Adult Psychiatric Morbidity Survey 2014 - UK Data Servicedoc.ukdataservice.ac.uk/doc/8203/mrdoc/pdf/8203_apms_2014_proj… · (510), in hospital and not back during the survey period

Adult Psychiatric Morbidity Survey

2014

Project Instructions

Interviewer instructions Coder instructions and code

lists

UK Data Archive Study Number 8203 - Adult Psychiatric Morbidity Survey, 2014: Special Licence Access

National Study of Health and Wellbeing Interviewer Instructions (P05012)

Contents.

1 Overview of the Research Programme. .......... 2

1.1 Survey Overview ...................................................................................... 2 1.2 Purpose and Aims of the Survey ............................................................ 2 1.3 Our Client .............................................................................................. 2 1.4 Ethical Clearance ..................................................................................... 3

2 Fieldwork Overview. ......................................... 3

2.1 The Interview ............................................................................................ 3 2.2 Fieldwork Dates ....................................................................................... 3 2.3 Sample .............................................................................................. 3 2.4 Serial numbers ......................................................................................... 4 2.5 Interview Length ...................................................................................... 4

3 Who to Interview. .............................................. 4

3.1 The Address Record Form (ARF) ........................................................... 4 3.2 Dwelling Unit Selection ........................................................................... 5 3.3 Household Selection ............................................................................... 6 3.4 Adult Selection ......................................................................................... 6 3.5 People unable to take part due to health or capacity ........................... 6 3.6 Language Difficulties ............................................................................... 7

4 Getting People to Take Part. ............................ 8

4.1 Making Contact and Appointments ........................................................ 8 4.2 Documents you could use on the doorstep .......................................... 8 4.3 Webpage .............................................................................................. 9 4.4 Tips for Introducing the Survey ............................................................ 10 4.5 Things you can mention on the doorstep ............................................ 10 4.6 Incentive ............................................................................................ 11

5 The Stage 1 Interview. .................................... 12

5.1 Content ............................................................................................ 12 5.2 Administering the CAPI Questionnaire ................................................ 12 5.3 Administering the Self-Completion/CASI Questionnaire ................... 13

6 During the Stage 1 Interview. ........................ 14

6.1 Privacy during the Interview ................................................................. 14 6.2 Respondent Distress and Interviewer Safety ...................................... 14 6.3 Partial Interview Definition .................................................................... 15 6.4 Consent to Data Linkage ....................................................................... 15

2

7 Stage 2 Interview. ........................................... 17

8 Survey Documents. ........................................ 19

9 Returning Work to the Office. ....................... 19

Appendix A: Questionnaire Instructions. ......... 20

9.1 Overview of the questionnaire .............................................................. 20 9.2 Introductory Questions ......................................................................... 21 9.3 General Health, Activities of Daily living and Caring .......................... 21 9.4 Service use and medication .................................................................. 22 9.5 Appetite and Weight Change ................................................................ 24 9.6 Common Mental Disorders (CIS-R) ...................................................... 24 9.7 Self-harm and suicidal thoughts and behaviour ................................. 25 9.8 Psychosis - Psychosis Screening Questionnaire (PSQ) .................... 26 9.9 ADHD Screening Questionnaire ........................................................... 26 9.10 Work Related Stress ............................................................................ 27 9.11 Smoking, drinking and drug use (mostly self-completion) ............. 27 9.12 Personality Disorder Screen (self-completion) ................................. 28 9.13 Bipolar Disorder screening questionnaire ........................................ 29 9.14 Autism Screening Questionnaire (self-completion) ......................... 29 9.15 PTSD & Military Experience (self-completion) .................................. 29 9.16 Domestic Violence and Experience of Abuse Self-completion) ...... 30 9.17 Child Neglect (Self-completion) ......................................................... 30 9.18 Self-Harm (self-completion) ................................................................ 30 9.19 Discrimination, sexual identity & behaviour, menopause ............... 30 9.20 End of the self-completion ................................................................. 30 9.21 Intellectual Functioning ...................................................................... 31 9.22 Stressful life events, parenting, and social support ......................... 33 9.23 Resilience Section ............................................................................... 34 9.24 Socio-demographic section ............................................................... 34 9.25 Property and Financial Strain ............................................................. 34 9.26 Follow-up Questions, Consent, Vouchers, and Admin .................... 35

Appendix B: The ARF ........................................ 36

Appendix C: 41+ DUs or Adults Table .............. 39

Appendix D: Disclosure of Harm Guidance .. 40

Appendix E: Reading Test Word Definitions ... 42

Key Features. Subject: Stresses & strains of everyday life, mental health, physical health and wellbeing.

Eligibility: Use the selection procedure to select one adult aged 16+. If necessary, select one dwelling unit and household per address.

Sample size: Around 10,000 (including a boost region)

Data collection: Face-to-face CAPI interview with computer self completion section. Average interview time is 90 minutes. There is a £15 incentive.

Assignment size: Most points have 22 addresses. Wakefield boost points have 25 addresses.

Fieldwork period: May 2014 – May 2015 Contacts. Project Number P05012.01

Brentwood Contacts Neil Barton (Project Coordinator) 01277 200600

Materials Email: [email protected]

Research Contacts Sally Bridges 020 7549 7021

Sally McManus 0207 549 7045 [email protected] (Email is the best way to reach Sally)

NatCen Social Research | National Study of Health and Wellbeing 1

mailto:[email protected]

mailto:[email protected]

1 Overview of the Research Programme. The National Study of Health and Wellbeing is a nationwide survey conducted every seven years. It was last carried out by NatCen in 2007, before then the Office for National Statistics (ONS) conducted the study in 1993 and 2000.

The principal function of the study is to provide the best quality data on prevalence and trends in mental health in England.

1.1 Survey Overview There are two stages to the fieldwork. NatCen conducts Stage One interviews. Stage Two is carried out by psychologists from the University of Leicester who conduct follow-up interviews for a sub-sample of respondents. Stage Two respondents will include both people with and without mental health issues. Information about the last survey can be found: www.hscic.gov.uk/catalogue/PUB02931 In field the survey is known as the ‘National Study of Health and Wellbeing’. Among policy and academics it is known as the ‘Adult Psychiatric Morbidity Survey’.

1.2 Purpose and Aims of the Survey This survey is part of a national programme of mental health surveys, which has an extremely high profile among mental health policy makers and practitioners working in the field. It is the primary source for national prevalence data on mental health and mental disorder, and provides key evidence about people with mental health problems and their use of, and need for services. The survey also looks at the relationship between mental health problems and stressful life events, and the use of alcohol, tobacco and drugs. This assists the NHS, Department of Health and other bodies such as charities, in their development of policies and provision for people with a range of mental disorders. Example findings from previous household surveys in the series include:

About 1 in 6 adults had a common mental disorder, such as anxiety or depression.

Just under a quarter of people with a common mental disorder were receiving treatment of some kind.

One in four adults had a hazardous pattern of drinking in the last year.

Psychotic disorders, like schizophrenia, are very rare (about 5 per 1,000)

1.3 Our Client The survey is commissioned by:

The Health and Social Care Information Centre (HSCIC)

2 NatCen Social Research | National Study of Health and Wellbeing

http://www.hscic.gov.uk/catalogue/PUB02931

To explain who they are their website says: ‘We are the trusted national provider of high quality information, data and IT systems for health and social care organisations so they can provide better services and improve health standards.’ Until April 2013, HSCIC was part of the NHS; now they are a government agency but separate from the NHS. The National Study of Health and Wellbeing is mostly funded by the Department of Health, with involvement from the NHS. Some funding also comes from Local Authorities (for the boost fieldwork).

1.4 Ethical Clearance This survey gained ethical clearance from an NHS Health Research Authority ethics committee in March 2014, reference 14/L0/0411.

2 Fieldwork Overview. 2.1 The Interview Stage 1: A face-to-face interview with one randomly selected adult (16+) in the household. As well as standard CAPI questions it includes a self-completion CASI section (there is no paper self-completion) and some cognitive measures. Full detail about the Stage 1 interview content can be found in Appendix A. Stage 2: We would like to follow-up a small number of those interviewed at Stage 1 with a Stage 2 interview. These interviews are carried out by specially trained interviewers from the University of Leicester. You will be asking for consent for someone to contact the respondent about taking part in a second interview at the end of the CAPI. Further information about the Stage 2 interviews can be found in Section 7.

2.2 Fieldwork Dates The survey will be in the field for over a year so we can look at seasonal variations in mental health. Fieldwork is divided into quarters: Quarter one: May, June, July 2014

Quarter two: Aug, Sept, Oct 2014

Quarter three: Nov, Dec, Jan 2015

Quarter four: Feb, Mar, Apr 2015

It is key that you keep to fieldwork dates. This is both so that the sample is evenly distributed throughout the year for analysis of seasonality effects, and because fieldwork progress is very closely monitored by our client.

2.3 Sample The sample covers England only.

Addresses have been randomly selected from the Postcode Address File (PAF).

Sample points are issued at the start of each calendar month.

Most points have 22 addresses. All points in the Wakefield Boost have 25 addresses.


There will be five weeks to do the fieldwork for a point, plus an additional sixth week for mopping up.

An important KPI is to visit all your addresses in the first 7 days. You will be given the target response rate for your point each month – our national target is 60% response rate. Wakefield Boost We are increasing the sample in the Wakefield area; this has been funded by Wakefield Council. The key differences for Wakefield area: The sample covers the Wakefield Local Authority area.

Boost points have 25 addresses, due to the small number of available postcode areas.

2.4 Serial numbers The serial numbers are 7 digits long: - Digit 1 = Quarter number (1, 2, 3, 4, 5, 6)

- Digits 2, 3, 4, 5 = Point no. (2 is the sample type: Main =1; Wakefield = 2))

- Digit 6, 7 = Address number (usually 01 to 22, sometimes up to 25)

2.5 Interview Length The interview will last an average of around 90 minutes. There will be quite a lot of variation, with respondents with few health difficulties having a shorter interview, and respondents with a lot of problems having an interview that may be much longer (this is recognised in the fee structure). If you have a particularly long interview and if the respondent is getting tired, you may want to suggest that you take a break or continue the next day.

3 Who to Interview. 3.1 The Address Record Form (ARF) A full break-down of the ARF can be found in Appendix B. In overview, the ARF contains the following sections: Section 1: Code the observation question for every non-deadwood address.

Sections 2 and 3: You should use this section if you need to select a dwelling unit (DU) or household if there are more than one at an address. At each address you only need to interview one adult (16+).

Section 4: Enables you to select one adult (aged 16+).

Section 5: Is where you need to code the final outcome.

Section 6: Provides useful information to help us decide whether an address is suitable for reissue.


Section 7: If your selected respondent is unable to take part because they are ill at home (510), in hospital and not back during the survey period (520), or physically or mentally incapable of taking part in a survey (530) you will need to answer the questions in section 7. These questions are to be asked of whoever you are able to make contact with to give more information about why the respondent is unable to take part. Please enter as much detail as possible here.

Look-up chart: There is a look-up chart for addresses with 13-40 dwelling units or/and households to enable you to select one. If there are 41+ dwelling units or households, please use the look-up chart in Appendix C. Fieldwork dates: The dates of each fieldwork month are on the back of the ARF. The fieldwork month you are working on is written at the top of the front page of the ARF. Frequently Asked Questions

Can non-English speaking members of a household be excluded from selection? No, they would need to be coded as 540. All members of the household need to be included in the selection process otherwise we will systematically bias our sample, which biases and changes our results. Can non-English speaking households be coded as ‘Deadwood’? Unfortunately no, again this would need to be coded as 540. This is following the standard procedure used on other NatCen projects and is not unique to Health and Wellbeing. The reason being Deadwood is only designed for non-existent residential buildings, rather than buildings ‘vacant’ of eligible respondents. 3.2 Dwelling Unit Selection

DEFINITION OF DWELLING UNIT: A dwelling unit is a living space with its own locked front door. This can be either a street door or a door within a house or block of flats. Usually there is only one dwelling unit at an address. The most common type of multiple dwelling unit address is a property that once existed as a whole house but has later been converted into flats.

EXAMPLE The selected address on the ARF label is ‘123 High Street’, but you find doorbells for these flats: 123a, 123b, 123c, 123d. This is called a ‘Divided address’ – in this example there are 4 dwelling units to choose from. You will need to ensure each flat has a chance of being selected, by listing them and making a selection.

If there is more than one dwelling unit a random selection has to be made:

List all the addresses at Section 2.2 on the ARF – there’s instructions in there about the order to list them in.

Use the selection label on the front of the ARF, the top row represents the number of DUs at the address. The code below the number of DUs tells you which one to choose.

If you need to select from 41 or more dwelling units (unlikely!), then please refer to Appendix C of these instructions.


3.3 Household Selection DEFINITION OF A HOUSEHOLD: A household is one person or a group of people living in a dwelling unit who share a living room or dining area AND share cooking facilities.

You should select only one household per dwelling unit to be included in the survey. As with dwelling units, if there is more than one household, a random selection has to be made. Follow the instructions on your ARF:

List the name/initials of one of the people from each household at Section 3.2 on the ARF, in alphabetical order.

Use the selection label on the front of the ARF, the top row represents the number of DUs/HHs at the address. The code below the number of HHs tells you which one to choose.

3.4 Adult Selection We are interviewing one adult (aged 16 or over, no upper age limit) in every household. You will need to select one adult to interview using the selection label. Follow the instructions on your ARF:

List the adults in alphabetical order at Section 4.2.

Use the selection label on the front of the ARF, the top row represents the number of adults. The code below tells you which adult to select.

