Table of contents


Adults :: Adult mental health [Update in progress] :: Summary


Adults with mental health problems are one of the most socially excluded groups in society, and one in four adults will experience mental health problems at some point in their lives. Mental health and physical health are interlinked, with people with mental illness experiencing higher rates of morbidity and a lower life expectancy, and people with chronic physical health problems more likely to experience mental health problems.

Mental health problems impact on individuals, families, communities and society as a whole, with immense social and financial costs. Mental health problems contribute a higher percentage of total disability adjusted life years in the UK than any other chronic illness (26.6% in 2004, compared to CVD 16.2%, cancer 15.6% and respiratory illnesses 8.3%) [1]. Recent estimates put the full cost of mental health problems in England at £105.2 billion, the majority due to the negative impact on the quality of life for individuals with mental health problems [2]. Mental illness accounts for about 11% of total NHS spend.

This chapter focuses on adult and older people's mental health only. There is a separate chapter on dementia.

This chapter will provide an overview of the level of need in the population in the key areas of

• promoting mental health and wellbeing for the whole population and particular risk groups
• Treatment and support for recovery for those who have mental ill-health
• Preventing suicide

Key issues and gaps

Issues and gaps related to incidence / prevalence and service provision Mental health is responsible for 23% of disability adjusted life years in the UK which is higher than any other chronic illness.

Of those Medway residents claiming incapacity benefit, 42% are claiming it due to mental health issues.

The prevalence and incidence of both common mental health problems and psychosis in the population nationally appears to be remaining stable.

However numbers of older people with depression will increase due to the demographic changes.

The last JSNA highlighted issues around forensic maternal mental health: ADHD, autism, personality disorders. Service changes have been implemented to address these.

Primary care remains a matter for concern.

Recommendations for Commissioning

  1. Mental health promotion work needs to address wellbeing at work issues.
  2. Targeted interventions to prevent suicide are needed for middle-aged men
  3. Mental health primary care services are currently being reviewed and redesigned with pilots of primary mental health care workers being implemented. Interventions for mental health promotion should be integrated into the development of such services.
  4. Variation in primary care registers and QOF indicators relating to primary care need to be investigated and addressed.
  5. Work should continue to be done to identify issues along the pathway preventing uptake and retention in services and issues relating to access to services for vulnerable groups identified in the equity audit need to be addressed.
  6. Appropriate services for veterans mental health should be in place.
  7. Psychiatric liaison services in Medway Foundation Trust should continue to be supported including a substance misuse component should continue.
  8. Physical health checks for people with mental health issues. Currently low in KMPT. Best models of care and shared care protocols need to be developed.
  9. Low percentage of people in employment with severe mental illness needs to be addressed.
  10. Demand for inpatient services in Medway needs to be monitored on an ongoing basis to ensure that appropriate bed provision is available for those who need it.


[1]   Department of Health. New Horizons: a shared vision for mental health 2009; Department of Health. .
[2]   Centre for Mental Health. The economic and social costs of mental health problems in 2009/10 October, 2010; Centre for Mental Health. .