Isle of Wight Joint Strategic Needs Assessment (Mental Health)

1 Produced by IWC Public Health Team

People make healthy choices for healthy lifestyles – Mental Health Last updated: September 2013

Joint Strategic Needs Assessment

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Hampshire Primary Care Trust

Cornwall UA & Isles of Scilly PCT

England

Portsmouth City Teaching PCT

Great Yarmouth & Waveney PCT

Southampton City PCT

Isle of Wight NHS PCT

Torbay Care Trust

Blackpool PCT

Crude prevalence rate (%)

Crude Mental Health prevalence - Isle of Wight and its ONS Peers: 2011/12

Sources: Quality and Outcomes Framework as at end of July 2012 accessed via NHS Information Centre Copyright

© 2011, The Health and Social Care Information Centre, Prescribing Support Unit. All rights reserved.

Notes: These are crude rates and therefore do not take any account of the underlying age/sex distribution of the

population

Summary / Key Points

The crude mental health prevalence is

significantly worse than the England average.

Total contacts per 100,000 to Mental Health

Services are lower than the England Average.

The Island has the highest recorded crude rate

prevalence of Dementia in the UK.

The crude depression prevalence for the Island

is lower than the England average but not

significantly.

There is a significant difference across the

Island with the South Wight Locality presenting

a significantly higher recorded prevalence of

depression.

Suicide rates nationally are the third lowest in

Europe.

Suicide rates on the Island are highest

compared to our statistical neighbours but with

no significant difference due to small numbers.

Suicide rates are higher in males than females

across the country.

The level of population need

Mental Health

WHO describes Mental Health as “not just the absence

of mental disorder, but it is defined as a state of well

being in which every individual realises his or her own

potential, can cope with the normal stresses of life, can

work productively and fruitfully, and is able to make a

contribution to her or his community”.

The Mental Illness Needs Index 2000 is based on

illnesses severe enough to require hospital treatment

from time to time and is derived from data relating to

1998 and shows the predicted rates of admissions by

ward area. A score of 1 is the England average; overall

the Island scores 1.05 indicating that there is 5% higher

than average need for mental health services. The

darkest blue sections on the map show areas with the

greatest need with more than 23% higher than average

need. The four highest predicted areas are Ryde North

East and Ryde North West, Pan and Ventnor.

The crude mental health prevalence of the Island is

above the England prevalence of 0.82 with a

prevalence of 1.02 with a significantly worse than

average rate of hospital admissions for mental health

(nepho). Based on NHS funding the Island is not

significantly different to the England average for its

allocated spends on mental health per head (nepho).




0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4

West & Central Wight Locality

Isle Of Wight NHS PCT

South Wight Locality

North & East Wight Locality

Rate

Crude Mental Illness prevalence - Isle of Wight and its localities: 2011/12

Sources: Quality and Outcomes Framework as at end of July 2011 accessed via NHS Information Centre Copyright © 2012, The

Health and Social Care Information Centre, Prescribing Support Unit. All rights reserved.

Notes: These are crude rates and therefore do not take any account of the underlying age/sex distribution of the population.

0.0 0.2 0.4 0.6 0.8 1.0 1.2





Rate

Crude Dementia prevalence - Isle of Wight and its localities: 2011/12




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1

1.1

2006/07 2007/08 2008/09 2009/10 2010/11 2011/12

% o

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nce

Year

Crude Mental Illness prevalence - Isle of Wight and England Trend

Isle of Wight England




0.0 0.2 0.4 0.6 0.8 1.0 1.2

England


Blackpool PCT

Portsmouth City Teaching PCT

Hampshire Primary Care Trust

Cornwall UA & Isles of Scilly PCT

Great Yarmouth & Waveney PCT

Torbay Care Trust



Crude Dementia prevalence - Isle of Wight and its ONS Peers: 2011/12

Sources: Quality and Outcomes Framework as at end of July 2012 accessed via NHS Information Centre Copyright

© 2011, The Health and Social Care Information Centre, Prescribing Support Unit. All rights reserved.

Across the island the North and East Wight locality has

the highest prevalence of mental health but there is no

significant difference when benchmarking between the

three localities. Adult and elderly secondary mental

health services on the Island are being used at a

significantly higher rate than the England and South

East rate (nepho).

The Islands prevalence of mental health has been

significantly higher than the England’s average over the

last five years and has increased by 8% since 2006/07

however the growth of mental health prevalence on the

island has been much slower than the national growth

of 11%. The number of total contacts with mental

health services per 100,000 populations for 2010/11

was 32, significantly lower than the England rate of 313

per 100,000. This measure includes all contacts with

mental health staff, including Psychiatrists, Community

Psychiatric, Nurses, Clinical Psychologists,

Occupational Therapists, Physiotherapists, Consultant

Psychotherapists and Social Workers (nepho)

Dementia

Dementia is a syndrome characterised by the

catastrophic, progressive global deterioration in

intellectual function and is a main cause of late life

disability (nepho). As we age the prevalence of

dementia increases and therefore areas with higher

elderly populations will have higher rates of recorded

dementia. Dementia is more common in older people

but can affect people at any age with one in 14 people

over the age of 65 and one in six over the age of 80

having some form of dementia (PSSRU).