The selected respondent doesn’t want to take part, but someone else in the household does, can I interview them instead? Unfortunately no – if we used interviews from self-selected respondents this would bias our sample and survey answers. Our data is representative because it is a random sample of the population. Where possible, try to persuade the selected respondent to take part (see Section 4 of these instructions for more information). 3.5 People unable to take part due to health or capacity Doorstep Proxy Questions There are proxy questions in the ARF (Section 7) that should be asked of (or about) selected respondents that are unable to take part due to health or capacity reasons. These include (but are not limited to):

A health related illness, injury, or frailty, A long stay in hospital, An age related frailty, Cognitive impairment, A mental issue, or A learning difficulty. These proxy questions aim to establish why the selected person is not able to take part. This information can be provided by anyone in the household but ideally should be someone who knows the selected respondent well. You need to use your own tact, skill and judgment to identify a person to ask. You might ask these questions from a: parent, adult child, other relative or family member, friend or neighbour (where suggested by the selected respondent).

If you do ask these questions, this information will need to be entered into the Admin block before you submit the case back to the office.


Gaining this information is reflected in the fee structure.

3.6 Language Difficulties If your respondent cannot understand English you will not be able to carry out an interview with them. A lot of the questions in the interview are subjective and about feelings, so a good level of English is required to be able to understand them and answer fully. Additionally, because so much of the interview uses standardised questions with fixed wordings, we cannot use interpreters, either professional or family members. It would also be inappropriate to use family members given the subject matter in the full interview.


4 Getting People to Take Part.

4.1 Making Contact and Appointments An important KPI is to visit all your addresses in the first 7 days. There are various documents available to help you make contact with the address, and/or your selected respondent: 1) Sorry I Missed You Letter If after repeated attempts at different times of the day and week you still have not been able to make contact with a household, you could try using the Sorry I Missed You Letter. Blank envelopes are also provided. This is a letter that you can post through the respondent’s door. The letter makes reference to the advance letter and has space for you to write your name and contact number. This letter may come in useful when making contact with people living in flats with entry phone systems. 2) Contact Card This is a blank survey specific card you can use in any way you like, e.g. you can use it as a reminder, or to leave contact details so that they can contact you.

Once you have made a respondent selection, you can arrange an appointment to interview if you are not there at a convenient time. Try and get the respondent to write down the time/date you arrange on the contact card themselves as research shows they are less likely to break the appointment this way. 4.2 Documents you could use on the doorstep

1) Survey Leaflet The study leaflet is not sent out with the advance letter. People at the household will not have seen the leaflet yet, so offer this on the doorstep. It explains the survey in more detail, as well as giving some examples of how the study has made a difference. Once an appointment has been made, leave the leaflet with the respondent. This helps ensure informed consent.


When you have arranged an interview, you may want to write the time and date on the front of the study leaflet as a reminder for the respondent.

2) Advance Letter Laminate/Copy The advance letter will be sent out by the office around seven days before your fieldwork is due to start (second class postage). The envelope will have the NHS logo on it. You can use the advance letter laminate as a prompt to respondents on the doorstep. 4.3 Webpage Alongside the doorstep documents you can direct people to the study webpage on the NatCen website: www.natcen.ac.uk/healthandwellbeing


4.4 Tips for Introducing the Survey The key thing is to avoid too much detail too soon and keep your introduction brief.

When introducing the survey, generally avoid terms such as ‘mental illness’. The

survey leaflet may help. In the study leaflet, we talk about ‘dealing with the stresses and strains of everyday life’ and ‘health and wellbeing’. The study covers many different aspects of physical and mental health as well as general wellbeing, life circumstances and experiences. In the Dress Rehearsal, interviewers found the following helpful:

o Referring to the stresses and strains of everyday life that we all experience o Stresses and strains due to work, illness or caring for someone o Stresses and strains brought on by busy lives – that can impact on your health

Think about the kind of questions that people may ask, and have short answers ready. In particular consider some of the information about how the survey is used so that you can engage people with a story about how it’s made a difference.

How long will it take? On average the interview takes 90 minutes. This may be off putting for some people. Explain that the survey is very thorough as it is only carried out every 7 years. What will you ask me? There will be questions on a range of health, wellbeing and lifestyle topics. Respondents don’t have to answer any questions they don’t want to.

If you make contact, but the resident is too busy to talk to you at that time, you could leave the survey leaflet with them and say that you will call back at a more convenient time to discuss it further.

After you have selected an eligible adult, you will be going on to arrange the interview. If your selection has fallen on someone other than the person on the doorstep, you may need to make an appointment to visit when the selected respondent will be around, to make an appointment to do the interview. Try not to go into too much detail about the survey until you see your selected respondent, to avoid a second-hand version of the survey being passed on.

It is obviously important to reassure respondents about confidentiality and to make it clear that no information from the survey will be passed on to anyone in a way that would allow any individual to be identified.

The voluntary nature of the survey should also be covered, and the fact that individuals can refuse to answer particular questions or end the survey at any time.

4.5 Things you can mention on the doorstep

Government Related

It is a national survey on behalf of the Health and Social Care Information Centre. It’s widely used by government departments, charities, academics and the NHS.

It provides the government with accurate and up-to-date information on the health and wellbeing of the population.

The information will be needed by whichever government is in office and the information is available to all political parties.

It is used to help plan NHS services.


Confidentiality

Answers are treated in the strictest confidence in accordance with the Data Protection Act 1998.

No-one outside the research team will know who has been interviewed, or will be able to identify an individual's results.

Results are only published as aggregate statistics.

Names and addresses are always kept separately from survey data.

Signify its importance & status

It is a very important survey.

It is the largest national survey to look at the wellbeing and mental health of the general population. Over 35,000 people have taken part.

It is carried out every 7 years, and has been going since 1993.

Give some examples of how it’s been used

Describe population coverage & why certain groups should participate

The survey covers the whole population, including people who have little contact with the health services as well as people who make more use of them.

Each person selected to take part in the survey is vital to the success of the survey. Their address has been randomly selected - not the one next door. No-one else can be substituted for them.

To get an accurate picture, we must talk to all the sorts of people who make up the population - the young and the old, the healthy and the unhealthy, those who use the NHS and those who use private medicine, and those who like the current government's policies and those who do not.

Young people might think that health services are not for them now - but they will want them in the future and it is the future that is now being planned.

Older people might think that changes will not affect them - but health services for the elderly are very important and without their help in this survey valuable information for planning these will be lost.

4.6 Incentive There is a £15 high street gift card for each respondent as a token of appreciation. The incentive cards will be sent to you straight from Love2shop (and not contained in your work packs). You will enter in CAPI the reference number from the card that you hand over to the respondent. The activation is done in office on the day following the transmission of the productive case. The amount to be loaded on the card (£15) is generated from the CAPI program.


5 The Stage 1 Interview. 5.1 Content A full overview of each of the topics is in Appendix A. The study includes a lot of questions about different aspects of mental health. These questions are designed for generating rates and trends for population mental health. They are not suitable for generating individual level diagnoses and we never feed such information back to respondents. Therefore it is very important that respondents do not believe that the study provides them with a ‘mental health check’. Rather, the questionnaire covers a very wide range of topics including measures of behaviours, personality types and feelings. 5.2 Administering the CAPI Questionnaire 1. Sensitive or unusual question topics Respondents may find some of the questions strange. For those who have experience of what the questions are asking about, these questions won’t feel odd. Never try to explain the question or give further detail beyond what is on the screen. If a respondent isn’t sure, repeat the question. Do not anticipate that sensitive subjects will distress respondents. Previous waves in the survey series show that most people will have no experience of many of the topics asked about, and for those who do, their experience will not seem unusual to them. Do not presume just because someone has experienced a ‘traumatic’ event that they will recognise it as such, or be unable to talk about it openly. Just keep reading the questions in a straightforward way. Respondents don’t need to answer every question if they don’t want to. Establish at the start of the interview what the respondent should say if they don’t want to answer, e.g. “next question please”, rather than have them politely answer when they don’t want to or not know how to refuse. 2. Intellectual functioning section These questions are made up of three separate activities (for more detail on the separate tests and their administration, refer to Appendix A). Two of the tests are only administered to those aged 60 and over and are designed to look at the possible onset of dementia. You may be familiar with these questions if you have worked on ELSA. For these you will need the ‘10 Word Recall’ document and the ‘Animal Names’ document. The other activity (the reading test) is answered by everyone (if English is their first language) and is a more generic indicator of intellectual functioning. Definitions of the words can be found in Appendix E.


Some people may not like to be ‘tested’ in this way so care needs to be taken in introducing this section. As it comes after the rather ‘heavy’ self-completion section of the questionnaire you could describe it as a change or a bit of light relief. Some people may struggle with these activities, or feel embarrassed or frustrated by them. Be patient and encouraging, but avoid helping respondents by giving tips or hints to answers. There are checks in the reading tests to end it sooner if a number of incorrect answers are provided in a row. It is important that you feel familiar with these set of questions and how to administer them. We recommend you practice by administering the tests on yourself so that you can experience what it feels like to answer these questions. 5.3 Administering the Self-Completion/CASI Questionnaire The CASI covers the most sensitive questions (e.g. experience of domestic violence) to help respondents feel able to answer honestly. The CASI has a locking function. When the respondent comes to the end of the CASI it locks so that you can’t review any of their answers. You can tell the respondent about this function before they start the CASI, to provide reassurance. We expect most respondents will complete the CASI independently. It is long: it will take around 30 minutes. Bring something to do during this time, perhaps some work, a crossword or reading material. The helps the respondent not to feel pressured to complete the CASI too quickly. Before handing over the CASI, there are two practice questions you should go through together. These questions are designed to help the respondent feel familiar with how to navigate, and help you assess whether they may need additional assistance. Some respondents may need assistance in completing the CASI. In previous waves, older respondents in particular were sometimes not able or willing to use a computer. In such circumstances it is ok for you to complete the CASI together with the respondent. These questions are highly sensitive, so it will be important to re-emphasise that they do not have to answer any questions that they do not want to. Assistance can take different forms, and it will be important to establish with the respondent the best way for you to provide support, to make them feel comfortable. For example, you can read out the question and the response options – and then the respondent may want to code their answer directly, for more privacy.


6 During the Stage 1 Interview. 6.1 Privacy during the Interview Many of the questions ask about feelings and personal problems - it is important that, wherever possible, the interview is conducted with the respondent on their own. 6.2 Respondent Distress and Interviewer Safety With the majority of respondents you should encounter no problems and even those with problems may find the interview therapeutic. However, as with any PAF sample, you need to think of your own safety and wellbeing first and use your previous interviewing experience in assessing potential risks. Many of you will have worked on other surveys and will be aware of the potential for distress to a few respondents. In your work pack is a supply of ‘Useful Contacts’ leaflets with telephone numbers of organisations that may be able to help. You should leave one of these leaflets with every respondent.

If you find yourself with someone who is getting upset or distressed, be prepared to stop and if appropriate offer to go back another time to finish the interview. As in the previous surveys, the help you can offer to a respondent will be limited because of confidentiality issues and because you are not there as a counsellor. Our usual advice is to suggest that the respondent speak to their GP, or some other support group. If a respondent discloses something in the interview that makes you concerned for them or someone else, you will need to follow the NatCen policy on Disclosure of Harm (see Appendix D for this policy). In brief, you should report this immediately to your team leader, area manager or the research team. The NatCen disclosures committee is in place to review disclosure/concerns about respondents, and will take a decision about what action should be taken, if any. You should not take any other action yourself, unless it is an emergency situation that requires a 999 call. If a respondent does become distressed or discloses something of concern, you will need to complete a special report form when submitting back to the office. These will be logged and reviewed by Operations and the research team. It is


important that we have an accurate log of incidents/issues so that the research team is aware of the types and nature of issues in the field. This information will be used to indentify support needs of interviewers and respondents, and aid development of future briefing materials. This project has a group of psychiatrists acting as expert advisers who will provide advice to staff on the appropriate action in the unlikely event of concerns about the safety of any respondent. It is important that you take care of yourself when working on this study. The survey covers a range questions that may trigger something for you, or you may feel upset for respondents. We recommend that you limit interviews on this study to two per day, if possible. You may find it helpful to debrief with another interviewer, team leader, area manager or with one of the research team following difficult interviews. If at any point you do not want to work on this study anymore, please notify your team leader. 6.3 Partial Interview Definition For a partial interview (outcome code 210), the questionnaire must have been completed at least as far as completing the first question of the Psychosis Screening Questionnaire (variable name PSQ1). See section 9.8 in Appendix A for information about these questions. If the respondent terminates the interview before then, the case should be coded as a refusal. 6.4 Consent to Data Linkage Respondents are asked if they will consent to link their anonymised survey answers with government held health information. The three health registers we seek to link to are: NHS Central Register; NHS Cancer Register; Hospital Episode Statistics Register. No answers given during the survey will be attached to their name on the register. You can reassure people that no-one else will know that their name has been flagged in this way and it does not mean that they will be contacted again in the future. If they give consent to do this they need to read and sign the consent form provided:

**


Important Note – Completing the Consent Form **

We cannot use consent forms that are not correctly completed. Please take the time to make sure it’s correct. To complete the consent form: 1) Respondent reads the white information side.

2) Respondent flips the form over to the blue side.

3) Respondent reads, adds their name, signs and dates the blue side.

4) You add your name, sign and date the blue side.

5) Leave the white side with respondents (labelled ‘Respondent Copy’)

6) Send the blue side to the office (labelled ‘Office Copy’) in your return of work envelopes. This can be done in batches of up to 9 consent forms (please do not include more than 9 consent forms in one envelope for information security purposes). Please check: The correct date has been used; Respondent and you have both signed and written your name correctly.

A signature on a consent form is only valid where the respondent is properly informed and capable of understanding. It is important that you allow respondents time to read the consent form and that you are confident they understand what they are agreeing to. You should also be prepared to answer any questions they might have. How do we link the survey answers to respondent’s health records? We link the two sets of information via the respondent’s NHS number. However because most people don’t know their NHS number we have to find it out using respondent’s name, address and date of birth (DOB). Here are the stages of the linking process: 1) Gain informed consent for data linkage during the interview from the respondent. 2) Survey answers are separated from respondent’s name, address and DOB and stored securely separately. 3) Name, address and DOB are securely sent to the NHS Central Register, where their health record and NHS number is identified. A flag is put on the NHS Central Register that they have taken part in the National Study of Health and Wellbeing. 4) Respondent’s NHS Number is securely sent back to NatCen from the NHS Central Register. The NHS number is added to the dataset with respondent’s survey answers (this does not contain any names, addresses or DOBs). 5) Respondent’s survey answers are linked to the NHS Cancer Register and Hospital Episode Statistics Register using their NHS number. Why link respondent’s survey answers with their health records? The aim of data linkage is to make the answers respondent’s have given ‘go further’:

We can find out additional information respondents may not know e.g. specific timings of hospital admissions;

We can find this information out without taking up any additional respondent time or burden;


We can follow-up respondent’s health in the future using the health records. This means we don’t have to visit respondents again to find out about their health.

