The Scottish Health Survey 2024 - volume 1: main report
This report presents results for the Scottish Health Survey 2024, providing information on the health and factors relating to health of people living in Scotland.
Part of
1. Mental Health and Wellbeing
Jack Terris
1.1 Introduction
Mental health is defined by the World Health Organisation (WHO) as a state of well-being in which every individual realises their own potential, can cope with the stresses of life, can work productively, and is able to make a contribution to their community[i].
Many factors can have an impact on mental health and wellbeing including social, cultural, political, environmental and economic factors such as living and working conditions and social support[ii]. Social determinants that put some groups at greater risk of poor mental health than others include poverty, loneliness, unemployment, age and provision of unpaid care[iii].
Poor mental health has a considerable impact on individuals, their families and society as a whole[iv]. Approximately one in four people in Scotland are facing a mental health problem in any given year[v]. Those with a mental health condition have a higher risk of having/developing a physical illness, this being diagnosed later and record higher mortality rates[vi].
Loneliness is a significant public health problem[vii] that can reduce quality of life, as well as physical and mental health. The health risks associated with loneliness have been compared with the effects of factors such as smoking daily, hazardous/harmful drinking and obesity[viii] and linked to cardiovascular disease, high blood pressure, decreased immune function, depression and cognitive decline[ix].
Eating disorders can have a significant impact on an individual’s physical health and/or their ability to function fully in day-to-day life, as well as their mental wellbeing and that of others around them[x],[xi]. Eating disorders can lead to a number of physical and mental health conditions including cardiovascular problems, osteoporosis, organ failure, intestinal distress[xii], as well as depression, social anxiety and attention deficit hyperactivity disorder (ADHD)[xiii].
1.1.1 Policy background
In June 2023, the Scottish Government published a new Mental Health and Wellbeing Strategy[xiv] jointly with the Convention of Scottish Local Authorities (COSLA), with a focus on promoting positive mental health and wellbeing, preventing mental health issues occurring or escalating and tackling underlying inequalities and providing mental health and wellbeing support and care in the right place at the right time. The Strategy’s first Delivery Plan[xv] and Workforce Action Plan[xvi], published on 7 November 2023, describe the work that the Scottish Government and partners, will undertake over 18 months under each of the Strategy’s 10 priorities, many of which are focused on the mental health and wellbeing of children, young people and families[xvii]. The Mental Health and Wellbeing Strategy Leadership Board was established in August 2024 in order to monitor and support these ten mental health priorities and their associated actions[xviii].
The National Specification for the Care and Treatment of Eating Disorders in Scotland, published in November 2024, is a response to the 2021 National Review of Eating Disorder Services. The Specification aims to address two key areas of focus – consistency and clarification of responsibilities in service provision. It sets out a baseline of service provision that is person-centred, safe and effective, reducing and preventing gaps in care provision with clear protocols and a service structure that fulfils these values[x].
1.1.2 Reporting on mental health and wellbeing in the Scottish Health Survey
In this chapter, the following data are presented for adults:
- Mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale-WEMWBS)
- Possible psychiatric disorder (General Health Questionnaire 12-GHQ-12)
- Anxiety and depression scores, attempted suicide and self-harm (Clinical Interview Schedule - Revised – CIS-R)
- Loneliness
- Prevalence of eating behaviours and feelings related to food that could be indicative of a possible eating disorder
Figures are reported by age, sex and area deprivation. Eating behaviours and feelings related to food that could be indicative of a possible eating disorder are also reported by mental wellbeing.
An interactive data dashboard is also available presenting key indicators for Scotland, NHS Boards and local authority areas.
The area deprivation data are presented in Scottish Index of Multiple Deprivation (SIMD) quintiles. To ensure that the comparisons presented are not confounded by the different age profiles of the quintiles, the data have been age-standardised. For a detailed description of both SIMD and age-standardisation as well as definitions of other terminology used in this chapter and for further details on the data collection methods for mental health and wellbeing, loneliness and eating behaviours and feelings related to food that could be indicative of a possible eating disorder, please refer to the Scottish Health Survey 2024 volume 2 technical report.
1.1.3 Comparability with other UK statistics
The Health Survey for England (HSE) [xix], the Health Survey Northern Ireland[xx] and the National Survey for Wales[xxi] provide estimates of adults’ mental health and wellbeing prevalence in the other UK countries. The surveys are conducted separately and have different sampling methodologies, so mental health and wellbeing prevalence estimates across the surveys are only partially comparable.
