed general health and the second is mental health and wellbeing. Both are critical measures of the population's overall health status and are key markers of health inequalities.[1] The chapter also presents figures on the provision of unpaid care to others because of a long-term physical condition, mental ill-health or disability, or problems related to old age.

The World Health Organisation (WHO) considers mental wellbeing to be fundamental to their definition of health.[2] Mental disorders often co-exist with other diseases, including cancers and cardiovascular disease, and many of the risk factors covered in this report, such as obesity, excessive alcohol consumption, and low levels of physical activity, are common to both mental disorders and other non-communicable diseases.

Mental illness represents a significant public health challenge globally. Those with mental disorders have disproportionately higher disability and mortality than the general population, dying on average more than 10 years earlier.[3] Neuropsychiatric disorders are the second largest contributor to the burden of disease in Europe and mental disorders account for around 40% of all years lived with disability.[3] Accounting for 4.3% of the global burden of disease, depression is now the largest single cause of disability worldwide (11% of all years lived with disability globally) and is the leading chronic condition in Europe.[2],[3] Inequalities in mental health and wellbeing exist. Globally, depression is more prevalent among women than men.[2] While throughout Europe, prevalence of most mental disorders is higher among those living in more deprived areas.[3]

The provision of unpaid care to family members, friends or others is not shared equally across social groups, with women more likely to provide care than men, especially between the ages of 35 and 64. The health and wellbeing of carers can be negatively affected by the demands placed upon them, with many carers themselves living with long-term conditions, or experiencing low wellbeing.

1.1.1 Policy background

The Mental Health Strategy for Scotland: 2012-2015,[3] published in August 2012, sets out the Scottish Government's key commitments in relation to improving the nation's mental health and wellbeing and for ensuring improved services and outcomes for individuals and communities. The strategy promotes safe, effective and person-centred health and care. In addition to focussing on improved service delivery there is also a focus on the actions that individuals and communities can take to maintain and improve their own health.

Supporting the Scottish Government's overall purpose, the strategy builds upon the work of a number of key policy documents including Delivering for Mental Health[4] (published in 2006), and Towards a Mentally Flourishing Scotland[5], which preceded the current strategy, and was aimed at promoting good mental wellbeing, reducing the prevalence of common mental health problems, suicide and self-harm, and improving the quality of life of those experiencing mental health problems and mental illnesses.

Coinciding with the end of the Choose Life[6] ten year national strategy on preventing suicide, the Scottish Government demonstrated its ongoing commitment to reducing suicide in the Suicide Prevention Strategy 2013-2016[7] published in December 2013. The strategy is built around five themes: responding to people in distress; talking about suicide; improving the NHS response to suicide; developing the evidence base; and supporting change and improvement.xvi Eleven commitments are included in the strategy, including the commitment that NHS Health Scotland will continue to host the Choose Life National Programme for Suicide Prevention.[7]

One of the Scottish Government's National Outcomes is the overall strategic objective for health: We live longer, healthier lives.[8] This is supported by a number of National Indicators including 'improve self-assessed general health' and 'improve mental wellbeing'.[8] Data from the Scottish Health Survey (SHeS) is used to monitor progress towards both these indicators. In addition, the purpose target to improve healthy life expectancy over the 2007 to 2017 period uses SHeS data for children (aged 0-15) in the calculations used to measure progress. Scotland also has a set of national, sustainable mental health indicators for adults and children, covering both outcomes and contextual factors that confer increased risks of, or protection from, poor mental health outcomes.[9] SHeS is the data source for 28 of the 54 indicators for adults[10] and over 20 of the indicators for children.[11]

There was an NHS Scotland HEAT target to reduce the suicide rate between 2002 and 2013 by 20%.[12] By 2013, the suicide rate declined by 19%, just short of the target.[12] There are additional NHS Scotland HEAT targets for specialist Child and Adolescent Mental Health Services (CAMHS), and for access to Psychological Therapies (across all ages in the population), to achieve 18 week maximum referral to treatment times from December 2014.[13] Figures for the quarter ending September 2014 show that the target was met for 78% of referrals of children and young people. Figures from data at an early stage of development suggest that around 81% of patients (across all ages) starting a psychological therapy met the target during the same period.[13],[14]

The Scottish Government published Caring Together: The Carers Strategy for Scotland 2010-15,[15] in July 2010. Building on the work of an earlier publication, The Future of Unpaid Care in Scotland,[16] the strategy sets out actions to support carers and ensure their health and wellbeing. These include the Scottish Government's commitment to the voluntary sector Short Breaks Fund,[17] and the inclusion of an indicator on carers in the core part of the GP contract.[18] Moreover, the Reshaping Care for Older People Change Fund[19] is supporting the carers of older people in many different ways.