This final point is particularly important because from our survey answers we know a lot about our respondents right now, but nothing of their future health outcomes. Data linkage means we can follow certain groups of people to see if they are more likely e.g. to have more hospital admissions or a diagnosis of cancer than other groups of people. These groupings are based on their survey answers, e.g. their mental health status, household income or their answers to certain survey questions. Data linkage is used already for this reason by a number of different studies including: Cancer Research UK linked the Hospital Admissions and NHS Cancer Register to

investigate the likelihood of getting and surviving cancer by different ethnic groups. Nuffield Trust (a health research charity) followed patients receiving a new health a

social care service to see if they were less likely to be admitted to hospital more frequently (using the Hospital Episode Statistics Register).

Million Women Study has tracked over a million women aged 50+ since 1998 using

all three health information datasets. The study is funded by the NHS and Cancer Research UK.

Institute of Child Health (at University College London) has used all three health

information datasets (and others), to follow women who received hormone treatments (e.g. IVF) to conceive a child. They are trying to find out if receiving these treatments increases the risk of a cancer diagnosis in the future and can link to these datasets many years after the women have received the treatment.

Gaining consent to data linkage is a really important part of the National Study of Health and Wellbeing so please do all you can to gain consent.

7 Stage 2 Interview. 7.1 Agreement to the Stage 2 Interview The majority of respondents will not be selected to take part in a Stage 2 interview. However, the selection of respondents is done after the Stage 1 interview has been transmitted; therefore getting agreement to the Stage 2 interview from everyone is crucial to the success of the study as a whole. It is during the clinical interview at Stage 2 that the validated assessment of serious mental health conditions takes place. At the end of the interview is a question about consenting to be contacted about Stage 2. The question is designed to be as short as possible, but we do need to mention our collaborators at the University of Leicester as we need the respondent’s agreement to pass their contact details to them. However you should also feel able to amend the wording here to be appropriate to the situation you are in, for example:

The follow-up question is situated immediately after you give the £15 token of appreciation. You can inform respondents they will receive a further £15 for the Stage 2 interview.

You can also mention that they are not agreeing to do the second interview, only for someone to tell them about it and let them decide.


If the respondent has expressed any concern about confidentiality you can reassure them that the interviewer from the University of Leicester will be the only person to know their name.

If the respondent did not like the socio-demographics questions in the interview you can reassure them that the second interview focuses only on their health and personality.

7.2 Information for the Stage 2 Interviewer We would like you to record details that may be useful for the Stage 2 interviewers when respondents agree to be re-contacted. As well as contact details during the CAPI, the Admin Block includes an open question where you can record factual information about those respondents. Please try to include:

General directions to locate a difficult-to-find address

Locating/identifying dwelling units in multi-DU addresses

Alternative (e.g. work) phone number given by respondent

Best time to call, if the respondent will be away during a certain period

There is a space for up to 200 characters to be typed in. You must not record information at this question that would identify an address or individual, or anything that you would not want any person in the household to see.


8 Survey Documents. Details of the survey documents have been covered elsewhere. Here a list of all survey documents, equipment and tools: Doorstep documents: Advance letter/laminate Survey leaflet ARF Contact card Sorry I Missed You letter

Documents/Equipment needed during the interview: Show cards Word recall document (for respondents aged 60+) Animal naming document (for respondents aged 60+) Gift card Consent Form Useful contacts leaflet

Reference documents / tools: Project Instructions Study webpage - www.natcen.ac.uk/healthandwellbeing

9 Returning Work to the Office. You should transmit CAPI work at the end of each day. It is very important that work is returned promptly as we need as accurate a picture as possible about how fieldwork is going so that we can keep our client informed, and take decisions about reissues etc. Remember consent forms must also be returned to the office. You should wait to send them in batches of no more than 9 per envelope (any more than 9 per envelope is an information security risk). Before returning them, please make sure all consent forms are completed correctly.


http://www.natcen.ac.uk/healthandwellbeing

Appendix A: Questionnaire Instructions. Before you begin an interview, remember to check the date and time in the CAPI.

9.1 Overview of the questionnaire Face to face 1 Introductory questions, including household grid General health and wellbeing Activities of daily living and caring Doctor diagnosed health conditions Service use and medication Common mental disorders Self harm and suicidal behaviour Psychosis screening questions Attention Deficit Hyperactivity Disorder (ADHD/ADD) Work related stress and work-life balance Smoking Drinking 1 Self-completion Drinking 2 Drug use Personality disorder (if aged 16-64 years) Social functioning Autism Bipolar disorder Post-traumatic stress disorder Military experience Domestic violence and abuse Neglect in childhood Self harm and suicidal behaviour (questions repeated) Discrimination Sexual identity Sexual behaviour (if aged 16-64 years); Menopause (if female and 40-59 years)

Face to face 2 3 Intellectual functioning activities (2 asked if aged 60+; 1 of all with English as a first

language) Key/stressful life events Parenting Social support Religion Social capital and participation

The interview consists of the following modules. Please do not name these modules with respondents. Additionally with screening tests, please do not say beforehand what conditions the screening tests are for, as this could affect the results.


Socio-demographics and debt Gift card Recall, consent to data linkage and admin.

9.2 Introductory Questions This section includes a standard household grid to collect information about the selected respondent, other members of the household and their relationships to each another.

As part of this, you are asked to enter the person number of the respondent. This is the person number from the household grid, not from the ARF. Select the person number from the list that appears on the screen at this question.

Language: please record if the respondent’s first language is English. This question is important because the reading test (part of the intellectual functioning module) is only asked of respondents whose first language is English.

9.3 General Health, Activities of Daily living and Caring 1) General Health Question Aim: to establish how the respondent regards their own general health. 2) Activities of Daily Living Aim: to assess whether the respondent experiences difficulty with a range of different activities of daily living. For each statement respondents are asked to say whether they have: no difficulty at all; yes some difficulty; or yes a lot of difficulty. If they have any difficulty with any of the activities they are asked about who provides them with assistance. These questions are our main measure of disability and impairment. 3) Being a Carer Aim: to find out whether respondents’ have any caring responsibilities for anyone who is disabled and/or sick (including due to old age). If they do, we ask how many hours of care they provide, whether they live with the person they care for, and what their relationship is to that person. Paid care is not to be included. Being a carer is likely to have an impact on mental health, collecting this information allows us to explore this relationship. 4) Subjective wellbeing Aim: We use the 14 item Warwick-Edinburgh Mental Wellbeing Scale to assess a respondents’ subjective wellbeing. The scale covers aspects of subjective wellbeing that are to with ‘feeling good’, as well as aspects of wellbeing that are more to do with being able to ‘function well’. This information has enabled us to show that while wellbeing and mental health are linked, they are not the same thing. This information means we can explore what factors enable people with a mental disorder to also have a high level of wellbeing. 5) Physical health conditions Aim: to find out if respondents’ have ever had certain physical health conditions, with follow-up questions about each condition reported. These questions are specifically about physical health conditions: mental health conditions are covered separately. This information allows us to explore the links between physical and mental health. Respondents are asked whether they have ever had any of the conditions listed on the showcard. This includes childhood conditions that have continued into adulthood. For each condition reported, you ask: Whether it was diagnosed by a doctor or other health professional,


Whether they have had the condition in the last year (they should say yes if the

condition has been present - even if they have had no symptoms, for example due to use of medication or an aid); and

Whether they have had any treatment or prescribed medication for it in the last year (treatment includes therapies, like physio, but medications should only include prescribed medication not those bought over the counter).

You will still ask about treatment or medication in the last year even if they report not having had the condition in the last year. For example, some people may continue with treatment after a condition has been resolved. 6) Sight and hearing impairment Aim: Very little is known about whether or not people with sensory impairments are more likely to experience poor mental health than those without. This data will be key in addressing this question. 7) Learning Difficulties Aim: A few questions are asked to establish whether or not the respondent believes that they have a learning difficulty or intellectual impairment, what the condition is (if that is known), how severe they feel the condition is, and to what extent this impacts on what they can do. 8) Psychiatric conditions Aim: Previous surveys in this series did not ask whether or not respondents’ they think they have a specific mental disorder, and whether or not a doctor had ever diagnosed that disorder. The information collected in the 2014 survey will be the first national, general population information on this topic, and will provide crucial context for the other measures included in the study. If they report that they have had more than one in the last year, they are asked which they feel most interferes with their life. This is very much a subjective assessment, but it does relate to which condition they feel most interferes with their life at the current point in time.

9.4 Service Use and Medication 1) Medication Aim: to find out if respondents are taking any of the most commonly prescribed medications for psychiatric conditions (including injectable medications). We aren’t asking respondents about all the medications they are taking as this would take too long. If respondents’ report taking any of these you are routed to a question asking to see the medication packet. If they are able to show you the packet you can then verify whether or not it has been correctly coded. There is also a question on what condition the respondent believes they are taking the medication for. 2) Counselling Aim: to find out if respondents are receiving any type of therapy or counselling. This question is asked of all respondents, even if they have not mentioned any mental health problems. Some people may have recovered from a condition, and are still in receipt of counselling or other treatment. 3) GP Consultations


Aim: we are primarily interested in finding out about GP consultations for mental and emotional problems. ‘Talking to a doctor’ can mean seeing him/her (at home, surgery, health centre etc.) or speaking to him/her on the telephone. This does not include social chats with a friend/relative who happens to be a doctor. Visits to a doctor at a clinic (e.g. family planning clinic) are included, but we do not want to include talking with a doctor at a hospital or special clinic as these talks will be covered later under outpatient visits. You are asked to code details of up to six mental or emotional problems for which the respondent had talked to a doctor. This involves using a look-up file. If they have had more than six problems, you should ask about the six which the respondent considers to be the most important. If the problem is not available in the look-up file you should search within the file for ‘98’ and enter this instead. 4) Inpatient Stays Aim: to find out about inpatient stays in the past 12 months and past 3 months, as well as specific inpatient stays for a mental health problem. Include: stays in private hospitals and clinics, dialysis patients required to stay in hospital overnight, stays for sight or hearing problems. Exclude: stays for giving birth. An inpatient stay lasts from admission to discharge, so if an informant was sent home for the weekend during a spell as an inpatient, this counts as one spell. 4) Outpatient Visits Aim: as with inpatient stays, to find out about outpatient visits in the past 12 months and past 3 months, as well as specific outpatient visits for a mental health problem. Outpatient visits are visits to hospital or clinic for treatment or check-ups, either on an appointment basis or just through turning up. These include visits to day hospitals, private consulting rooms and casualty/A&E departments. Day patients are defined as patients admitted to a hospital bed during the course of a day or to a day ward where a bed, couch or trolley is available for his/her use. They are admitted with the intention that care and treatment can be completed in a few hours so they will not need to stay in hospital overnight. If a patient is admitted as a day patient but then stays overnight, they should be counted as an inpatient. Note that some people may receive treatment or check-ups at day centres. These should be included as outpatient episodes, whereas visits to day centres for social and leisure activities are excluded here. Include dialysis patients if they are admitted only for the day and are not required to stay overnight. Those staying overnight are included as inpatients. 5) Day Activity Centres and Community Care Services Aim: to find out if respondents’ have used any of the three specific types of day activity listed on the show card; and to see if they have used any of a range of types of community care services in the last 12 months. These questions cover services not already mentioned in the service use section. For example, meetings with a psychiatrist at an outpatient clinic should already have been


included in the outpatients section. However, visits by a psychiatrist to the respondent’s home would be included here. 6) Treatment not received Aim: to find out if respondents’ have asked for any type of counselling or mental health related medication in the last 12 months but not received it. If they have, they are asked whether or not they are currently on a ‘waiting list’. This does not necessarily mean a formal list; it is just to establish whether or not they are expecting to receive the counselling in due course. 9.5 Appetite and Weight Change Aim: there are a few questions about appetite and recent changes in weight, as these can be symptoms of poor mental health. 9.6 Common Mental Disorders (CIS-R) This group of questions are used together to assess common mental disorders in the general public. They are a set of standardised questions used on other surveys called the ‘Clinical Interview Schedule-Revised’ or CIS-R. These questions are among the most important in the whole study. Purpose of the CIS-R: is to identify the presence of common mental disorders (like anxiety and depression), and where these occur: to establish the nature and severity of neurotic symptoms, so that we can derive more specific diagnosis from all the data. England’s prevalence of, and trends in, common mental disorder are derived from these questions, so they are crucial. The main body of the CIS-R has 15 sections, each labelled at the top of the CAPI screen e.g. “CISR – SOMATIC SYMPTOM”. Each section deals with a particular type of symptom and the final section assesses the overall effect of these neurotic symptoms. All the sections are opinion questions. The sections are as follows: A Somatic symptoms (physical symptoms) B Fatigue (or tiredness) C Concentration and forgetfulness D Sleep problems E Irritability F Worry about physical health G Depression H Depressive Ideas I Worry J Anxiety K Phobias L Panic M Compulsions N Obsessions O Overall effects If respondents do not know what is meant by a particular symptom, or do not understand the question, you should not reword or paraphrase. Content of the CIS-R 1) Existence and severity of neurotic symptoms


