Mental Health and Wellbeing Strategy: Initial Monitoring Report and Monitoring Framework
The first monitoring report outlining progress towards Scotland’s Mental Health and Wellbeing Strategy outcomes, supported by an accompanying monitoring framework.
Summary Outcome 1: The overall mental health and wellbeing of the population is increased, and mental health inequalities are reduced.
Background
Summary Outcome 1 (SO1) of the Mental Health and Wellbeing Strategy focuses on improving the overall mental health and wellbeing of people in Scotland and reducing mental health inequalities. The outcome is central to the Strategy’s vision of a Scotland free from stigma and inequality, where everyone can realise their right to the best possible mental health and wellbeing.
Metrics for monitoring SO1 are grouped under two core components of the outcome:
- Improving the overall mental health and wellbeing of the population
- Reducing mental health inequalities
Table 3 presents the specific metrics grouped under each component.
Table 3. Metrics for Monitoring Summary Outcome 1
|
Core components |
Metrics |
|
Improving the overall mental health and wellbeing of the population |
|
|
Reducing mental health inequalities |
|
The following sections present each of these components and associated metrics in detail, offering insight into baseline measures and observed changes related to SO1.
1. Improving the overall mental health and wellbeing of the population
The first component of Summary Outcome 1 focuses on improving the overall mental health and wellbeing of the population. There are six metrics used to monitor this component.
Average mental wellbeing scores of adults
The Scottish Health Survey (SHeS) reports on mental wellbeing in Scotland using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). WEMWBS asks individuals to rate 14 positively worded statements about their mental health, resulting in a total score between 14 and 70. Higher scores indicate better mental wellbeing.
In SHeS 2024, the average adult WEMWBS score was 48.5, an increase from the baseline score of 47.0 in 2022. This increase is statistically significant.
Percentage of adults reporting high life satisfaction scores
Tracking life satisfaction scores for the adult population provides valuable insights into the general sense of well-being across Scotland. SHeS measures life satisfaction by asking adults to rate how satisfied they are with their life overall, using a scale from 0 (extremely dissatisfied) to 10 (extremely satisfied). Although there are no specific thresholds for interpreting the scale, SHeS uses the following categories to summarise responses:
- High satisfaction: scores of 9 or 10
- Average satisfaction: score of 8
- Below average satisfaction: scores of 0 to 7
This report uses the proportion of adults reporting high satisfaction (scores of 9 or 10) for monitoring progress on Summary Outcome 1.
In SHeS 2024, 31% of adults in Scotland reported high life satisfaction, up from 30% in the baseline year of 2022. However, this increase is not statistically significant.
Percentage of adults with a possible psychiatric disorder
SHeS reports on the prevalence of possible psychiatric disorders using the General Health Questionnaire (GHQ-12). This is a standardised scale that measures mental distress and ill-health by asking people questions about concentration, sleep patterns, self-esteem, stress, despair, depression, and confidence over the past few weeks. A score of 4 or higher on the GHQ-12 suggests the presence of a possible psychiatric disorder.
In SHeS 2024, 22% of adults in Scotland recorded a GHQ-12 score of 4 or more, indicating a possible psychiatric disorder. This represents a statistically significant decrease from 27% in the baseline year of 2022.
Percentage of adults with symptoms of anxiety and depression
SHeS reports on symptoms of anxiety and depression every two years, using the Clinical Interview Schedule – Revised (CIS-R). This tool measures a range of emotional and behavioural symptoms related to depression (such as low mood and reduced enjoyment) and anxiety (including nervousness and tension). The most recent data come from the combined 2023/2024 dataset, with baseline data from the combined 2021/2022 dataset.
- In 2023/2024, 16% of adults had two or more symptoms of anxiety, a decrease of 1 percentage point from 17% in 2021/22.
- In 2023/2024, 10% of adults had two or more symptoms of depression, a statistically significant decrease of 3 percentage points from 13% in 2021/22.