HSE 2019 also provided estimates of the prevalence of possible eating disorders in the English adult population by using the SCOFF questionnaire[xxii]. The survey has a different sampling methodology to SHeS, so prevalence estimates across the surveys are only partially comparable.
1.2 Results
Summary points
In 2024:
- After increasing for the first time since the pandemic in 2023 (48.9), mental wellbeing (mean WEMWBS scores) for adults remained at a similar level (48.5).
- The proportion of adults with a possible psychiatric disorder (22%) (GHQ-12 score of 4 or more) remained at a similar level to 2023 (21%) following a decrease from 2022 (27%).
- One in four (25%) females reported a possible psychiatric disorder (GHQ-12 score of 4 or more), significantly more than males (18%).
- The proportion of adults with a possible psychiatric disorder (GHQ-12 score of 4 or more) was highest among those living in the most deprived areas (31%) compared with those living in the least deprived areas (17%).
- The proportion of adults who reported having felt lonely ‘most’ or ‘all of the time’ decreased from 10% in 2023 to 7%, similar to the proportion in 2021 (8%).
- Thirteen per cent of adults self-reported eating behaviours and feelings related to food that could be indicative of a possible eating disorder. This was highest for those aged 16-24 (26%) and lowest for those aged 65 and over (4%-5%).
- Adults with self-reported eating behaviours and feelings related to food that could be indicative of a possible eating disorder had a significantly lower mean WEMWBS score (42.2) compared with those who did not (49.4).
In 2023/2024 combined:
- The prevalence of two or more symptoms of depression among adults was 10%, a decrease from 13% in 2021/2022 combined.
- The prevalence of two or more symptoms of depression was much higher among adults living in the most deprived areas (23%) than among those living in the least deprived areas (4%).
- Consistent with previous years, a larger proportion of females reported two or more symptoms of anxiety (18%) compared with males (13%).
- Adults aged 16-34 were most likely to have intentionally self-harmed, 17%-18% compared with 0%-1% among those aged 65 and over.
1.2.1 After increasing for the first time since the pandemic in 2023, adult mental wellbeing remained at a similar level in 2024
The mean WEMWBS score for all adults was 48.5 in 2024 a similar level as the first post-pandemic increase in 2023 (48.9). The 2024 score remains significantly lower than the mean WEMWBS scores recorded in pre-pandemic years (49.4 – 50.0 between 2008 and 2019).
Note: WEMWBS scores range from 14 to 70. Higher scores indicate greater wellbeing.
Figure 1A, Table 1.1
1.2.2 Mental wellbeing was lowest for adults aged 16-24 or 45-54
Significant variations in mean WEMWBS scores by age were evident in 2024, however, this did not follow a linear pattern. The highest WEMWBS score was recorded for adults aged 65-74 (50.4) and the lowest for those aged 16-24 (47.7) or 45-54 (47.4).
Table 1.2
1.2.3 The proportion of adults with a possible psychiatric disorder remained higher in 2024 than those recorded prior to 2021
Just over one in five (22%) adults reported a GHQ-12 score of four or more (indicative of a possible psychiatric disorder) in 2024, a proportion towards the lower end of the range recorded since 2021 (21%-27%) but one that remains higher than those recorded between 2003 and 2019 (14%-19%).
Note: GHQ-12 scores range from 0 to 12. Scores of 4 or more indicate possible psychiatric disorder/mental ill health.
Differences in GHQ-12 scores by sex were also evident in 2024, with a significantly larger proportion of females (25%) reporting a GHQ-12 score of 4 or more compared with males (18%).
Figure 1B, Table 1.3
1.2.4 Those aged 16-64 were more likely to record a GHQ-12 score of four or more, indicative of a possible psychiatric disorder, than older adults
As reported in previous years, a larger proportion of younger adults recorded a GHQ-12 score of 4 or more in 2024, with 22% - 27% of those aged 16-64 doing so compared with 16% of those aged 65 and over.
Figure 1C, Table 1.4
1.2.5 Adults living in the most deprived areas were much more likely to report a GHQ-12 score of four or more, indicative of a possible psychiatric disorder
The proportion of adults (age-standardised) with a GHQ-12 score of 4 or more increased with deprivation in 2024, from 17% among those living in the two least deprived areas to 31% among those living in the most deprived areas.