In each section, the first few questions establish the presence of a particular neurotic symptom in the past month. For those respondents who had such symptoms in the past month, you will be routed to further questions, which ascertain the frequency, duration, severity and the time since onset of the symptoms. Note that all of the sections A to N have this structure except for section H 'Depressive ideas' which is really a continuation of section G 'Depression'. 2) Reference periods We have included the time reference period, where relevant, on the showcards used in this section. Each section begins by asking whether the symptoms were present in the past month (except section H 'Depressive Ideas'). The past month refers to every day in the past month up to and including yesterday. If respondents’ reply that they 'felt the same as usual' or that the symptoms were present 'no more than usual' instead of saying the symptoms were present in the past month, you should treat this as if the symptoms were present. These replies could indicate chronic symptoms, which must not be ignored. Those who had symptoms in the past month are asked the subsequent questions which relate to the past week. The past week refers to the past seven days, up to and including yesterday. This is usually computed automatically from the system date on your computer. However, should the date on your computer be wrong the interview date will also be wrong and so you will get errors. Should this occur - please phone the Help Desk. 3) Frequency of symptoms In each section where the symptoms were present in the past month, respondents are asked how many days the symptoms were present in the past week. If the respondent replies that the symptom was present 'all the time’, e.g. 'the worry is always there at the back of my mind' then you should prompt for an answer. Similarly you should prompt for an answer if the respondent does not know how often the symptom was present. If the respondent is unsure e.g. whether the symptom was there on 3 or 4 days, you should record the less frequent code (i.e. 3 days). 4) Duration of symptoms In all sections except section H 'Depressive Ideas', the respondent is asked about the duration of symptoms. This refers to how long the symptoms lasted on any day in the past week. You may need to make it clear that this refers to the total number of hours the respondent had the symptom. In other words, if the respondent had three headaches in the day, they should estimate the total time headaches were experienced in that day. However at sections L 'Panic' and N 'Obsessions', we are not interested in the total amount of time the symptoms lasted in a day, but in how long the 'panic attack' or the episode of having an obsessive thought lasted. This does not depend on how many times the person had an obsessive thought or panicked. If the respondent does not know the duration of symptoms, you should prompt for an answer. If the respondent is unsure e.g. whether the headache lasted for 3 hours or more, you should assume that it did not. 9.7 Self-harm and suicidal thoughts and behaviour Aim: These data are the only general population information on the extent of suicide attempts and self-harming. Data from the previous waves of the surveys have highlighted


the high rate of self-harm among younger women, and the growing rates among young people generally. It is important to take your time over this section, to thank respondents for answering the questions and to help them to orientate themselves back into the rest of the interview by explaining what the next few questions are about. This is all outlined in the CAPI questionnaire. Five of the questions from this face-to-face section are also contained in the self-completion section. This is to give respondents a second opportunity to report some of these sensitive thoughts and behaviours. The reason we don’t just ask these questions in the self-completion is because some respondents are unable or unwilling to complete the self-completion CASI, and these questions are particularly important. Additionally, looking at previous waves of the survey, we found respondents were generally willing to disclose answers to these questions in a face-to-face setting. 9.8 Psychosis - Psychosis Screening Questionnaire (PSQ) Aim: these are a set of standardised questions used to identify the possible presence of psychosis by means of psychotic symptoms. The word ‘psychosis’ is not used. This section does not aim to establish the frequency or severity of symptoms –just to see if any such symptoms are present. As with the CIS-R, these questions are designed to give an estimate of prevalence in the general population, and are not designed to provide a diagnosis of any mental health problem at an individual level. Each of the main questions finds out whether a particular behaviour, thought or feeling has been experienced in the past year. If it has, you are routed on to an additional question which establishes whether the behaviour, thought or feeling is severe enough to be regarded as a symptom of psychosis. On occasions respondents may have difficulty interpreting the questions or find them unusual. In such cases you should simply repeat the question, and not try to explain the question further. What are psychoses? Psychoses produce disturbances in thinking and perception that cannot be explained as responses to experience, and are severe enough to distort the person’s perceptions of the world and the relationship of events within it. 9.9 ADHD Screening Questionnaire Aim: ADHD is an extremely complex disorder. As such, this set of standardised questions is included to identify a sample of respondents for possible follow-up studies, rather than generate a reliable prevalence estimate in the general population. Again, these questions are not designed to provide a diagnosis of any mental health problem at an individual level. This brief set of questions has been used to screen adults for ADHD in community samples. It is a widely used tool (in research and clinical practice) developed with the World Health Organisation. As with the Psychosis Screening questions (9.8), if respondents’ have difficultly interpreting the questions or find them unusual, simply repeat the question. What is ADHD? Attention deficit hyperactivity disorder (ADHD) is a complex condition characterised by excessive lack of sticking with activities that require cognitive involvement (‘inattentiveness’), impulsiveness or hyperactivity that significantly interferes

with everyday life. Additionally, these symptoms should be continually present and not just on occasions, e.g. when nervous or excited about a stressful or exciting event.


9.10 Work Related Stress Aim: to find out about respondents’ everyday working conditions and any work-related stress. Research using previous waves of this survey has shown that working conditions can have a big impact on mental health and wellbeing. In particular how much control you have over your work, levels of support at work and relationships between job effort and reward can all have an impact. 9.11 Smoking, Drinking and Drug Use (mostly self-completion) Aim: to find out about respondents’ behaviour related to smoking, drinking and drug use. There is a lot of research about the effects these behaviours can have on physical and mental health, and emotionally wellbeing – both positive and negative effects. 1) Smoking The aim of this section is to estimate smoking prevalence and the number of cigarettes smoked. We are asking only about cigarettes, as cigar and pipe smoking is no longer common. Therefore, ignore any reference to snuff, tobacco or tobacco products that are chewed or sucked or herbal tobaccos. Specific questions: QtyWeek: Give an overall weekly number of cigarettes, enter DK and record these amounts as a last resort, using the notepad facility. If more than 97 cigarettes are smoked per day, enter 97. CigAge: This question is asked of all current and ex-cigarette smokers. Someone who says in reply to CIGNOW that they currently smoke cigarettes may not consider that they ever smoked cigarettes regularly. If they say this at CigAge, code 1. 2) Drinking After a few questions to assess whether or not people drink at all and, if not when and why they became teetotal, the drinking section is administered in the self-completion section. You should present the respondent with the showcard with the different sized measures and glasses for them to use in this section. Specific questions These questions are designed to be answered as a self-completion therefore although you should be familiar with these questions, an in-depth knowledge is not necessary. However you should be aware that some respondents who are routed into the Severity of Alcohol Dependence questionnaire may not see themselves as heavy drinkers, and may resent some of the questions in this section. There is also a question that asks the respondents to recall a “typical period of heavy drinking in the last 6 months”. If your respondent complains that this doesn’t apply to them, suggest they think of an occasion when they “have drunk a lot”. Failing that, you can suggest they think of a “usual” drinking session. If the respondent does drink, the self-completion section begins. CASI Practise questions Explain how to use the computer. There are two practice questions for you to complete with the respondent. Use these to assess whether your respondent can use a computer or if they may need your assistance. Show respondents how to: Select/code a response Code ‘Don’t Know/does not apply’ (CTRL+K or 9) Skip a question (CTRL+R)


Change a response Move to the next question (ENTER) Go back to a previous question. Except in exceptional circumstances all respondents should self-complete this section, which will run into the drugs and then the personality disorder sections. If you suspect that the respondent has difficulty reading you should offer to read the questions. 3) Drug Use (self completion) The questions in this section look at overall use of drugs, including a measure of dependence and some questions about treatment for drugs problems. Due to time constraints, the detailed questions on drug use are only used for a sub-group of the most commonly used drugs for which dependence is likely to be a problem. This section is asked as a self-completion on the laptop and it follows on directly from the drinking questions. Those who have never taken drugs will only be asked two questions so it will generally be over very quickly. Respondents who are tee-totallers will enter the self-completion section at this point. Specific questions Treatment questions: some of this information may have already been collected in the service use section but they are included here to get bit more detail and to cover a wider time scale. If questioned, advise the respondent to include treatment both for addiction itself; e.g., methadone prescriptions given to registered addicts, detoxification and withdrawal programmes, and for health-related problems, such as ulcers from injecting. Respondents who have only taken cannabis might resent this question, as they may not see it as a 'drug'. Re-assure them that these questions are asked of lots of different people. Respondents who have used cannabis regularly (at least 2-3 times a week) in the past 4 weeks will be asked 5 additional follow-up questions about their cannabis use. 9.12 Personality Disorder Screen (self-completion) Aim: these set of standardised questions are designed to examine personality disorder. Again, these questions are not designed to provide a diagnosis of any mental health problem at an individual level. What is a personality disorder? The term ‘personality’ refers to the enduring characteristics of an individual that are shown as ways of behaving in a variety of circumstances. When a person’s personality traits have developed to such an inadequate or excessive degree as to cause damage or suffering to the person or to other people, the person is said to have a personality disorder. Administration of the questions Except in exceptional circumstances all respondents must self-complete this section. If you suspect that the respondent has difficulty reading you should offer to read the questions from the screen. But even if you read out the questions, the respondent should still ideally have the laptop in front of them to type in their response to each question knowing that you cannot see their responses. If someone seems to be rather slow at completing this section offer to take over reading the questions for them, but again, the respondent must ideally still type in their response to each question.


If a respondent refuses to continue with this section before answering all the questions enter ‘refusal’ for all the remaining unanswered questions. 9.13 Bipolar Disorder Screening Questionnaire Aim: this set of standardised questions is included to people who may have symptoms of bipolar disorder. They are not designed to provide individual level diagnoses. What is Bipolar Disorder? It’s a condition that affects your moods, which can swing from one extreme to another. If you have bipolar disorder, you have periods or episodes of: • Depression – where you feel very low and lethargic; • Mania – where you feel very high and overactive. 9.14 Autism Screening Questionnaire (self-completion) Aim: this set of standardised questions aim to provide a general population level prevalence of autism. They are not designed to provide individual level diagnoses. What is Autism? Autistic Spectrum Disorder (ASD) is a life-long developmental disorder characterised by deficits in communication, social functioning and imagination resulting in the failure to develop normal peer relationships. Specific Questions Some of the questions in this section may seem a little odd to respondents, due to the nature of the condition that is being assessed. In the introduction to this section respondents are reassured that some of the questions may seem a little strange, and that the questions are about the kind of person they are, and the way they prefer to do things. They are asked to ‘answer all the questions to the best of your ability, even if some of them don't seem to apply to you’. 9.15 Posttraumatic Stress Disorder & Military Experience

(Self-Completion) Aim: these standardised questions are designed to establish symptoms of post-traumatic stress disorder in the general population. They are not designed to provide individual-level diagnoses for respondents. What is PTSD? Posttraumatic stress disorder (PTSD) is distinct from other psychiatric illnesses in that its diagnosis requires exposure to a traumatic stress (being actually involved in, witnessing or confronted with life endangerment, death, serious injury or threat to self or others) which is accompanied by feelings of intense fear, horror, or helplessness. Specific Questions Respondent are asked about symptoms that are associated with PTSD. These symptoms are: re-experiencing (such as distressing dreams or flashbacks); avoidance and numbing symptoms (such as avoidance of thoughts, feelings or talking about the event; avoiding situations, people, etc that remind them of event; poor recall of important aspects of event); and hyperarousal (sleep disruption, irritable, on-edge, hypervigilance). All respondents are then asked if they have ever served in the Armed Forces. If they have, they are asked a few follow-up questions about this service, and if it is related to their traumatic experience. Please be aware that this section may upset or cause discomfort to some individuals that have had such traumatic experiences. It is worth noting that questions are not asked about the specific details of the event(s) but rather their reaction to them.


9.16 Domestic Violence and Experience of Abuse (Self-completion)

Aim: these questions aim to find out respondents’ experience of domestic violence and abuse (as a survivor and perpetrator). This self-completion section includes questions relating to experience of domestic violence in adulthood, sexual abuse in adulthood and sexual and physical abuse in childhood. These questions are based on those asked in the British Crime Survey and in the national survey of Elder Abuse. Respondents are reminded that all their answers will be completely confidential, and that the computer will hide them so the interviewer cannot see what they have answered. Please be aware that this section may upset or cause some discomfort to some individuals that have had such abusive experiences. Specific Questions - For this survey family violence is seen as violence from a family member other than a partner or ex-partner. The questions are introduced as being about events that they may or may not have experienced SINCE the age of 16. They are asked to include all relevant events, even if they did not seem important at the time. - For this survey domestic violence is seen as violence from or towards partner or ex-partner. The questions are introduced as being about events that they may or may not have experienced SINCE the age of 16. They are asked to include all relevant events, even if they did not seem important at the time. - For this survey sexual abuse in adulthood refers to sexual abuse since the age of 16 and sexual and physical abuse in childhood refers to experiences before the age of 16. 9.17 Child Neglect (Self-completion) Aim: this short set of questions aims to find out respondents’ experience of childhood neglect. The questions are taken from a national NSPCC survey. 9.18 Self-Harm (self-completion) Aim: these shortened set of questions are a repeat from earlier in the interview, to help measure how reliable the answers to such questions are when asked face-to-face. There are also some additional questions on help seeking following self-harm. The introduction to the questions explains these questions are repeated from earlier in the interview. After completing this section a message comes on the screen that advises them that if they have ever felt like this they should talk to their GP or The Samaritans. If necessary you can refer respondents to the ‘Useful Contacts’ leaflet. 9.19 Discrimination, Sexual identity, Sexual Behaviour and

the Menopause (self-completion) Aim: these questions ask about experience of discrimination experienced in the past 12 months; sexual identity; sexual behaviour (only asked if respondent is aged 16-64 years); experience of menopause and related symptoms (only asked of women aged 40-59). 9.20 End of the Self-Completion These are the last questions in the self-completion component of the interview. A note comes up on screen at this point stating that the questions will now be ‘locked’, and asking the respondent to hand the laptop back to the interviewer. You may wish to reiterate or demonstrate to the respondent that you will not be able to see their answers to the CASI questions.


HandBack At the point at which the laptop is to be handed back to the interviewer, there is a screen at which you can’t move on unless ‘5000’ is coded. This is to ensure that the respondent does not continue with the questionnaire into the section that should be administered face to face.