Prevalence rate of mental health conditions for GP patients
Public Health Scotland (PHS) publishes data on disease prevalence rates on selected conditions for patients across general practices. Prevalence rates refer to the proportion of people, out of every 100 registered patients, who have been recorded as having a particular condition.
The PHS dataset does not include every general practice in Scotland, but it covers the vast majority. The most recent information is available from 847 practices, which accounts for over 95% of the 886 practices listed in the April 2025 GP Practice Contact Details and List Sizes publication. In terms of population coverage, this represents over 96% of all patients registered with a GP in Scotland.
For mental health, the dataset reports on three specific conditions:
- Depression
- Eating disorders
- Severe mental illness, which includes schizophrenia, bipolar affective disorder, other psychoses, or patients who have been prescribed Lithium within the past six months and not discontinued.
GP patient data shows that in 2025:
- Depression: 15 per 100 registered GP patients were recorded as having depression, slightly down from 15.2 in the baseline year of 2022.
- Eating disorders: 0.6 per 100 registered GP patients were recorded as having an eating disorder, unchanged from the 2022 baseline.
- Severe mental illness: 1.1 per 100 registered GP patients were recorded as having severe mental illness, unchanged from the 2022 baseline.
Percentage of adults who have ever deliberately self-harmed
SHeS reports on adults who have ever deliberately self-harmed. Self-harm is not a mental health condition or illness but a range of behaviours that can be an indicator of poorer mental health and wellbeing (Scottish Government, 2023a). The most recent data come from the combined 2023/2024 dataset, with baseline data from the combined 2021/2022 dataset.
In 2023/2024, 8% of adults in Scotland reported having ever deliberately self-harmed, a decrease of 2 percentage points from 10% in 2021/2022. However, this change is not statistically significant.
2. Mental health inequalities
The second component of Summary Outcome 1 focuses on reducing mental health inequalities. There are six metrics used to monitor this component. Where data is available, these metrics are disaggregated by population groups providing insight into how mental health outcomes vary across different groups within the population and help to identify where inequalities persist.
Average mental wellbeing scores, by population group
Data from SHeS 2024 provides insight into how mental wellbeing, as measured by WEMWBS, varies across population groups. The 2022 SHeS dataset is used as the baseline.
Sex
In 2024, the average WEMWBS score for men was 48.7, an increase from 47.7 at the 2022 baseline. For women, scores rose from 46.5 to 48.3 over the same period. This represents a statistically significant increase in wellbeing scores for both men and women.
Age
In 2024, adults aged 65–74 had the highest average mental wellbeing score (50.4), while those aged 45–54 had the lowest (47.4). Table 4 shows average score changes across all age groups. Statistically significant improvements between 2022 and 2024 were observed for the 25–34, 35 - 44, and 45 - 55 age groups. Adults aged 65–74 had significantly higher average mental wellbeing scores than those in most other age groups in 2024 (16–24, 35–44, 45–54,55–64 and 75+).
Table 4: Average mental wellbeing scores by age group, 2022 and 2024
|
Age group |
2022 (Baseline) |
2024 |
Score change between 2022 and 2024 |
|
16-24 |
46.5 |
47.7 |
+1.2 |
|
25-34 |
46.0 |
49.1 |
+3.1 |
|
35-44 |
46.4 |
48.0 |
+1.6 |
|
45-54 |
45.5 |
47.4 |
+1.9 |
|
55-64 |
47.1 |
47.9 |
+0.8 |
|
65-74 |
49.8 |
50.4 |
+0.6 |
|
75+ |
49.3 |
49.2 |
-0.1 |
Source: Scottish Health Survey
Area deprivation
In 2024, adults living in the most deprived areas of Scotland reported lower average mental wellbeing score (45.1) compared with those in the least deprived areas (50.0). These differences are statistically significant.