Recognising that children and young people may also provide unpaid care - and are likely to have particular needs - the Scottish Government, along with COSLA, published a separate strategy to support them: Getting it Right for Young Carers,[20] which aims to ensure that young carers are relieved of inappropriate caring roles and supported to be children first and foremost. Questions to ascertain the prevalence of young carers (aged 4-15) were introduced to SHeS in 2012.

1.1.2 Reporting on mental health, wellbeing and unpaid care provision in the Scottish Health Survey (SHeS)

This chapter begins by updating adult and child trends in self-assessed health, a useful measure of how individuals regard their own overall health status. Trends in wellbeing have also been updated for men and women separately. Prevalence of depression and anxiety symptoms among adults in 2012/2013 is compared with prevalence in earlier years of the survey. The chapter then provides the latest figures for self-perceived work-related stress among adults in paid employment or on government training. As only a sub-sample of adults were asked questions on depression, anxiety, self-harm and suicide, the figures presented in this chapter are based on combined years of data to allow for greater accuracy.

The overall prevalence of providing unpaid care in 2013 is presented, with separate figures provided for children (aged 4-15) and adults (aged 16 and over). In addition, the number of hours of unpaid care provided by carers per week is also shown. To increase the precision of these latter estimates, they are based on two years of combined data.

1.2 Methods and definitions

1.2.1 Self-assessed general health

Each year participants aged 13 and over are asked to rate their health in general with possible answer options ranging from 'very good' to 'very bad'. For children under the age of 13 the question is answered by the parent or guardian completing the interview on their behalf. This question is used to monitor the National Indicator 'improve self-assessed health,' while the data on children is used in the calculation of healthy life expectancy used to monitor the purpose target on this. It is also included in both the adult and child mental health indicators sets.[9]

1.2.2 Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)

Wellbeing is measured using the WEMWBS questionnaire. It has 14 items designed to assess: positive affect (optimism, cheerfulness, relaxation) and satisfying interpersonal relationships and positive functioning (energy, clear thinking, self-acceptance, personal development, mastery and autonomy).[21] The scale uses positively worded statements with a five-item scale ranging from '1 - none of the time' to '5 - all of the time'. The lowest score possible is therefore 14 and the highest score possible is 70; the tables present mean scores.

The scale was not designed to identify individuals with exceptionally high or low levels of positive mental health so cut off points have not been developed.[22] The scale was designed for use in English speaking populations, however in a very small number of cases, the questions were translated to enable the participation of people who did not speak English.[23]

WEMWBS is used to monitor the National Indicator 'improve mental wellbeing'.[8] It is also part of the Scottish Government's adult mental health indicator set, and mean score for parents of children aged 15 years and under on WEMWBS is included in the mental health indicator set for children.[9]

1.2.3 Depression and anxiety

Details on symptoms of depression and anxiety are collected via a standardised instrument, the Revised Clinical Interview Schedule (CIS-R). The CIS-R is a well-established tool for measuring the prevalence of mental disorders.[24] The complete CIS-R comprises 14 sections, each covering a type of neurotic symptom and asks about presence of symptoms in the week preceding the interview. Prevalence of two of these neurotic symptoms - depression and anxiety - were introduced to the survey in 2008. Given the potentially sensitive nature of these topics, they were included in the nurse interview part of the survey prior to 2012.[25] Since 2012 the questions have been included in the biological module, with participants completing the questions themselves on the interviewer laptop (CASI).

The following two mental health indicators are based on the depression and anxiety information collected on the survey:

Percentage of adults who have a symptom score of 2 or more on the depression section of the CIS-R.
Percentage of adults who have a symptom score of 2 or more on the anxiety section of the CIS-R.

1.2.4 Suicide attempts

In addition to being asked about symptoms of depression and anxiety, participants were also asked whether they had ever attempted to take their own life. The question was worded as follows:

Have you ever made an attempt to take your own life, by taking an overdose of tablets or in some other way?

Those who said yes were asked if this was in 'the last week, in the last year or at some other time'. Note that this question is likely to underestimate the prevalence of very recent attempts, as people might be less likely to agree to take part in a survey immediately after a traumatic life event such as this and due to underreporting in response to a question administered face to face. Furthermore, suicide attempts will only be captured in a survey among people who do not succeed at their first attempt.