The rest of the interview is interviewer-administered. 9.21 Intellectual Functioning Aim: there are three parts to the intellectual functioning section – two of which are only administered to those aged 60 and over. Those two sections are designed to look at the possible onset of dementia. The other section is answered by everyone (if English is their first language) and is a more generic indicator of intellectual functioning.

Administering the tasks and questions Some people may not like to be ‘tested’ in this way so care needs to be taken in introducing this section. However, as it comes after the rather ‘heavy’ self-completion section of the questionnaire you could describe it as a change or a bit of light relief. What are the 3 tasks and questions? 1. The Modified Telephone Interview for Cognitive Status (TICS-m). Only asked of those asked 60+. These questions were first developed to screen for the presence of dementia in older people. It includes items addressing orientation, comprehension, calculation, language and memory retention and recall. Most items are rather easy but the word list learning task and counting backwards in 7s can be demanding. Administering: Read the questions exactly as written. You may repeat a question on request if the subject has not heard or understood properly. For the word list learning task, be sure to read the words clearly at the rate of one per second. However this list should not be repeated, even if the subject claims not to have heard. Do not give any hints or be tempted to help the subject in any way if they do not know an answer. However, you should encourage the subject to attempt an answer if they say 'don't know' without apparently trying. Word recall Initially this question tests the respondents' ability to recall a list of 10 words straight after being read out. Read out the 10 words at a steady pace (around one word per second). Use the ’10 Word Recall’ document to record in the first column the words recalled and then transfer the answers to CAPI. After a few more questions the respondent is asked to recall the words again, use the second column to record these words, again then transfer this to CAPI. The word recall isn’t timed, but do not allow respondents to spend too long on this task. Subtract 7 from 100 Respondents are asked to do a series of number subtractions. They begin by taking 7 away from 100. This should be 93. They should then continue taking 7 away from what

If the respondent is aged under 60, and English is not their first language none of the intellectual function questions will be asked, and you will be routed straight to the next set of questions.


they have left over until you tell them to stop. Respondents should carry out a total of 5 subtractions (including the first). Type in the number that the respondent gives you. CAPI automatically works out if this is the correct answer. Respondents may make a mistake, say the wrong number, but continue to take 7 away correctly from that number. They will still get a correct score for these later subtractions. 2. The National Adult Reading Test (NART). Asked of all ages if English is their first language. This task assesses the respondent’s ability to read and pronounce, correctly, 50 words. All of the words have non-standard pronunciation, and therefore the correct pronunciation cannot easily be guessed. This task is asked of all ages except when English is not their first language (this will be automatically routed from the question at the start of the interview). For your information a definition of the words can be found in Appendix E. Administering Instruct the respondent to read out the words one at a time, and to wait until you say 'OK' before they proceed with the next (this gives you time to mark their response). The test terminates if they get four words in a row wrong. Encourage respondents to guess if they say 'don't know'. In order to be correct the exact pronunciation should be given. 3. Animal Naming. Only asked of those asked 60+. This is a test of 'verbal fluency', which assesses how well respondents can retrieve information from memory. The respondent has to name as many animals as they can within one minute. Administering Read the instructions exactly as on screen. Make sure that the respondent understands what is required before proceeding. When ready, the CAPI instructs you to Press 7 and <Enter> to start the timer. The screen will remain the same and looks like this:

Please ensure you have your laptop volume turned up before starting the timer. If the respondent stops before the time is up, say “Can you name more animals?”.

The timer starts as soon as you press <7> and <Enter> and does not take you to a new screen (the screen remains the same). After 1 minute a

computer voice says ‘Stop now’. Press <Enter> to continue after this.


Any animal is permissible, but try to avoid scoring repetitions, mythical animals and made up words. Sub-members of a group are permissible i.e. after dog had been provided, Alsatian, poodle, Labrador would still all score. If the respondent gives the name of an animal which you have not heard of (e.g. kudu) give them the benefit of the doubt and count them as correct. Press F9 to in the CAPI for a reminder of these rules. Write the responses on the “Animal Names” sheet provided. It is very important that the flow of the respondent is not limited in any way. If the respondent is saying animals more rapidly than can be written down in full, switch to a suitable abbreviation such as first letters or a tally. If this is necessary, however, be certain to monitor for repetitions, which do not count towards the total.. You will be asked to enter the total number of different animal names given by the respondent. General rules and advice for asking the cognitive functioning questions - Interview the subject, if at all possible, away from family members who may answer for them, inhibit them, or make them anxious, - Avoid the temptation to give any hints yourself! - Be sensitive to the possibility that subjects may feel demeaned by being asked some of the simpler cognitive items, remind them that ‘we have to ask these same questions to everybody’, - Be aware that subjects who are in the early stages of cognitive impairment may become angry or frustrated when they find that they cannot answer questions satisfactorily. Be patient and encouraging. - If a subject wishes to revise their response to a cognitive item (unprompted) then check that they are sure they wish to change their answer, and code the new answer (whether it is right or wrong). 9.22 Stressful life Events, Parenting, and Social Support Aim: these questions aim to find out about stressful life events that the respondent has experienced. There are also questions about experiences in childhood and looks at the social support a respondent has available. These kinds of things can have an impact on mental and emotion al wellbeing. 1) Stressful life events Stressful life events are associated with mental health problems. Similar questions to these have been asked on the previous surveys of health and wellbeing. Respondents are shown a series of cards on which there are lists of stressful life events and asked when they experienced them. For recent events, details of the availability of support are then collected. Specific questions There is a question about whether the respondent was ever taken away from home into local authority care. It is possible to have a care order and stay at home and these cases should not be counted. 2) Experiences in childhood There are a few questions about growing up with parents and about whether the respondent is parent themselves. Specific questions


We ask whether the respondent is the ‘natural parent’ of any children. Do not probe the answer given, but if queried exclude miscarriage, abortion, and adoption, and include any children who were stillborn or have died. 3) Social support These questions are about people whom the respondent feels close to including relatives, friends and acquaintances, both living with them or living elsewhere. Friends or acquaintances may be professionals such as a voluntary worker or a counsellor, if the respondent thinks of them in this way. They are all opinion questions. For people who are lonely and isolated, this section can be upsetting so needs to be handled with sensitivity. 9.23 Resilience Section Aim: there has often been a focus on the risk factors for negative mental health outcomes, but there is now increasing interest in identifying and assessing the related protective and resilience factors. This section covers questions on two areas of interest, that is, religion and neighbourhood characteristics. 1) Religion Respondents are first asked to indicate whether they belong to a specific religion and what it is. They are then asked how much they agree with 3 statements related to religion. 2) The physical neighbourhood For some years there has been significant interest in the influence of environmental and community factors on people’s well-being. Therefore a set of questions assessing respondent’s perceptions of their social environment will be asked of all respondents. Specific questions The questions ask about the respondent’s environment. We define ‘around here’ as “anywhere you can walk to, from your home, in 5 minutes”. However we do not define ‘area’. We want respondents to decide for themselves what ‘area’ means to them because it will be very different depending on where the respondent lives. If a respondent does query ‘area’ with you, respond by saying something such as ‘there isn’t a set definition, area means different things to different people’. 9.24 Socio-Demographic Section Aim: these are a set of standard questions collecting information about respondents’ background and current circumstances. You will be familiar with many of them from other surveys and include questions on: - Ethnicity (what a respondent thinks they belong to, not based on your judgement), - Education, - Employment status - State benefits & other income (to provide an overall measure of income). If a respondent is unable to provide information about household income from other sources (e.g. a 17 year old may not know his/her parents’ income), but someone else in the household could, it is acceptable to obtain the information from someone else. 9.25 Property and Financial Strain Aim: there is considerable concern and research into the impact housing conditions and social exclusion in general has on mental health and wellbeing. For example, there is an


association between poorer mental wellbeing and having mould in your house. This section therefore covers housing tenure, housing conditions and debt. 9.26 Follow-up Questions, Consent, Vouchers, and Admin Aim: in this final section we aim to gain consent to re-contact for the Stage 2 interview (if they are selected), consent to be contacted for a follow-up quality check call-back and consent to data linkage. This is also the point at which you should give the respondent the voucher as a token of appreciation. Order of the final section: 1) Thanks and give the voucher. Remind the respondent they will not be able to use it for at least 24 hours (the card is activated in Brentwood when you transmit the completed interview). 2) Asking to consent to be re-contacted for the Stage 2 interview. 3) Those that refuse a second interview are then asked the standard recall question. 4) Asking to consent to data linkage to health records. Please see section 6.4 for further information.


Appendix B: The Address Record Form (ARF)

1st Page: Address details, selection label, call/visit record, space for final outcome code, space for any appointment made.

Includes fieldwork dates.

2nd Page: Observation question (there’s only 1), and the procedure for selecting a Dwelling Unit if there are more than one at that address.


3rd Page: Procedure for household selection and adult selection if there is more than one at the address.

4th Page: List of all outcome codes grouped by type. Includes routing with the next steps after selecting that code.


5th Page: Additional information for any refusals, and space for any further information about any unproductive outcome codes.

Lookup selection chart if there are 13+ Dwelling Units, Household or People at the address.

6th/7th Page: Proxy questions that need to be asked about all selected respondents who can’t take part because of “5.4 Other unproductive” reasons (which are: ill at home, away or in hospital, physically or mentally unable). They should be answered by someone else in the household if the selected respondent is unable to complete them.


Appendix C: More than 41 Dwelling Units or Adults NUMBER OF DUs/Persons:

SELECT NUMBER: NUMBER OF DUs/Persons:

SELECT NUMBER:

41 34 71 25

42 2 72 48

43 23 73 12

44 40 74 33

45 19 75 71

46 20 76 56

47 1 77 6

48 35 78 38

49 39 79 44

50 44 80 72

51 18 81 62

52 12 82 47

53 31 83 29

54 50 84 39

55 55 85 3

56 4 86 48

57 26 87 35

58 29 88 22

59 42 89 10

60 36 90 88

61 27 91 56

62 18 92 31

63 9 93 50

64 17 94 11

65 38 95 49

66 52 96 25

67 66 97 2

68 28 98 94

69 45 99 80

70 53 100 38


Appendix D: Disclosure of Harm, Guidance for NatCen’s Fieldworkers Introduction Maintaining the confidentiality of respondent data is central to NatCen’s work. Those who collect our data1 are required to work in accordance with the confidentiality requirements of the Data Protection Act 2000. Our researchers are obligated to follow the ethical guidelines of the Social Research Association which make clear commitments to respondents on data confidentiality. Survey nurses are obliged to act in accordance with clauses 5.3 and 5.4 of The NMC code of professional conduct: standards for conduct performance and ethics (Nursing and Midwifery Council 2004). In rare instances, you may encounter a situation during a field visit where you feel that the safety and wellbeing of an individual could be at risk2; or you may have concerns about illegal activity which could harm the public. As a result you may feel that information about an individual or individuals should be passed on, for example to social services or to the police. What to do? We request that you only take action on your own initiative when there is a clear and

immediate need to protect an individual by calling the emergency services (ambulance, fire service, police).

In other cases we ask that you don’t attempt to deal with the situation yourself. If a

respondent volunteers information about the issue you should listen and respond appropriately but not probe or get drawn into lengthy discussions, in case they receive the incorrect impression that you have a professional responsibility to take decisions or act on their behalf. Do not volunteer information about disclosing, and if asked directly we suggest you explain that you need to discuss the issue with someone senior at NatCen.

As soon as possible after leaving the household, you should make brief notes of

the situation, and report your concerns (see overleaf). If respondents ask for help, please encourage them to seek help, rather than

offering to do this yourself. You can provide them with any project leaflet containing helpline telephone numbers. Please say that you will pass their request to someone at NatCen.

There is a process in place for senior staff who are experienced in such matters to carefully consider appropriate action (see overleaf). Whom to contact – Operations Department During office hours Freelance survey interviewers and nurses should phone the Head of Freelancer Resources Unit, the Field Manager or the Director of Operations in Brentwood on 01277 200600. Out of Office hours call the Field Special Assistance Line on 07894 587660 If you wish to discuss the situation informally before reporting to Brentwood, contact your Area Manager or Deputy during office hours.

1 Freelance interviewers, survey nurses and staff members carrying out qualitative or quantitative fieldwork 2 Examples include physical or psychological abuse, restriction of freedom, or neglect, unsafe or unsanitary conditions, lack of adequate supervision or support


What we will need to know Your name, ID and a contact telephone number;

What you observed or heard, and why you are concerned;

Whether an individual requested disclosure / non-disclosure;

Whether an individual indicated that they have sources of help / support (eg. GP, health visitor, social worker, family members) who are aware of their problems;

Your thoughts on what should be done next and why;

Your views on what could happen as a result of disclosure or non-disclosure.

We’ll need this verbally at first, but you will be asked to provide details later in writing. Personal details should be kept to a minimum in any written report, i.e. refer to a serial number and forenames only, not a full name and address. What happens next? NatCen staff will immediately review the situation, and will either decide on what actions to take, or will rapidly refer the incident to the NatCen Disclosure Board for guidance and a final decision. The Board is chaired by the Chief Executive. We will tell you the decision and the reasons for it, and will offer you appropriate support.

This guidance aims to protect the interests of all parties: you, the respondent, and NatCen. By asking you to refer your concerns to us for consultation, NatCen thereby takes responsibility for any decision about disclosure. If you choose not to follow these guidelines, and disclose personal information about a respondent to individuals or organisations outside NatCen, you should be aware of the potentially serious consequences. This could include NatCen withdrawing work held by you, and not offering you further assignments of fieldwork.