The Island had the highest recorded prevalence of

dementia in the UK for 2011/12 which is linked with

additional psychiatric symptoms such as adjustment

disorder, anxiety, psychiatric symptoms and alcohol

related issues.

Across the Island the South Wight Locality has the

highest recorded rate of dementia but with no statistical

difference between the three. Dementia goes

undiagnosed in a lot of people with many not having

access to care that could be available to them.




0.0%

0.2%

0.4%

0.6%

0.8%

1.0%

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12

% o

f patients

GP Practice Dementia Registers - Recorded Prevalence Rates: Patients on Registers as % of All Patients - All Ages

England IW

Data Source: Quality Outcomes Framework

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1,000

2,000

3,000

4,000

2012 2013 2014 2015 2016 2018 2020

nu

mb

er

of p

eo

ple

Isle of Wight: Estimated Prevalence of Dementia:Number of Persons aged 18+ - up to 2030

Data Source: POPPI (age 65+) & PANSI (age 18-64)

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500

1000

1500

2013 2016 2018 2020

num

ber

of people

aged 6

5+

Isle of Wight: Estimated Prevalence of Dementia: Number of People Age 65+ - Persons by Age and Year

65-69 70-74 75-79 80-84 85-89 90+

Data Source: Projecting Older People Population Information System (POPPI)

2584

1339

0

1,000

2,000

3,000

Estimated (2012) Recorded (2011-12)

num

ber

of people

Isle of Wight: Estimated vs GP-Recorded Dementia Prevalence: Persons, All Ages

Data Sources: POPPI (prevalence estimates); Quality Outcomes Framework (GP-Recorded data)

0

500

1,000

1,500

2,000

2,500

2012 2013 2014 2015 2016 2018 2020

nu

mb

er

of p

eo

ple

ag

ed

65

+

Isle of Wight: Estimated Prevalence of Dementia: Number of People Age 65+ - by Gender

Male Female

Data Source: Projecting Older People Population Information System (POPPI)

Dementia prevalence has increased on the island over

the last five years and nationally. In terms of numbers

there has been an increase of 66.5% registered with

dementia and a total increase from 0.6% to 1% total

prevalence compared to the national prevalence of

0.4% in 2006/07 to 0.5% in 2011/12.

The prevalence rates have been applied to the ONS

population projections of the 65 and over population to

give estimated numbers of people predicted to have

dementia up to 2020. It is predicted there will be a

further 21% increase in registered dementia prevalence

by 2020.

Across the predicted years the largest predicted age

group increase is in the 70-74 years olds with a

predicted rise of 44% from 2012 to 2020 followed by the

90+ age group with a 33% increase. There was an

increase in all age groups with the exception of the 65-

69 age groups with a predicted 9% decrease.

The increase by gender from 2012 to 2020 is predicted

to be larger in males with a predicted 32% increase

compared to a predicted 16% increase in females.

The Delphi consensus was used to estimate the

numbers of people with dementia. This method is used

to predict estimates when an evidence base exists but

the recorded data is incomplete. It is believed that

there is a much higher rate of dementia than the

recorded prevalence which suggests that there are still

many people who have not been diagnosed and appear

on the Dementia register. On the Island it is estimated

that there could have been another 1,245 people in

2012 with Dementia on the Island that have not been

receiving correct medical help.




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Portsmouth CityTeaching PCT

England


Hampshire PrimaryCare Trust

Torbay Care Trust

Cornwall UA & Isles ofScilly PCT

Great Yarmouth &Waveney PCT

Blackpool PCT


Crude Depression prevalence - Isle of Wight and its ONS Peers: 2011/12

Sources: Quality and Outcomes Framework as at end of July 2011 accessed via NHS Information Centre Copyright © 2011, The Health and Social

Care Information Centre, Prescribing Support Unit. All rights reserved.

Notes: These are crude rates and therefore do not take any account of the underlying age/sex distribution of the population. Denominator is

number of people aged 18+ on depression register but numerator is complete list size (all ages)

0 2 4 6 8 10 12 14





Rate

Crude Depression prevalence - Isle of Wight and its localities: 2011/12

Sources: Quality and Outcomes Framework as at end of July 2011 accessed via NHS Information Centre Copyright © 2012, The Health and Social Care Information

Centre, Prescribing Support Unit. All rights reserved.

Notes: These are crude rates and therefore do not take any account of the underlying age/sex distribution of the population. Localities are defined according to GP

practices.

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4

6

8

10

12

14

2008/09 2009/10 2010/11 2011/12

% o

f P

revale

nce

Year

Crude Depression prevalence - Isle of Wight and England Trend

Sources: Quality and Outcomes Framework as at end of July 2011 accessed via NHS Information Centre Copyright © 2012,

The Health and Social Care Information Centre, Prescribing Support Unit. All rights reserved.


Localities are defined according to GP practices.