Since 2012 the questions have been included in the biological module, with participants completing the questions themselves on the interviewer laptop (CASI).

1.2.5 Deliberate self-harm

Since 2008, participants have been asked whether they have ever deliberately harmed themselves in any way but not with the intention of killing themselves. Those who said that they had deliberately self-harmed were also asked if this was in the last week, last year or at some other time. The percentage of adults who have deliberately harmed in the last year is one of the national mental health indicators for adults.[9]

Since 2012 the questions have been included in the biological module, with participants completing the questions themselves on the interviewer laptop (CASI).

1.2.6 Self-perceived work related stress

In 2009, 2011 and 2013, the survey also included a series of questions on working life from the adult mental health indicators set.[10] As work is considered to be an important contextual factor associated with mental health, adults in paid employment or on a government training scheme were asked questions about their experience of stress at work, as well as their work/life balance, and working conditions. Results for the question on stress at work are included in this chapter.

1.2.7 Provision of unpaid care

The provision of unpaid care is measured by asking participants if they look after, or give any regular help or support to, family members, friends, neighbours or others because of a long-term physical condition, mental ill-health or disability; or problems related to old age. Caring which is done as part of any paid employment is not asked about. This question has been asked of adults aged 16 and over since 2008, and of children aged 4 to 15 since 2012. Those who say they provide such care are then asked how many hours per week they typically provide. Additional questions, not reported here, explore the support available to carers, and the impact that caring has on activities such as employment.

1.3 SELF-ASSESSED GENERAL HEALTH

1.3.1 Trends in self-assessed general health among adults since 2008

The proportion of adults (aged 16 and over) self-reporting 'good' or 'very good' general health has been relatively constant since 2008 (between 74% and 77%), as presented in Table 1.1. Similarly, in the last six years there has been very little change in the percentage assessing their health as 'bad' or 'very bad' (7% in 2008 to 2011; 9% in 2012 and 8% in 2013). Self-assessed general health has been stable among both men and women over this period. Table 1.1

1.3.2 Trends in self-assessed general health among children since 2008

The proportion of children (aged under 16) reported to be in 'good' or 'very good' general health has also remained stable since 2008 (95% in both 2008 and 2013). Between 2008 and 2013, the general health of just 0-1% of children was described as 'bad' or 'very bad'. While the percentage in 'very good' health increased significantly between 2008 and 2011, prevalence had returned to 2008 levels by 2013 (66%). Self-reported general health has been relatively stable over the years for both boys and girls. Table 1.1

1.3.3 Self-assessed general health among adults in 2013, by age and sex

In 2013, one in three (34%) adults assessed their health in general as 'very good', and a further 40% described theirs as 'good'. Overall, 8% assessed their general heath as 'bad' or 'very bad'. Men and women's assessments of their general health were not significantly different from each other in 2013 (75% of men and 74% of women reported that their health in general was 'good' or 'very good').

As expected, there were strong age-related patterns to self-assessed general health (Figure 1A). Younger people were more likely than older age groups to describe their health as 'good' or 'very good' in 2013, as in previous years. For example, 93% of men aged 16-24 described their health as 'good' or 'very good' compared with 49% of those aged 75 and over; the respective figures for women were 86% and 56%. As shown in Figure 1A, the prevalence of 'bad' or 'very bad' health was negligible for the youngest age group (0% for men and 3% for women), compared with 18% of men and 14% of women aged 75 and over. This age-related pattern was more pronounced among men. Figure 1A, Table 1.2

Figure 1A Percantage of adults (aged 16+) with 'bad' or 'very bad' self-reported general health, 2013, by age and sex

1.3.4 Self-assessed general health among children in 2012/2013 combined, by age and sex

Overall, in 2012/2013, two in three (67%) children aged 0-15 had general health that was described as 'very good', and a further 27% were described as being in 'good' health. The general health of 5% of children was described as 'fair', while for just 1% it was described as 'bad' or 'very bad'. The general health of boys and girls was very similar in 2013, with 94% of boys and 95% of girls in either 'good' or 'very good' health, and just 1% of both boys and girls described as being in either 'bad' or 'very bad' health.