Appendix E: National Adult Reading Test (NART) Word Definitions

These definitions are from the Oxford online dictionary (www.oxforddictionaries.com) which also has a function that allows you to listen to how a word should be pronounced. These definitions are for your information/ interest only. You do not need to know the definitions of these words nor does your respondent. q1 CHORD (kawd) noun. A group of (typically three or more) notes sounded together, as a basis of harmony: a G major chord q2 ACHE (ake) noun. 1. A continuous or prolonged dull pain in a part of one’s body 2. An emotion experienced with painful or bittersweet intensity: an ache in her heart q3 DEPOT (deppo) noun. 1. A place for the storage of large quantities of equipment, food, or goods: an arms depot 2. A place where buses, trains, or other vehicles are housed and maintained and from which they are dispatched for service. q4 AISLE (ile) noun. 1. A passage between rows of seats in a building such as a church or theatre, an aircraft, or train: the musical had the audience dancing in the aisles q5 BOUQUET (BOO-kay or BO-kay) noun. 1. An attractively arranged bunch of flowers, especially one presented as a gift or carried at a ceremony. 2. Characteristic scent of a wine or perfume: the aperitif has a faint bouquet of almonds q6 PSALM (sarm) noun. A sacred song or hymn, in particular any of those contained in the biblical Book of Psalms and used in Christian and Jewish worship: a delightful setting of Psalm 150. q7 CAPON (KAY-pon) noun. A castrated domestic cock fattened for eating. q8 DENY (di-NIGH) verb. 1. State that one refuses to admit the truth or existence of: both firms deny any responsibility for the tragedy. 2. Refuse to give (something requested or desired) to (someone): the inquiry was denied access to intelligence sources q9 NAUSEA (NAW-zia) noun. A feeling of sickness with an inclination to vomit: a wave of nausea engulfed him. q10 DEBT (dett) noun. A sum of money that is owed or due: I paid off my debts q11 COURTEOUS (KUR-tius) adjective. Polite, respectful, or considerate in manner: she was courteous and obliging to all. q12 RARIFY (RARE-ifie) verb. Make or become less dense or solid.


q13 EQUIVOCAL (e-KWIV-oh-kl) adjective. Open to more than one interpretation; ambiguous: the equivocal nature of her remarks q14 NAÏVE (NIGH-eve) adjective. (Of a person or action) showing a lack of experience, wisdom, or judgement: the rather naive young man had been totally misled q15 CATACOMB (KATT-a-koom) noun. An underground cemetery consisting of a subterranean gallery with recesses for tombs, as constructed by the ancient Romans. q16 GAOLED (jayld) noun. British for jailed. A place for the confinement of people accused or convicted of a crime: he spent 15 years in jail. q17 THYME (time) noun. A low-growing aromatic plant of the mint family. The small leaves are used as a culinary herb and the plant yields a medicinal oil. q18 HEIR (air) noun. 1. A person legally entitled to the property or rank of another on that person’s death: his eldest son and heir the heir to the throne. 2. A person who inherits and continues the work of a predecessor: they saw themselves as heirs of the Cubists Synonyms: successor, next in line, inheritor, etc. q19 RADIX (RAY-DICKS) noun. 1. Mathematics The base of a system of numeration. q20 ASSIGNATE (ASS-ig-neight) From the word assignation. Noun. 1. An appointment to meet someone in secret, typically one made by lovers: his assignation with an older woman. 2. The allocation or attribution of someone or something as belonging to something: this document explains the principles governing the assignation of lexical units to lexemes q21 HIATUS (high-EIGHT-us) noun. A pause or break in continuity in a sequence or activity: there was a brief hiatus in the war with France q22 SUBTLE (suttl) adjective. 1. (Especially of a change or distinction) so delicate or precise as to be difficult to analyse or describe: his language expresses rich and subtle meanings 2. Making use of clever and indirect methods to achieve something: he tried a more subtle approach. 3. archaic Crafty; cunning: the subtle fiend dissembled q23 PROCREATE (PRO-cree-eight) verb. (Of people or animals) produce young; reproduce. q24 GIST (jist) noun. 1. The substance or general meaning of a speech or text: it was hard to get the gist of Pedro’s talk. 2. Law The real point of an action: damage is the gist of the action and without it the plaintiff must fail q25 GOUGE (gowdje) noun. 1. A chisel with a concave blade, used in carpentry, sculpture, and surgery. 2. An indentation or groove made by gouging.


http://www.oxforddictionaries.com/definition/english/successor%23successor__3

http://www.oxforddictionaries.com/definition/english/next%23next__19

http://www.oxforddictionaries.com/definition/english/inheritor%23inheritor__3

verb. 1. Make (a groove, hole, or indentation) with or as if with a gouge 2. North American. informal Overcharge or swindle (someone) q26 SUPERFLUOUS (sue-PER-flu-us) adjective. Unnecessary, especially through being more than enough: the purchaser should avoid asking for superfluous information q27 SIMILE (SIM-illy) noun. A figure of speech involving the comparison of one thing with another thing of a different kind, used to make a description more emphatic (e.g. as brave as a lion). q28 BANAL (b'n-arle) adjective. So lacking in originality as to be obvious and boring: songs with banal, repeated words q29 QUADRUPED (KWAD-rew-ped) noun. An animal which has four feet, especially an ungulate mammal q30 CELLIST (CHELL-ist) noun. Someone that plays a Chello, a bass instrument of the violin family, held upright on the floor between the legs of the seated player. q31 FAÇADE (fa-SARD) noun. 1. The principal front of a building, that faces on to a street or open space: the house has a half-timbered façade. 2. A deceptive outward appearance: her flawless public facade masked private despair q32 ZEALOT (zellat) noun. A person who is fanatical and uncompromising in pursuit of their religious, political, or other ideals. q33 DRACHM (dram) noun. A unit of weight formerly used by apothecaries, equivalent to 60 grains or one eighth of an ounce. q34 AEON (e-on) noun. 1. An indefinite and very long period of time: he reached the crag aeons before I arrived. 2. Philosophy (In Neoplatonism, Platonism, and Gnosticism) a power existing from eternity; an emanation or phase of the supreme deity. q35 PLACEBO (plass-EE-bo) noun. A medicine or procedure prescribed for the psychological benefit to the patient rather than for any physiological effect. q36 ABSTEMIOUS (ab-STEAM-ee-us) adjective. Indulging only very moderately in something, especially food and drink: ‘We only had a bottle.’ ‘Very abstemious of you.’ q37 DÉTENTE (day-TARNT) noun. The easing of hostility or strained relations, especially between countries: his policy of arms control and detente with the Soviet Union q38 IDYLL (ID-l) noun. An extremely happy, peaceful, or picturesque period or situation, typically an idealized or unsustainable one: the rural idyll remains strongly evocative in most industrialized societies


q39 PUERPERAL (poo-ER-pur-l) adjective. The period of about six weeks after childbirth during which the mother’s reproductive organs return to their original non-pregnant condition q40 AVER (a-VERR) verb. State or assert to be the case: he averred that he was innocent of the allegations q41 GAUCHE (gowsh) adjective. Unsophisticated and socially awkward: a shy and gauche teenager q42 TOPIARY (tope-ee-airy) noun. The art or practice of clipping shrubs or trees into ornamental shapes: [as modifier]: a specialist in topiary art q43 LEVIATHAN (le-VI-ath'n) noun. (In biblical use) a sea monster, identified in different passages with the whale and the crocodile, and with the Devil. q44 BEATIFY (bee-AT-ifie) verb. (In the Roman Catholic Church) announce the beatification of: he beatified Juan Diego, an Indian believed to have had a vision of the Virgin Mary in 1531 q45 PRELATE (PRELL-it) noun. A bishop or other high ecclesiastical dignitary. q46 SIDEREAL (si-DARE-ee-al) adjective. Of or with respect to the distant stars (i.e. the constellations or fixed stars, not the sun or planets). q47 DEMESNE (de-MAIN) noun. 1. A piece of land attached to a manor and retained by the owner for their own use: because labour was cheap, there were ample advantages in cultivating the demesne. 2. Law Possession of real property in one’s own right. q48 SYNCOPE (SING-k-pea) noun. 1. Medicine Temporary loss of consciousness caused by a fall in blood pressure. 2. Grammar The omission of sounds or letters from within a word, for example when library is pronounced q49 LABILE (LAY-bile) adjective. Liable to change; easily altered: persons whose blood pressure is more labile will carry an enhanced risk of heart attack q50 CAMPANILE (kam-pan-EE-lay) noun. An Italian bell tower, especially a free-standing one.



Fieldwork tips: • The ctudy ic invectigating the ctrec:ec and ctrainc of everyday life • £15 'thank you' gift card • 6-week fieldwor1l deadline. The m*rity of appointment chould be completed by week 5,

with week 6 uced for mop up.

Whall. say il ...

"I'm worried about data protection; I don't want everyone knowing my b · .. uSlness ...

"I can't do it because I'm going away ... "

"I want more information about the .. survey ...

"I don't think (my elderly motherlfather) is capable of taking part .... '

Answers are treated in strictest confidence in ~cordance with the Data Protection Act 1995.

The data you give us is treated anonymously. Results 3"e only ever presented as statistics.

No one will ever know you have taken part unless you tell them.

Going anywhere nice? I'm in the area for a while, I' ll ] pop back. When will you be back?

I hlve an information leaflet about the survey and about Nateen.

Have a look at our websites: Vfflw.natcen.ac.uk wVlw.natcen.ac.uklhealthandwellbeing

You can be with your mother/father while I do the int~rview if you like.

Interviewers have identity cards.

Your address has been chosen by a random selection. ]

WE gat a list of addresses from the post office, but we don't know who lives there until we visit you.


"Who are NatCen ... ?"

"How long will it take ... ?"

"I see my doctor all the time, I don't want to talk about my health ... "

"I don't like this Government so I want nothing to do with this ... ""

"What will you ask me about. .. ?"

NatCen have been conducting surveys for over 35 years. We are a registered charity and only conduct surveys that will contribute to public policy. NatCen is independent of all government departments. We are nothing to do with market research

The interview takes no more than 90 minutes, and it ] can take place at a time and place convenient for you.

The survey is not just about health, it is about lifestyles, your daily activitie~ and wellbeing as well. We can 't access your medical records. We are asking you different things to what you talk to your doctor about.

It's the only way the Government and NHS can find out about the health and wellbeing of people in England. The survey helps to find out where government money should be spent. This helps reduce waste spending.

The National Study of Health and Wellbeing has been running since 1993 and will run regardless of which government is in power. The findings help inform hea th policy, regardless of which government is in power.

There will be questions on a range of health, wellbeing ] and lifestyle topics. YOll don't have to answer any questions you don't want to.

Don't forget to point recpondent:: to the National Study of Health and Wellbeing webcite for more information: www.natcen.ac.uklheatthandwellbeing

CAPI Coding & Editing 2014 National Study of Health and Wellbeing P05012.01 v2 Changes between v1 and v2 in red text

Contents

1 Introduction ....................................................... 1

1.1 Questionnaire Content ............................................................................ 1

2 Instructions Overview ........................................ 3

2.1 Coding 3 2.1.1 Fully Closed Questions ............................................................................ 3 2.1.2 Open Questions ....................................................................................... 3 2.1.3 Other - Specify ......................................................................................... 3 2.1.4 ‘Other’ Codes ........................................................................................... 4 2.1.1 Coding ‘Don’t knows’ & ‘Refusals’ ............................................................ 4 2.1.2 SOC/SIC Coding ...................................................................................... 5 2.1.3 Recording Coding Decisions .................................................................... 5 2.1.4 DO NOT Delete Cases ............................................................................ 5 2.1.5 Interviewer Notes / Remarks .................................................................... 5

3 Specific Question Instructions ........................... 6

1 Introduction

These instructions describe the coding requirements for the National Study of Health and Wellbeing 2014 (P1724/ p05012). They contain the code frames you should use for the coding. In addition, they provide background information about the study and questionnaire to help put the interviews you work on in context, which may help you make coding decisions.

1.1 Questionnaire Content The table below shows the structure and topics covered in the questionnaire:

Respondent Interview Coded Questions

Face to face CAPI (1) [Block] Variable Household Grid

General health

Practical activities and caring responsibilities [CarerQ] PrRel/RelOth

Subjective wellbeing

Physical health conditions [HealthNew] Health/Xhealth

Learning disabilities [HealthNew] Learn3Cls

Psychiatric conditions [PychDiag] PychDiag1

Medications [Medic] Mwhy1Cls [Medic] Mwhy2Cls [Medic] Mwhy3Cls [Medic] Minjectwhy3Cls

Service use [Counsel] CnslV [Doctor] PMat

Common mental disorders [EIrrit] E4Cls [KPhobs] K31 / XK3 [MCompl] M3Cls [NObsns] N3Cls

Suicidal behaviour and self-harm [DelSh] DSH4d [DelSh] DSH13

Psychosis

NatCen Social Research | CAPI Coding & Editing 1

Respondent Interview Coded Questions

Attention deficit hyperactivity disorder (ADHD)

Work related stress [WStress] BulWho [WStress] BulForm

Smoking and drinking [1]

CASI self completion Drinking [2] Drug use Personality disorder Bipolar disorder Autism Post-traumatic stress disorder [PTSD] RegRes

[PTSD] Deploy Domestic violence, abuse and neglect Self harm Discriminaton Sexual behaviour, sexual identity

Menopause

Face to face CAPI (2) Intellectual functioning

Key life events

Parenting

Social support

Religion and spirituality

[Res] WhatRel / OthRel

Social capital and neighbourhood

Socio-demographics and debt

[Educ] Origin / Xorigin [Educ] COB / COBO [Educ] HiQuals / OthQuals [LastJb] WhyLeft [LastJb] Change2 [AwayWork] UndEmp

Recall, consent, voucher and admin

2 NatCen Social Research | CAPI Coding & Editing

2 Instructions Overview

2.1 Coding The questionnaire contains the following types of questions:

2.1.1 Fully Closed Questions The existing answer codes take care of responses, and no 'other' option is given (e.g. answer categories Yes or No). No back coding is required for these questions.

2.1.2 Open Questions For these the response is recorded verbatim - no answer codes are available for interviewers to use. For these questions researchers have looked at the answers given, and developed entirely new code frames from these responses. You should choose the most appropriate code or codes from these code frames. If the response does not fit any of these codes, it should be assigned to one of the ‘other’ codes, as appropriate.

2.1.3 Other - Specify This is the most common type of question which warrants backcoding. Interviewers have a list of answer codes with the option for 'other answer'. It will often be possible to code these responses back into the existing code frame, which is indicated in this code book within a text box (always listed first). This type of ‘backcoding’ should always be the coder’s first response.