0 1 2 3 4 5 6 7 8 9 10

England

Torbay Care Trust

Cornwall UA & Isles ofScilly PCT

Hampshire Primary CareTrust


Portsmouth City TeachingPCT

Great Yarmouth &Waveney PCT

Blackpool PCT


ADQs per STAR-PU

Anti-depressant prescribing rates (ADQs per STAR-PU) -Southampton and ONS Comparators: 2011/12

Sources: ePACT Toolkit Notes: ADQs are Average daily Quantities which are a standard measure of dose, STAR-PUs are population denominators weighted for the age profile of the particular therapeutic group

Depression

The symptoms and severity of depression can affect

people in different ways and vary from person to

person. In its mildest form someone may feel

persistently low in spirit but at its most severe,

depression can make someone feel suicidal and that

life is no longer worth living (NHS). Depression is quite

common and can affect around one in ten of us at some

point including young and old, men and women.

The Island in comparison to similar areas has a lower

rate of registered depression and is significantly below

the England average.

Across the Island there is a significant difference

between the three localities with South Wight having a

higher crude rate of registered depression with 11.7%

of patients registered compared to the West & Central

Wight Locality of 5.2% and the North & East Wight

Locality of 6.4%.

Over the last four years the registered depression rate

has increased at the same rate as the England increase

rate with a significant rise from 2008/09 to 2009/10 due

to a change in recording.

The Island is slightly above the England average for

prescribed anti depressants per therapeutic group

population.

Suicide

“Suicides are one of the main causes of lost years of

life after circulatory diseases and cancers” (SEPHO,

2006). In comparison to other countries in Europe, the

United Kingdom has a relatively low suicide rate. Out

of 18 countries in Europe the UK has the third lowest

rate and the 13th lowest out of 57 major countries in the

world (SEPHO 2006).




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2003-05 2004-06 2005-07 2006-08 2007-09 2008-10

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n Mortality from Suicide & Injuries of Undetermined Intent (All Ages): 2003-05 to 2008-10 Time Trend

Isle of Wight ENGLAND

Sources: Compendium of Clinical and Health Indicators / Clinical and Health Outcomes Knowledge Base

(www.nchod.nhs.uk or nww.nchod.nhs.uk).

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Portsmouth

Shepway CD

Thanet CD

Hampshire

Waveney CD

Dover CD

Great Yarmouth CD

Cornwall UA

Scarborough CD

Torbay UA

Carlisle CD

Southampton

Weymouth and Portland CD

Allerdale CD

Blackpool UA

Isle of Wight

Directly Age Standardised Rate per 100,000 Population

Mortality from Suicide & Injuries of Undetermined Intent (All Ages): 2008 to 2010 (pooled)


(www.nchod.nhs.uk or nww.nchod.nhs.uk)

Isle of Wight & ONS Comparator Local Authorities: PERSONS

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Portsmouth

Shepway CD

Thanet CD

Hampshire

Waveney CD

Dover CD

Great Yarmouth CD

Cornwall UA

Scarborough CD

Torbay UA

Carlisle CD

Southampton

Weymouth and Portland CD

Allerdale CD

Blackpool UA

Isle of Wight

Directly Age Standardised Rate per 100,000 Population

Mortality from Suicide & Injuries of Undetermined Intent (All Ages): 2008 to 2010 (pooled)

FEMALES

MALES


(www.nchod.nhs.uk or nww.nchod.nhs.uk)

Isle of Wight & ONS Comparator Local Authorities: BY GENDER

Suicide rates on the island are highest compared to its

comparators but there is no significant differences

which is due to small numbers.

Suicide rates across all the areas are significantly

higher in males than in females with no significant

differences across the areas.

Suicide mortality rates across the island have increased

year on year since 2004-06 compared to the England

rate which has slightly decreased. It is important to

note that, because of the relatively small number of

deaths of IW residents each year from suicide, even

three-year aggregated mortality rates are susceptible to

fluctuation. A small change in the annual number of

deaths can result in a significant change in the mortality

rate.

References

Brooks.P & Watson J, A Profile of Suicide Mortality in the

South East, South East Public Health Observatory, 2006.

Community Mental Health Profiles 2013,

http://www.nepho.org.uk/cmhp/index.php?pdf=E06000046

accessed 7th May 2013

Health & Social Care Information Centre, Quality & Outcomes

Framework http://www.qof.ic.nhs.uk/ accessed 8th May 2013

NHS Choices,

http://www.nhs.uk/Conditions/Depression/Pages/Introduction.

aspx accessed 13th May 2013

Personal Social Services Research Unit (2007), Dementia

UK: The Full Report, Alzheimer’s Society 2007

World Health Organisation,

http://www.who.int/features/qa/62/en/index.html accessed 9th

May 2013

http://www.nepho.org.uk/cmhp/index.php?pdf=E06000046

http://www.qof.ic.nhs.uk/

http://www.nhs.uk/Conditions/Depression/Pages/Introduction.aspx

http://www.nhs.uk/Conditions/Depression/Pages/Introduction.aspx

http://www.who.int/features/qa/62/en/index.html

Documents

Isle of Wight Joint Strategic Needs Assessment (Mental Health)