General health assessments varied significantly by age for children, with the percentage reported to be in 'very good' health higher among younger children and lower among those aged 12 and over (Figure 1B). For example, the general health of 66-74% of boys aged under 12 was reported to be 'very good', compared with 53-56% of those aged 12-15. More markedly, the general health of 65-73% of girls under 13 was reported as 'very good' compared with 48% of those aged 14-15. Figure 1B, Table 1.3

Figure 1B Percentage of children (aged 0-15) with 'very good' self-reported general health, 2012/2013 combined, by age and sex

1.4 WELLBEING

1.4.1 Trends in adult mean WEMWBS score since 2008

Table 1.4 demonstrates that mean scores for the WEMWBS measure of wellbeing have been relatively stable over the last six years, with only minor, non-significant, fluctuations since 2008 (50.0 in both 2008 and 2013). Wellbeing scores have not changed significantly for either sex since 2008 (ranging between 49.9 and 50.4 in men and between 49.4 and 49.7 in women). Table 1.4

1.4.2 Adult mean WEMWBS score in 2013, by age and sex

At 50.3, the WEMWBS mean score for men in 2013 was not significantly different to the score for women (49.7).

As found in previous survey years,[26] positive wellbeing has a non-linear age-related pattern. Among men, those aged 25-34 (51.1) and 65-74 (51.3) had the highest mean WEMWBS scores while those aged 45-54 (49.1) had the lowest (Figure 1C). For women, those aged 25-34 (50.4) and 65-74 (50.9) had the highest mean scores, while those aged 45-54 (48.7), along with those aged 16-24 (48.6), had the lowest. While survey data from a single year are cross-sectional and thus unable to detect age-related changes within cohorts, this pattern fits broadly with the recognised U-shaped curve in subjective wellbeing, in which levels of self-reported subjective wellbeing fall during the middle years of life.[27] Figure 1C, Table 1.5

Figure 1C WEMWBS mean score, 2013, by age and sex

1.5 DEPRESSION AND ANXIETY

1.5.1 Trends in symptoms of depression since 2008/2009

In 2012/2013, around one in ten (9%) adults had two or more symptoms of depression, indicating moderate to high severity; the equivalent figure in both 2008/2009 and 2010/2011 (8%) was very similar. There has, however, been a small but statistically significant decrease in the percentage of adults exhibiting no symptoms of depression (from 86% in 2008/2009 to 83% in 2012/2013), coupled with a corresponding increase in the prevalence of 1 symptom (from 5% in 2008/2009 and 2010/2011 to 8% in 2012/2013).

While the observed differences for women over the years were not statistically significant, there have been some significant changes in prevalence for men. Since 2008/2009 there has been a significant decline in the percentage of men exhibiting no depressive symptoms (from 89% to 84%). This decline was coupled with a corresponding increase in the percentage exhibiting one symptom (4% in 2008/2009 and 7% in 2012/2013). The observed increase in the percentage of men with 2 or more symptoms was not statistically significant (7% in 2008/2009 and 9% in 2012/2013). Table 1.6

1.5.2 Trends in symptoms of anxiety since 2008/2009

The percentage of adults with two or more symptoms of anxiety, indicating moderate to high severity, has not changed significantly since 2008/2009 (9% in 2008/2009 and 9% in 2012/2013). There has, however, been a significant decrease in the percentage of adults exhibiting no symptoms of anxiety (from 83% in 2008/2009 to 79% in 2012/2013) and a small but significant increase in prevalence of one symptom (from 9% in 2008/2009 and 7% in 2010/2011 to 11% in 2012/2013).

Across the years, the percentage of women exhibiting two or more symptoms of anxiety has always been higher than for men (12% and 7% in 2012/2013). Prevalence of one symptom has also been higher for women than for men (14% and 8%, respectively in 2012/2013).

Table 1.6

1.6 SUICIDE ATTEMPTS AND DELIBERATE SELF-HARM

1.6.1 Trends in suicide attempts since 2008/2009

In 2012/2013, 5% of adults reported having attempted suicide at some point in their life (Table 1.6); similar to levels in 2010/2011 (5%) and 2008/2009 (4%). While death records for the general population indicate that men are markedly more likely than women to complete a suicide,[28] when asked, women are more likely to report having made an attempt (6%, compared with 3% of men in 2012/2013). This is in line with findings from previous years.[26]

Table 1.6

1.6.2 Trends in deliberate self-harm since 2008/2009

In 2012/2013, 5% of adults aged 16 and over reported that at some point in their life they had deliberately harmed themselves without suicidal intent. This represents a significant increase in deliberate self-harm since 2010/2011, when 2% reported having done it at some point (3% in 2008/2009). Deliberate self-harm levels did not differ significantly between men and women (4% and 6%, respectively).