However, backcoding may not always be possible if existing answers codes do not cover a particular response. The researchers have looked at some early returns from the field and applied new codes to particular questions for use during editing. New codes are listed after the boxed backcodes, and should be used when existing question codes are not appropriate. Any other difficult cases should be referred to the researchers with a note on the factsheet.

‘Other-specify’ questions may be multi-coded or single-coded. Whether the question is multi or single-coded is indicated in this document. Most of the questions are multi-coded; that is more than one answer is allowed to be coded.

During coding, if the question to code is multi-coded you will code the 'other-specify" into a new edit field that contains the new code frame (i.e. the existing code frame with any additional codes).

However, if the question is single-coded then you will code the 'other-specify' back into the original question, which typically will have had extra codes added.


To get to the questions which require backcoding, press <END> and the program will take you to the 'Tryback' field, which is just after the question that requires backcoding. 'Tryback' instructs you to go back and code the answer. To assist you the verbatim text will appear within the 'Tryback' question (and at 'other specify', and also on the factsheet).

Once you have backcoded the 'other-specify', the program will route past the 'Tryback' field. If you are unclear about how to backcode leave them uncoded (i.e. leave it blank) or leave the original single code question as 'other specific' (typically code 94) and code Tryback as '3: Refer to supervisor/ leave for later'. This is the ONLY time that you should make use of this ‘Tryback’ field. If you have a query, make sure you route to 'Tryback' and code it '3'. This is the only way we can identify coding queries.

2.1.4 ‘Other’ Codes There are three types of ‘other’ codes allowed at all ‘other specify’ questions. These are:

Code 94: Other specific Code 95: Vague or irrelevant Code 96: Editor can’t deal with this Code 94: ‘Other specific’ if you are unable to code a response using any of the codes in the code frame then in the majority of the cases a code 94 should be used.

Code 95: ‘Vague or irrelevant’ should only be used for responses that are irrelevant, that is they do not answer the question.

Code 96: ‘Editor can’t deal with this’ should be used in cases where you find a response particularly difficult to code or if it is taking a long time to decide which code to allocate. These should be referred to researchers with a note made on the fact sheet.

Please note that the original ‘other’ option in the questionnaire should not be used in the edit program. If the code should remain as ‘other’ please code it at 94.

2.1.1 Coding ‘Don’t knows’ & ‘Refusals’ CAPI questions: if the answer is ‘don’t know’ or [ctrl+ <K>] the coder’s response is to use a ‘don’t know’ option if available in the code frame. If this is not available, you should enter [ctrl+ <K>] and record this on the fact sheet.

Where the answer is a refusal or [ctrl+<R>], the original question should be coded as ‘Refusal’, NOT as ‘other’, and record this on the fact sheet.


2.1.2 SOC/SIC Coding You will need to carry out SOC 2010 and SIC 2007 coding as standard at the questions specified.

2.1.3 Recording Coding Decisions Coding decisions should be written on the fact sheet. If the question has not been printed on the fact sheet please write the question name, original response and recoded response at the end of the fact sheet, and then send the fact sheet to the researchers.

2.1.4 DO NOT Delete Cases Please note that you should never delete a case unless you have been instructed to do so by a researcher.

We also want to retain the verbatim response variable (the text string) as well as your back-code.

Any cases that you find too difficult to code or are unsure about how to code should be referred to Debbie or Coral in the Data Unit, making a note on the factsheet.

2.1.5 Interviewer Notes / Remarks All remarks are listed at the end of the factsheet. Using these notes it may be possible to establish what the correct response to a particular question should have been and subsequently to recode it.

However, you should document any changes you make on the factsheet, noting the question name, original response, and recoded response. Please then make sure this factsheet is sent to the researchers.

If you find that recoding has affected subsequent routing please then flag this discrepancy to Debbie or Coral in the Data Unit.

Where problems arise that do not appear in these coding instructions, please contact Debbie or Coral in the Data Unit for advice.


3 Specific Question Instructions

3.1 RelOth Variable: RelOth

Type: Other – Specify

Routing: Respondents who answered ‘Other (please specify) at PrRel

Question text: PrRel: What is their relationship to you? They are my… [Regarding the person the respondent provides the most informal care/help and support to]

SINGLE CODE [1] Husband/Wife/Partner [2] Mother (including mother-in-law) [3] Father (including father-in-law) [4] Son (including step-son, adopted son or son-in-law) [5] Daughter (including step-daughter, adopted daughter or daughter-in-law) [6] Grandparent [7] Grandchild (including Great Grandchildren) [8] Brother / Sister (including step / adopted / in-laws) [9] Other family member [10] Friend [11] Neighbour [12] Somebody I help as a professional carer [13] Somebody I help as a voluntary helper New codes Where applicable use the following additional codes: [16] Colleague Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.2 HealthX Variable: HealthX


Routing: Respondents who answered ‘other’ to Health

Question text: Health: Now please look at the health conditions listed on this card. Have you ever had any of them since the age of 16?

MULTICODED – CODE ALL THAT APPLY [1] Cancer [2] Diabetes [3] Epilepsy/fits [4] Migraine or frequent headaches [5] Dementia or Alzheimer's disease [6] Cataracts/eyesight problems (even if corrected with glasses or contacts) [7] Ear/hearing problems (even if corrected with a hearing aid) [8] Stroke [9] Heart attack/angina [10] High blood pressure [11] Bronchitis/emphysema [12] Asthma [13] Allergies [14] Stomach ulcer or other digestive problems [15] Liver problems [16] Bowel/colon problems [17] Bladder problems/incontinence [18] Arthritis [19] Bone, back, joint or muscle problems [20] Infectious disease [21] Skin problems [96] None of these New codes Where applicable use the following additional codes: [24] Other complaints of heart/blood vessels/circulatory system

(e.g. heart murmur, low blood pressure, irregular heartbeat, transient ischemic attack (TIA)) or “mini stroke”

[25] Other respiratory complaints (e.g. pleural plaques, throat infection, breathlessness, chest infections) [26] Reproductive or hormonal system disorders

(e.g. thyroid problems, Poly-cystic Ovary syndrome (PCOS), Menopause)

[27] Other problems of bones/joints/muscles (e.g. Paget’s disease, hip replacement)

[28] Renal problems (e.g. kidney infection/transplant)

[29] Other nervous system disorders


(e.g. Multiple Sclerosis (MS), Myalgic encephalomyelitis (ME) [30] Complaints of teeth/mouth/tongue (e.g. non-cancerous, abscess, mouth ulcers) [31] Rheumatic diseases (e.g. Gout) [32] Other benign tumours

(e.g. hernia, prostate – not cancerous) [33] Balance problems/Meniere's disease (e.g. vertigo) [34] Mental disorders (e.g. stress, depression, bipolar disorder, schizoaffective disorder, Other

[94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this Note to coders Chronic Obstructive Pulmonary Disease (COPD) – back code to 11


3.3 Learn3Cls Variable: Learn3

Type: Open

Routing: Those who said yes at Learn1: Do you have a difficulty learning or an intellectual disability? and Yes at LnNam (Does the condition have a name?)

Question text: What is the name of the condition?

Note to coders: Code open answers into new code frame below. SINGLE CODE New code frame [1] Dyslexia [2] Dyspraxia [3] Dyscalculia [4] Dysgraphia [5] General learning difficulties/slow learner Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.4 PYCHDIAG1 Variable: PYCHDIAG1


Routing: Respondents who answered ‘Any other mental, emotional or neurological problem or condition’ at PYCHDIAG1

Question text: PYCHDIAG1: Now please look carefully at this card. Do you think that you have ever experienced any of these?

MULTICODED – CODE ALL THAT APPLY [1] A phobia [2] Panic attacks [3] Post-traumatic stress disorder [4] Attention deficit hyperactivity disorder (ADHD) or Attention deficit disorder (ADD) [5] Bipolar disorder (or 'manic depression') [6] Depression [7] Post-natal depression [8] Dementia (including Alzheimers) [9] An eating disorder [10] Nervous breakdown [11] A personality disorder [12] Psychosis or schizophrenia [13] Obsessive compulsive disorder (OCD) [14] Seasonal affective disorder [15] Alcohol or drug dependence [16] Any other anxiety disorder [17] Any other mental, emotional or neurological problem or condition [18] (Spontaneous) None of these New codes Where applicable use the following additional codes: [19] Stress/general anxiety/nerves (not a specific anxiety disorder) [20] Suicidal thoughts/tendancies [21] Schizoaffective disorder [22] Epilepsy [23] Other neurological disorder (e.g. Parkinsons) [24] Sleep problems Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.5 Mwhy1Cls Variable: Mwhy1Cls (up to 19 different medications)

Type: Open

Routing: Those who said yes at MedicWh1R: Are you currently taking any of these medications?

Question text: (May I just check) what condition do you take [this drug – up to 19 drugs possible for each case] for?

Note to coders: Code open answers into new code frame below. MULTICODED – CODE ALL THAT APPLY New code frame [1] A phobia [2] Panic attacks [3] Post-traumatic stress disorder [4] Attention deficit hyperactivity disorder (ADHD) or Attention deficit disorder (ADD) [5] Bipolar disorder (or 'manic depression') [6] Depression [7] Post-natal depression [8] Dementia (including Alzheimers) [9] An eating disorder [10] Nervous breakdown [11] A personality disorder [12] Psychosis or schizophrenia [13] Obsessive compulsive disorder (OCD) [14] Seasonal affective disorder [15] Alcohol or drug dependence [16] Any other anxiety disorder [19] Stress/general anxiety/nerves [20] Suicidal thoughts/tendencies [21] Schizoaffective disorder [22] Epilepsy [23] Other neurological disorder (e.g. Parkinsons) [24] Sleep problems [25] Physical health condition/pain relief Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.6 MWhy2Cls Variable: Mwhy2Cls (up to 25 different medications)

Type: Open





Mwhy3Cls Variable: Mwhy3Cls (up to 23 different medications)

Type: Open





3.7 MInjectwhy3Cls Variable: MInjectwhy3Cls (up to 5 different medications)

Type: Open

Routing: Those who said yes at INJECTWH: Are you currently having any of these medicines as a course of injections?




3.8 CnslV Variable: CnslV


Routing: Respondents who answered ‘Another type of therapy’ at CnslR

Question text: CnslR: Which type/s of counselling or therapy are you having?

MULTICODED – CODE ALL THAT APPLY [1] Psychotherapy or psychoanalysis [2] Cognitive behavioural therapy [3] Art, music or drama therapy [4] Social skills training [5] Couple or family therapy [6] Sex therapy [7] Mindfulness therapy [8] Alcohol or drug counselling [9] Counselling (include bereavement) New codes Where applicable use the following additional codes: [11] Eye movement displacement reprogramming (EMDR) Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.9 PMat Variable: PMat (up to 6 complaints)

Type: Other - specify

Routing: Routed from PMatNum: When you consulted the doctor about your mental, nervous or emotional problem, what did the doctor say was the matter with you?

Question text: What is the matter with respondent? (Up to 6 complaints)

Note to coders: Code open answers into new code frame below. Use the look up file at PICD to search for verbatim Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.10 E4Cls Variable: E4Cls

Type: Open

Question text: E4: What sort of things made you irritable or short tempered/angry in the past week?

Note to coders: Code open answers into new code frame below MULTICODED – CODE ALL THAT APPLY New code frame [1] Members of the family (e.g. children, parent(s). [2] Relationship with spouse/partner [3] Relationship with friends [4] Work colleagues [5] Strangers [6] Work (include lack of work) [7] Lack of sleep (include fatigue and tiredness) [8] Own physical illness/health [9] Own mental health [10] Housing problems (e.g. moving house, construction work) [11] Other people [12] Anything/everything makes respondent irritable – include those who

say ‘every little thing’, ‘slightest thing’, ‘everything’, ‘anything’ Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.11 XK3 Variable: XK3


Routing: Respondents who answered ‘Other phobia’ at K3

Question text: K3: Can you look at this card and tell me which of the situations or things listed you’ve avoided in the past month?

MULTICODED – CODE ALL THAT APPLY [1] Crowds or public places [2] Enclosed spaces [3] Social situations [4] Sight of blood or injury [5] Specific single cause New codes Where applicable use the following additional codes: [7] Exams [8] A specific person [9] Going to the dentist/doctors etc. [10] Heights [11] Things to do with death or disease [12] Animals/insects (e.g. spiders, snakes) [13] Inanimate objects (e.g. elastic bands, pins, staples) Note to coders: Needles – use code [5] Going outside – use code [1] Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.12 M3Cls Variable: M3Cls

Type: Open

Question text: M3: Since last (day of week) what sorts of things have you done over and over again?

Note to coders: Code open answers into new code frame below. MULTICODED – CODE ALL THAT APPLY New code frame [1] Compulsions over dirt/contamination (e.g. hoovering, washing

hands/utensils) [2] Need for checking (e.g. doors being left unlocked, leaving the gas

cooker/tap on) [3] Compulsion with ordering, arrangement or symmetry of objects Note to coders: For cleaning or washing of surfaces, clothes or bedding – use code [1] Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.13 N3Cls Variable: N3Cls

Type: Open

Question text: N3: What are these unpleasant thoughts or ideas that keep coming into your mind?

Note to coders: Code open answers into new code frame below. MULTICODED – CODE ALL THAT APPLY New code frame [1] Fear of death [2] Fear of physical illness [3] Fear of mental illness [4] About members of the family (e.g. children, parent(s). [5] Relationship with spouse [6] Fear of hospitals/operations [7] Something bad will happen (non specific) Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


BulWhoO Variable: BulWhoO


Routing: Respondents who answered ‘Other (give details)’ at BULWHO

Question text: BULWHO: Who was this person, or people (responsible for the bullying or harassment at work)?

MULTICODED – CODE ALL THAT APPLY [1] Your line manager or another manager [2] A colleague [3] A member of Human Resources [4] A student [5] Client or a customer [6] Member(s) of the public New codes Where applicable use the following additional codes: [8] Specific person (use if this is the name of a person) Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.14 BulformO Variable: BulformO


Routing: Respondents who answered ‘Other (please specify)’ at Bulform

Question text: Bulform: What form does or did the bullying take?