Figure 1D, Table 1.5
1.2.6 Prevalence of two or more symptoms of depression was lower in 2023/2024 combined than in 2021/2022 combined
In 2023/2024 combined, the prevalence of adults with two or more symptoms of depression was 10%, a decrease from 13% in 2021/2022 combined.
In 2023/2024 combined, 16% of adults reported two or more symptoms of anxiety, remaining similar to the level in 2021/2022 combined (17%) and an increase from 9% in 2008/2009 combined. Consistent with previous years, a larger proportion of females reported two or more symptoms of anxiety (18%) compared with males (13%).
In 2023/2024 combined, around than 1 in 20 (6%) adults reported to ever having attempted suicide, a proportion that remained within the range of 4%-7% since 2008/2009 combined. No significant variation by sex was recorded in 2023/2024 combined.
In 2023/2024 combined, 8% of adults had deliberately self-harmed, similar to 2021/2022 combined (10%) and an increase from 2% in 2010/2011 combined.
Figure 1E Table 1.6
1.2.7 Adults aged 16-34 were most likely to report experiencing two or more symptoms of anxiety, to have ever attempted suicide and/or ever self-harmed in 2023/2024 combined
The prevalence of adults with two or more symptoms of depression was lowest for those aged 65 and over (3%-4%) and highest for those aged 55-64 (16%).
Consistent with previous years, the proportion of adults with two or more symptoms of anxiety generally decreased with age in 2023/2024 combined, from 23%-25% of adults aged 16-34 to 6%-7% of adults aged 65 and over.
Having ever attempted suicide was also more prevalent among younger age groups in 2023/2024 combined, ranging from 8%-9% among those aged 16-34 and 1%-3% among those aged 65 and older. However, this pattern was not linear and fluctuated between age groups.
In 2023/2024 combined younger adults were also more likely to report having ever self-harmed (17%-18% among those aged 16-34 compared with 0%-1% of those aged 65 and over).
Table 1.7
1.2.8 The prevalence of depression among adults was highest amongst those living in the most deprived areas in Scotland in 2023/2024 combined
In 2023/2024 combined, the prevalence of two or more symptoms of depression (age-standardised) increased with deprivation from 4% of adults living in the least deprived areas to 23% among those living in the most deprived areas.
In 2023/2024 combined, the proportion of adults with two or more symptoms of the anxiety (age-standardised) was higher among adults living in the most deprived quintile (29%) than those living the four other quintiles (in the range of 12%-15%).
The proportion of adults reporting to have ever attempted suicide was highest in the most deprived quintile (9%), compared to 3% in the second least deprived quintile.
No significant differences were reported by area deprivation with regards to the prevalence of ever having deliberately self-harmed.
Figure 1F, Table 1.8
1.2.9 The proportion of adults who had felt lonely ‘most’ or ‘all of the time’ decreased in 2024 to a similar level as that recorded in 2021
The proportion of adults who reported having felt lonely ‘most’ or ‘all of the time’ in the week prior to being interviewed decreased from 10% in 2023 to 7% in 2024, similar to the proportion recorded in 2021 (8%). Similar patterns were recorded by sex (7% for both males and females).
Table 1.9
1.2.10 In contrast to previous years, the proportion of adults feeling lonely ‘most/all of the time’ did not vary significantly by age in 2024
Unlike previous years, there was not a linear pattern in the proportion of adults feeling lonely ‘most/all of the time’ by age, with proportions fluctuating from 10% among those aged 45-54 to 4% among those aged 65-74.
Table 1.10
1.2.11 The prevalence of self-reported eating behaviours and feelings related to food that could be indicative of a possible eating disorder was highest for younger adults and females in 2024
Among all adults in 2024, 13% self-reported eating behaviours and feelings related to food that could be indicative of a possible eating disorder. Prevalence was higher among females (17%) compared with males (9%).
A linear decrease was recorded by age. Around a quarter of adults (26%) aged 16-24 recorded eating behaviours and feelings related to food that could be indicative of a possible eating disorder compared with 4%-5% of those aged 65 and over.
Among males, the largest proportion was recorded for the 16-24 age group (17%), a proportion which more than double among females of the same age (35%).
Seven per cent of adults reported that feelings about food had interfered with an aspect of their life such as the ability to work, meet personal responsibilities and/or to enjoy a social life, a proportion that was higher among females (9%) compared with males (4%). This proportion also varied significantly by age, decreasing from 16% among those aged 16-24 to 1% among those aged 75 and over.