Table 1.6

1.7 INTERPRETING THE RECENT TRENDS IN MENTAL HEALTH

As already noted,[25] in 2012 the questions on depression, anxiety, suicide attempts and self-harm (all reported above) switched from being asked face-to-face by nurses, to being asked in a computer-assisted self-completion, as part of the biological module. The 2011 SHeS report noted that the prevalence of self-harm is typically higher when asked about in a self-completion rather than a face-to-face interview.[29] As the questions moved to a self-completion from 2012 onwards it is therefore possible that this change in interview mode contributed to the increase in prevalence. Similarly, we cannot discount the possibility that the decrease in the proportion of men reporting no depression symptoms, and in women reporting no anxiety symptoms, was caused by the change in interview mode. However, the static figures for suicide attempts suggest that the issue of mode effects and reporting biases operate in complex ways. The figures from the 2014 survey onwards will help to establish whether the 2012/2013 results are outliers, or are in fact evidence that earlier figures in the series were perhaps underrepresenting the prevalence of some of these outcomes in the population.

1.8 Self-perceived work-related stress

1.8.1 Trends in self-perceived work-related stress since 2009

The figures presented in Table 1.7 show that the percentage of adults (aged 16 and over) reporting that their jobs were 'very' or 'extremely stressful' has not changed significantly over time for those in paid employment or on a government training scheme (14% in 2013, 15% in 2011 and 14% in 2009). Similarly, there has been no change in the proportion of adults describing their job as 'not at all' stressful (18% in 2013 and 19% in 2009).

In addition to the 14% of adults in paid employment or on a government training programme who reported that their job was 'very' or 'extremely stressful,' around a third (32%) described their job as 'moderately stressful' and a similar proportion (35%) reported that theirs was 'mildly stressful'. Just under a fifth (18%) did not find their job at all stressful. There was no significant difference between the percentage of men and women reporting that their job was 'very' or 'extremely stressful' (13% and 15%, respectively). Table 1.7

1.9 PROVISION OF UNPAID CARE

1.9.1 Unpaid caring prevalence in 2013, by age and sex

Table 1.8 presents the prevalence of unpaid care provision in 2013, by age group. Among those aged 16 and over, 16% said they were providing unpaid care for a family member, friend or someone else, with women more likely to report this than men (19% and 13%, respectively). As previously reported,[26] the gap between the proportion of men and women providing unpaid care was largest for those aged 35 to 64. Unpaid care provision increases with age peaking at age 55-64 (19% of men, 28% of women), and then declined among the oldest age groups.

Children aged 4-15 were much less likely than adults to provide unpaid care for others, with 4% reporting this in 2013. Caring levels were very similar for boys and girls aged 4 to 15 (3% and 4%, respectively). There was, however, a notable increase in care provision with increased age, from 2% of those aged 4-11 to 8% of those aged 12-15. Table 1.8

Table list

Table 1.1 Self-assessed general health, adults and children, 2008 to 2013
Table 1.2 Adult self-assessed general health, 2013, by age and sex
Table 1.3 Child self-assessed general health, 2012/2013 combined, by age and sex
Table 1.4 WEMWBS mean scores, 2008 to 2013
Table 1.5 WEMWBS mean scores, 2013, by age and sex
Table 1.6 CIS-R anxiety and depression scores, suicide attempts and deliberate selfharm, 2008 to 2013
Table 1.7 Stress at work, 2009 to 2013
Table 1.8 Caring prevalence, 2013, by age and sex

Additional tables available on the survey website include:

  • Self-assessed general health, adults and children, by age & key demographics
  • Life satisfaction, by age & key demographics
  • Mean life satisfaction score, by age & key demographics
  • Adult mean WEMWBS score, by age & key demographics
  • Adult GHQ score (grouped), by age & key demographics
  • Adult GHQ mean score, by age & key demographics
  • Provides any regular help or care for any sick, disabled or frail person, by age & key demographics
  • Hours spent each week providing help or unpaid care, by age & key demographics
  • Length of time providing unpaid care, by age & key demographics
  • Whether employment affected by unpaid caring responsibilities, by age & key demographics
  • Sources of support as a carer, by age & key demographics