Limiting long-term condition
In 2024, adults with a limiting long-term condition reported a lower average mental wellbeing score (44.3) than those with a non-limiting condition (50.1) and those with no long-term conditions (51.0). While average scores have improved across all groups since 2022, a statistically significant gap in mental wellbeing remains between those with and without limiting conditions.
Percentage of adults reporting high life satisfaction scores, by population group
Data from SHeS 2024 provides insight into how life satisfaction varies across population groups, with 2022 used as the baseline. Life satisfaction is measured by asking participants to rate their satisfaction with life overall on a scale from 0 to 10, with scores of 9 or 10 considered indicative of high life satisfaction.
Sex
In 2024, 32% of men reported high life satisfaction (scores of 9 or 10), up slightly from 31% in 2022. Among women, 30% reported high life satisfaction in 2024, compared with 29% in 2022. These small differences between men and women, and the changes since 2022, are not statistically significant.
Age
In 2024, the proportion of adults reporting high life satisfaction (scores of 9 or 10) varied by age group. The highest proportion was among those aged 65–74 (35%), and the lowest among those aged 35–44 (27%). In 2024, high life satisfaction in those aged 65-74 was statistically significantly higher than those aged 35-44. This contrasts with 2022, when adults aged 65–74 had significantly higher levels of high life satisfaction than all other age groups.
When comparing 2024 with 2022, none of the changes in high life satisfaction across age groups were statistically significant. Table 5 presents the proportions of adults reporting high life satisfaction across all age groups.
Table 5: Percentage of adults who rate their life satisfaction as high by age group, 2022 and 2024
|
Age group |
2022 (Baseline) |
2024 |
Percentage change between 2022 and 2024 |
|
16-24 |
27% |
32% |
+5% |
|
25-34 |
26% |
29% |
+3% |
|
35-44 |
30% |
27% |
-3% |
|
45-54 |
26% |
30% |
+4% |
|
55-64 |
31% |
32% |
+1% |
|
65-74 |
39% |
35% |
-4% |
|
75+ |
32% |
33% |
+1% |
Source: Scottish Health Survey
Area Deprivation
In 2024, 18% of adults living in the most deprived areas of Scotland reported high life satisfaction, compared with 37% in the least deprived areas. In 2022, the figures were 23% and 34%, respectively.
Across all years from 2022 to 2024, adults in the least deprived areas consistently reported statistically significantly higher levels of high life satisfaction than those in the most deprived areas.
Limiting long-term condition
In 2024, 18% of adults with a limiting long-term condition reported high life satisfaction, compared to 37% of those with a non-limiting condition and 40% of those with no long-term condition. Although the proportions increased slightly for all groups compared with 2022, none of the changes over time were statistically significant, and the gap between those with limiting conditions and those without has remained broadly unchanged.
Percentage of adults with a possible psychiatric disorder, by population group
Data from SHeS 2024 provides insight into how the presence of a possible psychiatric disorder, as measured by GHQ-12 score of 4 or more, varies across population groups. The 2022 SHeS dataset is used as the baseline.
Sex
In 2024, 25% of women and 18% of men scored 4 or more on the GHQ-12. This represents a decrease from 2022, when 31% of women and 22% of men met this threshold. This is a statistically significant improvement for women and men. Despite the overall improvement, a persistent gender gap remains, with women reporting significantly higher levels of psychological distress than men.
Age
In 2024, the proportion of adults with a GHQ-12 score of 4 or more varied by age group. The highest proportion was among those aged 16–24 (27%), while the lowest proportions were among those aged 65–74 and 75+ (both 16%). These differences were statistically significant.
This contrasts with 2022, when adults aged 16–24, 45–54, and 55–64 had higher levels of psychological distress than those aged 65–74, with these differences being statistically significant.
When comparing 2024 with 2022, none of the changes in GHQ-12 scores across age groups were statistically significant, although most age groups showed a numerical decrease in the proportion scoring 4 or more. Table 6 presents the proportions across all age groups.