Figure 1G, Table 1.11
1.2.12 No significant differences by deprivation were observed in the prevalence of self-reported eating behaviours and feelings related to food that could be indicative of a possible eating disorder
Although the prevalence of eating behaviours and feelings related to food that could be indicative of a possible eating disorder was higher among adults living the most deprived areas (15%) than among those living in the least deprived areas (12%), this difference was not significant.
Table 1.12
1.2.13 Mental wellbeing was significantly lower in 2024 among adults with self-reported eating behaviours and feelings related to food that could be indicative of a possible eating disorder
In 2024, adults with eating behaviours and feelings related to food that could be indicative of a possible eating disorder recorded a mean WEMWBS score of 42.2, significantly lower than the mean of 49.4 for adults without a possible eating disorder. No significant differences were recorded between males and females.
Table 1.13
Table List
Table 1.1 Mental wellbeing (WEMWBS mean score), 2008 to 2024, by sex
Table 1.2 Mental wellbeing (WEMWBS mean score), 2024, by age and sex
Table 1.3 Possible psychiatric disorder (GHQ-12 score), 2008 to 2024, by sex
Table 1.4 Possible psychiatric disorder (GHQ-12 score), 2024, by age and sex
Table 1.5 Possible psychiatric disorder (GHQ-12 score) (age-standardised), 2024, by area deprivation and sex
Table 1.6 Anxiety and depression scores, attempted suicide and self-harm, 2008/2009 combined to 2023/2024 combined, by sex
Table 1.7 Anxiety and depression scores, attempted suicide and self-harm, 2023/2024 combined, by age and sex
Table 1.8 Anxiety and depression scores, attempted suicide and self-harm (age-standardised), 2023/2024 combined, by area deprivation and sex
Table 1.9 Loneliness, 2021 to 2024, by sex
Table 1.10 Loneliness, 2024, by age and sex
Table 1.11 Prevalence of eating behaviours and feelings related to food that could be indicative of a possible eating disorder, 2024, by age and sex
Table 1.12 Prevalence of eating behaviours and feelings related to food that could be indicative of a possible eating disorder (age-standardised), 2024, by area deprivation and sex
Table 1.13 Mental wellbeing (WEMWBS mean scores), 2024, by prevalence of eating behaviours and feelings related to food that could be indicative of a possible eating disorder and sex
References and notes
[i] World Health Organisation (2024). Mental Health [online]. Available at: https://www.who.int/health-topics/mental-health#tab=tab_1
[ii] World Health Organisation (2021). Comprehensive Mental Health Action Plan 2013-2030 [online]. Available at: https://www.who.int/publications/i/item/9789240031029
[iii] Mental health and wellbeing strategy. Edinburgh: Scottish Government (2023). Available at: https://www.gov.scot/publications/mental-health-wellbeing-strategy/pages/6/
[iv] World Health Organization (2022). World mental health report [online]. Available at: https://www.who.int/publications/i/item/9789240049338
[vi] Doherty, AM and Gaughran, F. (2014). The interface of physical and mental health. Social Psychiatry and Psychiatric Epidemiology, Vol 49, pp. 673-682. Available at: https://link.springer.com/article/10.1007/s00127-014-0847-7
[vii] A Connected Scotland: our strategy for tackling social isolation and loneliness and building stronger social connections. Edinburgh: Scottish Government (2018). Available at: https://www.gov.scot/publications/connected-scotland-strategy-tackling-social-isolation-loneliness-building-stronger-social-connections/
[viii] See: https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-ageing/social-isolation-and-loneliness
[ix] See: https://www.nia.nih.gov/health/loneliness-and-social-isolation/loneliness-and-social-isolation-tips-staying-connected
[x] National Specification for the Care and Treatment of Eating Disorders in Scotland. Edinburgh: Scottish Government (2024). Available at: https://www.gov.scot/publications/national-specification-care-treatment-eating-disorders-scotland/pages/1/
[xii] See: https://www.eatingdisorderfoundation.org/learn-more/about-eating-disorders/health-consequences/
[xiii] Tan EJ, Raut, T, Le LK-D, Hay, P, Ananthapavan, J, Lee Y-Y and Mihalopoulos, C. (2023). The association between eating disorders and mental health: an umbrella review. Journal of Eating Disorders, vol 11 (53). Available at: https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-022-00725-4
[xvi] See: https://www.gov.scot/publications/mental-health-wellbeing-workforce-action-plan-2023-2025/
Contact
ScottishHealthSurvey@gov.scot