Table 1.1 Self-assessed general health, adults and children, 2008 to 2013

All ages

2008 to 2013

Self-assessed general health

2008

2009

2010

2011

2012

2013

%

%

%

%

%

%

Men

Very good

37

37

35

37

36

34

Good

39

40

41

41

39

41

Fair

16

16

17

16

17

17

Bad

6

6

5

5

6

6

Very bad

2

1

2

2

2

2

Good/Very good

76

77

76

77

75

75

Bad/very bad

7

7

7

7

8

8

Women

Very good

35

36

35

36

32

34

Good

40

41

39

39

41

40

Fair

19

17

18

18

18

18

Bad

5

6

6

6

7

7

Very bad

2

1

2

2

2

2

Good/Very good

75

77

74

74

73

74

Bad/very bad

7

7

8

8

9

9

All adults

Very good

36

36

35

36

34

34

Good

39

40

40

40

40

40

Fair

17

16

18

17

17

17

Bad

5

6

6

6

7

6

Very bad

2

1

2

2

2

2

Good/Very good

75

77

75

76

74

74

Bad/very bad

7

7

7

7

9

8

Boys

Very good

68

69

65

69

65

68

Good

26

27

29

27

29

26

Fair

5

4

5

4

6

5

Bad

1

0

1

0

0

1

Very bad

0

0

0

-

0

0

Good/Very good

94

96

94

96

94

94

Bad/very bad

1

0

1

0

0

1

Girls

Very good

65

68

65

70

70

64

Good

31

27

29

26

25

30

Fair

4

4

4

3

5

4

Bad

1

1

1

1

1

1

Very bad

0

-

0

0

-

-

Good/Very good

96

95

95

96

95

95

Bad/very bad

1

1

1

1

1

1

All children

Very good

66

68

65

70

68

66

Good

29

27

29

27

27

28

Fair

4

4

5

3

5

5

Bad

1

0

1

1

0

1

Very bad

0

0

0

0

0

0

Good/Very good

95

95

94

96

94

95

Bad/very bad

1

1

1

1

0

1

Bases (weighted):

Men

3087

3598

3464

3608

2309

2344

Women

3376

3926

3775

3932

2504

2546

All adults

6463

7524

7239

7541

4813

4890

Boys

896

1333

916

1015

912

940

Girls

854

1273

876

970

873

899

All children

1750

2606

1792

1985

1786

1839

Bases (unweighted):

Men

2840

3285

3112

3279

2127

2138

Women

3622

4241

4128

4262

2686

2753

All adults

6462

7526

7240

7541

4813

4891

Boys

872

1333

960

998

878

948

Girls

878

1272

832

987

908

891

All children

1750

2605

1792

1985

1786

1839

Table 1.2 Adult self-assessed general health, 2013, by age and sex

Aged 16 and over

2013

Self-assessed general health

Age

Total

16-24

25-34

35-44

45-54

55-64

65-74

75+

%

%

%

%

%

%

%

%

Men

Very good

51

42

37

33

30

23

12

34

Good

42

47

45

43

36

33

37

41

Fair

7

10

13

15

21

31

33

17

Bad

0

1

4

6

9

11

13

6

Very bad

-

-

2

2

4

2

5

2

Good/Very good

93

88

81

76

65

56

49

75

Bad/very bad

0

1

6

9

13

13

18

8

Women

Very good

41

41

40

36

28

26

19

34

Good

45

41

41

35

39

40

37

40

Fair

11

14

13

16

20

22

30

18

Bad

3

2

3

10

10

11

11

7

Very bad

-

2

2

2

2

2

2

2

Good/Very good

86

82

81

71

68

66

56

74

Bad/very bad

3

4

5

12

13

13

14

9

All Adults

Very good

46

41

38

34

29

24

16

34

Good

43

44

43

39

38

37

37

40

Fair

9

12

13

16

21

26

32

17

Bad

1

2

4

8

10

11

12

6

Very bad

-

1

2

2

3

2

3

2

Good/Very good

89

85

81

74

67

61

53

74

Bad/very bad

1

3

6

10

13

13

15

8

Bases (weighted):

Men

339

367

387

438

366

269

178

2344

Women

334

389

412

462

383

303

264

2546

All adults

673

756

799

900

749

572

442

4890

Bases (unweighted):