MULTICODED – CODE ALL THAT APPLY [1] Threatening behaviour [2] Shouting or verbal abuse [3] Physical abuse [4] Humiliation [5] Excessive criticism [6] Constantly changing instructions [7] Excessive workloads [8] Setting unrealistic targets [9] Refusing reasonable requests (i.e. for leave or training) [10] Sexual harassment [11] Cyber bullying Note to coders: Back-code ridicule to ‘humiliation’. Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.15 RegResO Variable: RegResO


Routing: Respondents who answered ‘Other (please specify)’ at RegRes (Are you, or were you a regular, reserve or have you served as both a regular and as a reserve?)

Question text: RegResO: Please specify [Regarding military service experience]

SINGLE CODE [1] Regular [2] Reserve [3] Both Regular and Reserve New codes Where applicable use the following additional codes: [4] Other [5] National Service Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.16 DeployO Variable: DeployO


Routing: Respondents who answered ‘Another combat operation’ at Deploy. (During your service in the Armed Forces, did you deploy to...)

Question text: DeployO: Please specify which other combat operation

MULTICODED – CODE ALL THAT APPLY [1] Iraq [2] Afghanistan [3] Northern Ireland [5] Not deployed New codes Where applicable use the following additional codes: [6] Kosovo [7] Cyprus Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.17 DSH4d & DSH13 Variable: DSH4d & DSH13


Routing: Respondents who answered ‘Someone else (specify)’ at DSH4c & DSH12 (Who did you try to get help from? You may give more than one response. [Following an attempt to take own life or deliberate self-harm].)

Question text: DSH4c & DSH12: Who did you try to get help from?

MULTICODED – CODE ALL THAT APPLY [1] A friend [2] A member of your family [3] A neighbour [4] Your GP / family doctor [5] A hospital New codes Where applicable use the following additional codes: [7] Psychiatrist / Psychiatric or mental health nurse / counsellor or therapist

other mental health professional [8] Help line number / support group (e.g. Samaritans, Alcohol Anonymous) Notes to coders: At code 1 include colleagues Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.18 XYNotBoth Variable: XYNotBoth

Type: Other – Specify (ONLY IF VOLUNTEERED)

Routing: Respondents who answered ‘Or, is there another reason?’ at YNotBoth. If volunteered, type in other answer given, OTHERWISE TYPE ‘7’ AND <ENTER>

Question text: YNotBoth: Is that because there was... [If respondent answered no to ‘Did you live more or less continuously with both of your natural parents at home until you were 16?’]

SINGLE CODE [1] A divorce or separation [2] A death [3] You are adopted [4] Your parents never lived together New codes Where applicable use the following additional codes: [8] Boarding school [9] Evacuation [10] Taken away/taken into care Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this Note to coders – if more than one reason given, please code first reason.


3.19 OthRel Variable: OthRel


Routing: Respondents who answered ‘Any other religion’ at WhatRelR

Question text: WhatRelR: What is your religion?

SINGLE CODE (if more than one code the main religion) [1] Catholic [2] Protestant [3] Any other Christian denominations [4] Buddhist [5] Hindu [6] Jewish [7] Muslim [8] Sikh New codes [10] Non mainstream / alternative religions

(e.g. Church of Scientology, Church of Unification ‘Moonies’, Paganism, spiritualist, Kabalah, Mysticism)

Note to coders: Where appropriate include the following within code [3]Other Christian:

Church of England Methodist

United Reformed / Presbyterian / Congregational New Testament Church of God Church of God Prophecy Seventh Day Adventist Tabernacle Pentecostal Quakers (Religious Society of Friends) Other Christian Jehovah’s Witness Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.20 XOrigin Variable: XOrigin


Routing: Respondents who answered ‘Other ethnic group’ at Origin

Question text: Origin: What is ethnic group?

SINGLE CODE [1] White - English/Welsh/Scottish/Northern Irish/British [2] White - Irish [3] White - Gypsy or Irish Traveller [4] Any other white background (please describe) [5] Confirm any other white background [6] White and Black Caribbean [7] White and Black African [8] White and Asian [9] Any other mixed / multiple ethnic background (please describe) [10] Confirm any other mixed / multiple ethnic background [11] Indian [12] Pakistani [13] Bangladeshi [14] Chinese [15] Any other Asian background (please describe) [16] Confirm any other Asian background [17] African [18] Caribbean [19] Any other Black / African / Caribbean background (please describe) [20] Confirm any other Black / African / Caribbean background [21] Arab [22] Any other ethnic group (please describe) [23] Confirm any other ethnic group New codes All other specify descriptions will need to be recoded. This can either be to a specific code within a section (e.g. ‘Cornish’ at any other white background should be backcoded to White British) or it can be confirmed as any other background (e.g. Australian at ‘any other white background’ is correctly coded there. You should confirm this by selecting code [5]– this confirms you have looked at the verbatim and confirmed that it can’t be coded more specifically). Only recode within a main section - so, whichever of the main categories respondents describe themselves within (White; mixed/multiple ethnic groups; Asian/Asian British; Black/African/Caribbean/Black British; Other ethnic group) they should only be coded to the subcategories within this major category. For example, If British Asian is recorded at ‘other white’ it should be kept as other white. If it is recorded at Other Asian it should be kept at ‘other Asian’. The following are the confirmation codes for each section:


[5] Confirm any other white background [10] Confirm any other mixed / multiple ethnic background [16] Confirm any other Asian background [20] Confirm any other Black / African / Caribbean background [23] Confirm any other ethnic group Note to coders Here are some examples of where which ethnic groups should be coded where. This is not exhaustive. If you are unsure, please code as 96 [1] White – British Include: English, Scottish, Welsh and Cornish [5] Confirm any other white background

Include: Irish, Cypriot, Gypsy/Romany, Former USSR, Baltic States, Former Yugoslavia, Other European, White South African, American, Australian, New Zealander, Mixed White

[11] Asian or Asian British – Indian Include: Punjabi, Gujarati [12] Asian or Asian British – Pakistani Include: Kashmiri [14] Asian or Asian British – Chinese Include: Hong Kong [16] Confirm any other Asian background

Include: East African Asian, Sri Lankan, Tamil, Sinhalese, Caribbean Asian, Nepalese, Mixed Asian (i.e. mixture of descriptions in the Asian section).

[17] Black or Black British – African Include: Nigerian, Somali, Kenyan, Black South African, Other Black African countries

[18] Black or Black British – Caribbean Include: Caribbean and West Indian Islands (and also Guyana)

Exclude: Puerto Rican, Dominican and Cuban – which are Latin American

[20] Confirm any other Black/African/Carribean background Include: Black American, Mixed Black [23] Confirm any other ethnic background

Include: Japanese, Vietnamese, Filipino, Malaysian, Aborigine, Afghani, Burmese, Fijian, Inuit, Maori, Native American Indian, Thai, Tongan, Samoan

Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.21 COBO Variable: COBO


Routing: Respondents who answered ‘Elsewhere, write in the current name of country’ at COB

Question text: COB: What is your country of birth?

SINGLE CODE [1] England [2] Wales [3] Scotland [4] Northern Ireland [5] Republic of Ireland New codes Where applicable use the following additional codes: [7] Europe (include Turkey and Lativa) [8] Africa [9] Asia [10] Middle East [11] North America [12] South America [13] Caribbean [14] Australasia Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.22 OthQuals Variable: OthQuals


Routing: Respondents who answered ‘Other qualifications (specify)’ at HiQuals

Question text: HiQuals: Please look at this card and tell me whether you have passed any of the qualifications listed. Look down the list and tell me the first one you come to that you have passed.

SINGLE CODE [1] Degree level qualification or NVQ Level 5

[2] Teaching qualification or HNC/HND,BEC/TEC Higher or BTEC Higher or NVQ level 4

[3] A Levels / SCE Higher, or ONC/OND/BEC/TEC (not higher), or City & Guilds Advanced Final Level, or NVQ level 3, or BTEC National, or GNVC (Advance Level)

[4] O Level passes (Grade A-C if after 1975), CSE grade 1, Standard Grade level 1-3, or City & Guilds Craft/Ord level, or GCSE (Grades A-C) or NVQ level 2, or BTEC First or GNVQ (Intermediate level)

[5] CSE Grades 2-5, or GCE O-level (Grades D & E if after 1975), or GCSE (Grades D,E,F,G), or NVQ level 1, or GNVQ (Foundation level), or Standard Grade level 4-6

[6] CSE ungraded

[7] Other qualifications (specify)

[8] No qualifications

New codes Where applicable use the following additional codes: [9] School Certificate or Matric [10] Nursing qualifications SRN, SCM, SEN, RGN, RM, RHV, Midwife [11] NVQ Level not specified [12] Qualifications obtained during military service [13] Recognised Trade Apprenticeship completed [14] Clerical or Commercial Qualification (e.g. typing/book

keeping/commerce) [15] Qualifications outside of UK [16] Nursery Nurse Examination Board Qualification [17] Other vocational qualifications, not otherwise codable [18] Other academic qualifications, not otherwise codable [19] Other professional qualifications, not otherwise codable Other


[94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this If the level of qualification is unspecified (e.g. just City and Guilds) then code to the lowest level of the appropriate qualification. Inclusions/Exclusions for HiQuals: 1. Degree level qualification Include: CNAA degrees (granted by the Council for National Academic

Awards for degrees in colleges other than universities), Bachelor of Education (B.Ed) - not code 2

2. Teaching qualification Include: College of Preceptors 10. Nursing qualifications Include: State Enrolled Auxiliary Midwife Exclude: Dental Nurses/Hygienists qualifications - code to other 12. Military qualifications Include: Army/navy/air force certificates/qualifications; 1st/2nd/3rd class 14. Clerical or Commercial Qualifications Include: RSA - provided at least one subject is commercial e.g. commerce,

shorthand, typing, bookkeeping, office practice, commercial and company law, cost accounting;

Include: Pitmans - except for their school certificate, code as other = 36; Include: Regional Examining Union (REU) Commercial Awards, provided

that at least one subject is commercial. REU include - East Midland Education Union (EMEU)

15. Foreign Exclude: Qualifications which are described as equivalent to an existing

qualification in the codeframe – such as degrees obtained abroad. 17. Other vocational Include: Banking Exams (unless Institute of Banking mentioned = 19) Certificate of Prevocational Education/Training (CPVE/T)

Youth Training Scheme certificates Retail/commercial/industrial certificates RSA vocational subject certificates (not academic=18 or clerical=14)

Management certificates CLAIT – ICT skills training Health & Safety Training certificate (incl. NVQ, IEHO, CIEH)


European Computer Driving Licence (ECDL) 18. Other academic Include: 16+ exam certificate; Local, regional and RSA school certificates;

Arts foundation courses 19. Other professional:

This covers qualifications awarded by a recognised professional body only. (eg. Social Work Diploma, Chartered/ Management / Certified accountant)

The following should not be treated as qualifications for the purpose of this code-frame: Civil Service Examinations (for entrance, promotion, establishment etc.) Dancing Awards (including ballet qualifications) Drawing Certificates (eg. awarded by Royal Drawing Society) Driving Certificates and Driving Instructor's Qualifications (including Heavy Goods Vehicle Licence) Fire Brigade Examinations First Aid Certificates (including all Red Cross/St John's Ambulance qualifications) Forces Preliminary Examinations (to gain admission to university) GPO telecommunications, telegraphy etc. Labour Examinations (pre 1918 - this allowed children to leave school and start work at 13) Internal school examinations Local Authority Examinations for entrance, promotion etc. Music Grade Examinations and Certificates for learners (e.g. Associated Board of the Royal School of Music) Ordination/Lay Preachers Qualifications Play Group Leader's Qualifications Police Force Examinations Pre HNC/HND bridging or conversion courses Prison/Borstal Training Qualifications Scholarships other than for GCE 'A' Level Swimming Certificates (including life saving and instructors' certificates) Sports Coaching and Refereeing Qualifications Union Membership e.g. Equity, National Association of Head Teachers, IPCS (Institute of Professional Civil Servants) Partial qualifications (such as part way through degree, solicitor’s training etc) should be excluded.


3.23 WhyLeftO Variable: WhyLeftO


Routing: Respondents who answered ‘Or did you leave for some other reason?’ at WhyLeft. Please describe reason for leaving last job.

Question text: WhyLeft: May I just check, how did you come to leave your last job? Were you...

SINGLE CODE (code main reason if more than one) [1] Dismissed [2] Made redundant (include took voluntary redundancy) [3] Did you resign / give notice (including leaving an employment agency) [4] Retire (include compulsory, voluntary or early retirement) [5] Was it a temporary job or contract job that came to an end New codes Where applicable use the following additional codes: [7] Physical health reason/injury [8] Mental health reason/stress [8] Pregnancy/ to look after children/ be a carer [9] Left the country (include moved away to another area) Note to coders – include left to study, marry or do other things at code [3] Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.24 Change2Oth Variable: Change2Oth


Routing: Respondents who answered ‘Other changes’ at Change2.

Question text: Change2: What changes were made? [Regarding changes made at the respondent’s job/working conditions following poor health or disability]

MULTICODED – CODE ALL THAT APPLY [1] Change of duties [2] Change to number of hours worked [3] Change to the pattern of hours worked [4] Given permission to take emergency leave as needed [5] Equipment provided or adaptations made [7] No changes made New codes Where applicable use the following additional codes: [8] Change of location Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this


3.25 Undempo Variable: Undempo


Routing: Respondents who answered ‘Another reason’ at Undemp.

Question text: Undemp: If you were employed part time in your main job last week (less than 30 hours) was it because you...

SINGLE CODE [1] Could not find full-time work [2] Did not want full-time work New codes Where applicable use the following additional codes: [4] Retired Note to coders Include preferred part time work or needed part time work in code [2] Did not want full time work – this includes those who give reason as ‘children’, ‘student’ etc. Other [94] Other specific [95] Vague or irrelevant [96] Editor cannot deal with this