Table 6: Percentage of adults with a GHQ-12 score of 4 or more by age group, 2022 and 2024
|
Age group |
2022 (Baseline) |
2024 |
Percentage change between 2022 and 2024 |
|
16-24 |
35% |
27% |
-8% |
|
25-34 |
29% |
23% |
+6% |
|
35-44 |
27% |
22% |
-5% |
|
45-54 |
31% |
24% |
-7% |
|
55-64 |
29% |
23% |
-6% |
|
65-74 |
18% |
16% |
-2% |
|
75+ |
22% |
16% |
-6% |
Source: Scottish Health Survey
Area Deprivation
In 2024, 31% of adults living in the most deprived areas of Scotland recorded a GHQ-12 score of 4 or more, compared with 17% in the least deprived areas. In 2022, the proportions were 37% and 22%, respectively.
Across all years from 2022 to 2024, adults living in the most deprived areas consistently reported statistically significantly higher levels of psychological distress than those in the least deprived areas.
Long-term limiting condition
In 2024, 38% of adults with a limiting long-term condition recorded a GHQ-12 score of 4 or more, compared with 14% of those with a non-limiting condition and 13% of those with no long-term condition. These differences were statistically significant, indicating substantially higher levels of psychological distress among adults with limiting conditions. The percentage of adults recording a GHQ-12 score of 4 or more was statistically significantly lower in 2024 compared to 2022 for those with limiting long-term conditions and no conditions.
Percentage of people with symptoms of anxiety and depression, by population group
Aggregated data from the SHeS 2023/2024 datasets provide insight into the prevalence of anxiety and depression symptoms among adults, as measured by the Clinical Interview Schedule – Revised (CIS-R). The combined 2021/2022 dataset is used as the baseline for monitoring change over time.
The Health Behaviour in School-Aged Children (HBSC) 2022 survey reports on symptoms of anxiety and depression among children aged 11, 13, and 15. This serves as the baseline for children and young people. It uses:
- The General Anxiety Disorder-7 (GAD-7) scale to assess anxiety symptoms based on self-reported experiences over the past two weeks.
- The WHO-5 Wellbeing Index to measure current mental wellbeing. Scores range from 0 to 100, with scores of 50 or less indicating low mood and scores of 28 or less indicating risk of depression.
Sex
Data from the SHeS 2023/2024 shows that:
- 18% of women reported two or more symptoms of anxiety, compared with 13% of men. This represents a small decrease for women since 2021/2022 (20%), while the rate for men remained stable (12%). The difference between men and women across both periods remains statistically significant.
- 11% of women reported two or more symptoms of depression, compared with 9% of men. This reflects a slight decrease for both men and women from 2021/2022 (13% each). This is a statistically significant decrease for men.
Findings from the 2022 HBSC Survey also show gender differences in anxiety and depression among young people aged 11, 13, and 15:
- Girls aged 13 and 15 [1] were more likely than boys to report moderate or severe anxiety, with 47% of girls compared to 16% of boys.
- At each age point, girls were more likely than boys to report low mood or risk of depression. Among 15-year-old girls, over half (56%) were classified as experiencing either low mood or being at risk of depression, compared to 32% of boys of the same age.
Age
Data from SHeS 2023/2024 highlight age-related differences in symptoms of anxiety and depression among adults.
Adults aged 16–24 and 25–34 continued to report the highest levels of anxiety symptoms in 2023/2024 (25% and 23%), while levels were lowest among adults aged 65–74 and 75+ (7% and 6%). These differences were statistically significant, with younger adults experiencing markedly higher anxiety than older adults in both 2023/2024 and the baseline period of 2021/22. However, none of the changes within any age group over time between 2021/22 and 2023/24 were statistically significant.