Men

207

310

339

395

353

318

216

2138

Women

242

419

432

540

442

373

305

2753

All adults

449

729

771

935

795

691

521

4891

Table 1.3 Child self-assessed general health, 2012/2013 combined, by age and sex

Aged 0 - 15

2012/2013 combined

Self-assessed general health

Age

Total

0-1

2-3

4-5

6-7

8-9

10-11

12-13

14-15

%

%

%

%

%

%

%

%

%

Boys

Very good

72

66

71

72

74

71

56

53

67

Good

24

29

24

22

21

25

32

41

27

Fair

4

4

4

7

5

4

11

6

5

Bad

-

0

1

-

-

-

2

-

0

Very Bad

-

1

0

-

-

-

-

-

0

Good/Very good

96

95

95

93

95

96

88

94

94

Bad/very bad

-

1

1

-

-

-

2

-

1

Girls

Very good

73

72

73

72

65

67

65

48

67

Good

21

23

23

25

31

29

30

43

28

Fair

6

5

3

2

3

3

5

7

4

Bad

0

-

2

0

1

1

0

2

1

Very Bad

-

-

-

-

-

-

-

-

-

Good/Very good

93

95

95

97

96

96

94

91

95

Good/Very good

96

95

95

93

95

96

88

94

94

Bad/very bad

-

1

1

-

-

-

2

-

1

All children

Very good

73

69

72

72

70

69

60

50

67

Good

22

26

23

23

26

27

31

42

27

Fair

5

4

3

5

4

3

8

7

5

Bad

0

0

1

0

1

1

1

1

1

Very Bad

-

0

0

-

-

-

-

-

0

Good/Very good

95

95

95

95

96

96

91

93

94

Bad/very bad

0

0

2

0

1

1

1

1

1

Bases (weighted):

Boys

220

252

242

221

222

231

238

226

1852

Girls

221

234

242

220

191

232

236

196

1772

All children

441

486

484

441

413

463

474

422

3625

Bases (unweighted):

Boys

244

258

250

217

229

203

214

211

1826

Girls

251

267

252

226

197

203

213

190

1799

All children

495

525

502

443

426

406

427

401

3625

Table 1.4 WEMWBS mean scores, 2008 to 2013

Aged 16 and over

2008 to 2013

WEMWBS scoresa

2008

2009

2010

2011

2012

2013

Men

Mean

50.2

49.9

50.2

50.2

50.4

50.3

SE of the mean

0.20

0.16

0.19

0.19

0.24

0.25

Standard deviation

8.55

8.02

8.37

8.35

8.34

8.56

Women

Mean

49.7

49.7

49.6

49.7

49.4

49.7

SE of the mean

0.16

0.16

0.17

0.17

0.22

0.21

Standard deviation

8.48

8.51

8.67

8.37

8.63

8.70

All Adults

Mean

50.0

49.7

49.9

49.9

49.9

50.0

SE of the mean

0.14

0.12

0.14

0.14

0.18

0.17

Standard deviation

8.52

8.28

8.54

8.36

8.50

8.65

Bases (weighted):

Men

2785

3282

3171

3191

2063

2110

Women

3026

3586

3478

3540

2256

2351

All adults

5812

6868

6649

6731

4319

4461

Bases (unweighted):

Men

2539

2994

2842

2900

1909

1938

Women

3248

3886

3805

3845

2431

2561

All adults

5787

6880

6647

6745

4340

4499

a WEMWBS scores range from 14 to 70. Higher scores indicate greater wellbeing. Mean WEMWBS score is part of the national mental health indicator set for adults

Table 1.5 WEMWBS mean scores, 2013, by age and sex

Aged 16 and over

2013

WEMWBS scoresa

Age

Total

16-24

25-34

35-44

45-54

55-64

65-74

75+

Men

Mean

50.5

51.1

50.0

49.1

50.5

51.3

49.5

50.3

SE of the mean

0.69

0.56

0.63

0.53

0.58

0.54

0.73

0.25

Standard deviation

8.00

7.49

8.58

8.88

9.14

8.73

9.09

8.56

Women

Mean

48.6

50.4

50.1

48.7

49.9

50.9

49.7

49.7

SE of the mean

0.62

0.45

0.48

0.48

0.48

0.61

0.52

0.21

Standard deviation

8.37

8.36

8.60

9.28

8.69

9.44

7.65

8.72

All Adults

Mean

49.6

50.7

50.1

48.9

50.2

51.1

49.7

50.0

SE of the mean

0.48

0.36

0.42

0.39

0.36

0.44

0.47

0.17

Standard deviation

8.23

7.96

8.58

9.09

8.91

9.11

8.24

8.65

Bases (weighted):

Men

303

336

346

402

331

245

147

2110

Women

300

362

392

437

357

284

219

2351

All adults

603

699

738

839

687

529

365

4461

Bases (unweighted):

Men

185

283

305

368

322

293

182

1938

Women

221

393

412

514

416

350

255

2561

All adults

406

676

717

882

738

643

437

4499

a WEMWBS scores range from 14 to 70. Higher scores indicate greater wellbeing. Mean WEMWBS score is part of the national mental health indicator set for adults

Table 1.6 CIS-R anxiety and depression scores, attempted suicide and deliberate self-harm, 2008 to 2013

Aged 16 and over and participated in nurse visit (2008-2011) or biological module (2012-2013)

2008 to 2013

Mental health problem

2008/2009 combined

2010/2011 combined

2012/2013 combined

%

%

%

Men

Depression symptom score

0

89

89

84

1

4

4

7

2 or more symptomsa

7

7

9

Anxiety symptom score

0

87

87

85

1

6

5

8

2 or more symptomsb

7

8

7

Suicide attempts

No

97

96

97

Yes

3

4

3

Deliberate self-harm

No

98

98

96

Yes

2

2

4

Women

Depression symptom score

0

84

85

82

1

6

6

10

2 or more symptomsa

10

9

8

Anxiety symptom score

0

78

81

74

1

11

9

14

2 or more symptomsb

11

10

12

Suicide attempts

No

94

94

94

Yes

6

6

6

Deliberate self-harm

No

96

97

94

Yes

4

3

6

All adults

Depression symptom scorec

0

86

87

83

1

5

5

8

2 or more symptomsa

8

8

9

Anxiety symptom scored

0

83

84

79

1

9

7

11

2 or more symptomsb

9

9

9

Suicide attempts

No

96

95

95

Yes

4

5

5

Deliberate self-harm

No

97

98

95

Yes

3

2

5

Bases (weighted):

Men

1066

972

1051

Women

1154

1059

1129

All adults

2220

2031

2179

Bases (unweighted):

Men

974

875

971

Women

1246

1155

1214

All adults

2220

2030

2185

a Two or more symptoms indicate depression of moderate to high severity
b Two or more symptoms indicate anxiety of moderate to high severity
c Percentage of adults with a score of 2+ on depression section of CIS-R is part of the national mental health indicator set for adults
d Percentage of adults with a score of 2+ on anxiety section of CIS-R is part of the national mental health indicator set for adults

Table 1.7 Stress at work, 2009 to 2013

Aged 16 and over in paid employment / government training programme

2009, 2011, 2013

Stress at work

2009

2011

2013

%

%

%

Men

Not at all stressful

21

17

19

Mildly stressful

30

36

35

Moderately stressful

36

32

33

Very stressful

9

11

10

Extremely stressful

3

3

3

Very stressful/Extremely stressfula

13

15

13

Women

Not at all stressful

16

19

18

Mildly stressful

34

32

35

Moderately stressful

34

35

32

Very stressful

12

12

13

Extremely stressful

4

2

2

Very stressful/Extremely stressfula

16

14

15

All adults

Not at all stressful

19

18

18

Mildly stressful

32

34

35

Moderately stressful

35

33

32

Very stressful

11

12

11

Extremely stressful

4

3

3

Very stressful/Extremely stressfula

14

15

14

Bases (weighted):

Men

771

677

672

Women

673

647

635

All adults

1444

1324

1307

Bases (unweighted):

Men

655

581

583

Women

702

674

677

All adults

1357

1255

1260

a Percentage of adults who find their job very or extremely stressful is part of the national mental health indicator set for adults

Table 1.8 Caring prevalence, 2013, by age and sex

Aged 4 and over

2013

Regular carera

Age

Total 16+

4-11

12-15

Total 4-15

16-24

25-34

35-44

45-54

55-64

65-74

75+

%

%

%

%

%

%

%

%

%

%

%

Male

Provides regular care

1

8

3

9

9

10

15

19

17

13

13

Female

Provides regular care

2

7

4

14

12

21

25

28

20

9

19

All

Provides regular care

2

8

4

12

10

16

20

23

19

11

16

Bases (weighted):

Male

476

225

701

339

367

387

438

366

269

178

2345

Female

462

214

676

334

389

412

462

383

303

265

2547

All persons

938

439

1376

673

756

799

900

749

572

443

4891

Bases (unweighted):

Male

478

202

680

207

310

339

395

353

318

217

2139

Female

445

183

628

242

419

432

540

442

373

306

2754

All persons

923

385

1308

449

729

771

935

795

691

523

4893

a Provides regular help or care for any person for reasons of long-term ill-health, disability or problems relating to old age (excluding caring done as part of paid employment)