In 2023/24, adults aged 55–64 reported the highest levels of depression symptoms (16%), while levels were lowest among those aged 65–74 (4%) and 75+ (3%). However, across both 2023/24 and the 2021/22 baseline, there were no statistically significant differences between age groups, and none of the changes over time were statistically significant.
Findings from the 2022 HBSC survey show similar age-related patterns among young people:
- 32% of 13- and 15-year-olds reported moderate (18%) or severe (14%) anxiety symptoms, based on the GAD-7 scale.
- 35% of 11-, 13-, and 15-year-olds scored below 50 on the WHO–5 Wellbeing Index, indicating low mood or risk of depression.
Area deprivation
Data from SHeS show clear inequalities in symptoms of anxiety and depression by area deprivation.
- In 2023/24, 29% of adults living in the most deprived areas reported two or more anxiety symptoms, compared with 12% in the least deprived areas. This difference was statistically significant. In 2021/22, the corresponding proportions were 20% and 12%, respectively, and the difference was also statistically significant.
- In 2023/24, 23% of adults in the most deprived areas reported two or more depression symptoms, compared with 4% in the least deprived areas. A similar gap existed in 2021/22 (21% vs 9%), and the difference was statistically significant in both periods.
Long-term limiting condition
Data from SHeS shows that:
- In 2023/24, 28% of adults with a limiting long-term condition reported two or more anxiety symptoms, compared with 11% with a non-limiting condition and 8% with no long-term condition. Similar patterns were seen in 2021/22, and in both years these differences were statistically significant.
- In 2023/24, 17% of adults with a limiting long-term condition reported two or more depression symptoms, compared with 13% of adults with a non-limiting condition and 5% of those with no long-term condition. For adults with a limiting long-term condition, this represents a statistically significant decrease of 8 percentage points from 25% in 2021/22.
Prevalence rate of mental health conditions for GP patients, by population group
PHS publishes data on disease prevalence rates for selected conditions at general practices across Scotland. Prevalence rates refer to the proportion of people, out of every 100 registered patients, who have been recorded as having a particular condition. The dataset provides information on depression, eating disorders, and severe mental illness by gender and age. The dataset does not include every general practice in Scotland, but it covers the vast majority (95%).
Gender
- Depression: 10.9 per 100 registered male GP patients were recorded as having depression, remaining stable since 2022. Among female GP patients, 19.1 per 100 were recorded as having depression in 2025, this has gradually decreased from 19.5 in 2022.
- Eating disorders: 0.1 per 100 registered male GP patients were recorded as having an eating disorder, consistent since 2022. Among female GP patients, 1.1 per 100 were recorded as having an eating disorder in 2025, a small increase from 1.0 in 2022, 2023 and 2024.
- Severe mental illness: 1.1 per 100 registered male and female GP patients were recorded as having severe mental illness—including schizophrenia, bipolar affective disorder, other psychoses, or being prescribed Lithium within the past six months—which remained unchanged from 2022.
Age [2]
Depression: As shown in Figure 2, in 2024/2025 prevalence rates increase from adolescence, peaking at 24.9 per 100 GP patients around age 55, before gradually declining through older age to 14.5 per 100 GP patients by age 85. Similar age-related patterns in prevalence were also evident in 2022/23.
Figure 2: Depression prevalence rates by age band, Scotland 2022/23 - 2024/25.
Disease prevalence rates visualisation, Public Health Scotland 2025
Eating disorders: As shown in Figure 3, in 2025 eating disorder prevalence rates remained below 1 per 100 patients across all age bands, peaking at 0.9 per 100 patients between ages 20 and 50, before gradually declining to 0.1 by age 85. Similar age-related patterns in prevalence were also evident in 2022/23.
Figure 3: Eating disorder prevalence rates by age band, Scotland 2022/23 - 2024/25
Disease prevalence rates visualisation, Public Health Scotland 2025
Severe Mental Illness: As shown in Figure 4, in 2025 prevalence rates of severe mental illness gradually rose from adolescence and continue increasing into older age, peaking at 2.3 per 100 patients by age 85+. Similar age-related patterns in prevalence were also evident in 2022/23.
Figure 4: Severe mental illness prevalence rates by age band, Scotland 2022/23 - 2024/25
Disease prevalence rates visualisation, Public Health Scotland 2025
Percentage of adults who have ever deliberately self-harmed, by population group
Data from SHeS provides insight into the proportion of adults who have ever deliberately self-harmed.
- Sex: In 2023/24, 9% of women and 7% of men reported having ever deliberately self-harmed. In 2022/23, the figures were 11% and 8% respectively. However, none of the differences between genders or changes over time were statistically significant.
- Age: In 2023/24, self-harm was most common among younger adults, with 18% of 16–24-year-olds and 17% of 25–34-year-olds reporting having ever deliberately self-harmed, compared with 4% of 55–64-year-olds and 1% of those aged 65–74. These age differences were statistically significant, and a similar pattern was also found in the 2021/22 baseline. However, none of the changes within age groups between 2021/22 and 2023/24 were statistically significant.
- Deprivation: In 2023/24, 13% of adults living in the most deprived areas reported having ever deliberately self-harmed, compared with 7% in the least deprived areas. A similar pattern was seen in the 2021/22 baseline (14% vs 7%). However, none of the differences between deprivation groups, nor any changes over time, were statistically significant.
- Long-term limiting condition: In 2023/24, 16% of adults with a limiting long-term condition reported having ever deliberately self-harmed, compared with 14% of those with a non-limiting condition and 4% of those with no long-term condition. The difference between adults with limiting conditions and those with no long-term conditions was statistically significant, but differences involving the non-limiting group were not. Compared with the 2021/22 baseline, no group showed a statistically significant change over time.
Reflections on Summary Outcome 1
Summary Outcome 1 of the Mental Health and Wellbeing Strategy focuses on improving overall mental health and wellbeing in Scotland and reducing mental health inequalities. The available provides a useful baseline and early changes for tracking progress.
There have been some improvements in population mental health and wellbeing outcomes since 2022, including a statistically significant improvement in average adult mental wellbeing scores and a significant decrease in the proportion of adults scoring 4 or more on the GHQ-12 (indicating a possible psychiatric disorder). High life satisfaction increased slightly, although not significantly. Symptoms of anxiety and depression have decreased at a population level, but these changes were not statistically significant.
GP-recorded prevalence rates for depression, eating disorders, and severe mental illness have remained broadly stable. However, it should be noted that changes in clinical prevalence data can reflect a range of factors, such as increased awareness, improved diagnosis, and changes in help-seeking behaviour.
Despite some improvements in overall wellbeing, mental health inequalities remain persistent. Adults living in the most deprived areas, women, younger adults, and people with limiting long-term conditions consistently report poorer outcomes across multiple indicators. In some cases, such as anxiety symptoms and GHQ-12 distress by deprivation, the inequalities have widened or become statistically significant over time.
Data Gaps
There are two overarching data gaps that limit the ability to fully monitor Summary Outcome 1.
- Mental Health Condition Prevalence: Most of the metrics used to monitor the outcome are based on self-reported symptoms using screening tools, rather than clinical diagnoses. PHS data on patients registered to GP provides some insight into depression, eating disorders and some severe mental health conditions. However, there is a lack of information on clinically diagnosed mental health conditions across the whole population and across a range of mental health conditions.
- Equalities Data: There is limited availability of mental health data disaggregated by some protected characteristics, including ethnicity, religion or belief, and sexual orientation. This restricts the ability to monitor mental health outcomes across all population groups and limits understanding of the full extent of mental health inequalities in Scotland.
Footnotes
[1] The GAD-7 scale was only administered to children aged 13 and 15 years old.
[2] Prevalence rates for age bands are the proportion of registered GP patients within a specific age group who have been recorded as having a particular condition, expressed per 100 patients.