Chief Medical Officer for Scotland’s Annual Report summary 2017-2018: annex

Priority 3 – A Scotland Where We Have Good Mental Wellbeing

Mental wellbeing is about feeling good, maintaining positive relationships and living a life that has a sense of purpose. Good mental wellbeing arises where there is a supportive environment across all aspects of our lives, such as our workplaces, communities and education systems.

Burden of disease studies take account of both the length of life lost to premature death and the length of time lived with ill-health. Mental health problems represent a very substantial proportion of the overall burden of disease in Scotland. Although depression, anxiety and dementia are not responsible for a large percentage of early deaths in Scotland, we have selected these two topics because they are chronic conditions which people have to cope with for long periods of time. Mental health problems can often be prevented at the population level, and their impact on people can be reduced if there are sufficient structures and supports in place across society.

Figure 5: Percentage of men and women aged 16+ years reporting anxiety symptoms on the Clinical Interview Schedule-Revised (CIS-R) score by quintiles of area deprivation score

Source: Scottish Health Survey [2014-17 combined]^[6]

Figure 6: Percentage of men and women 16+ years reporting depression symptoms on the Clinical Interview Schedule-Revised (CIS-R) score by quintiles of area deprivation score

Source: Scottish Health Survey [2014-17 combined]^[6]

• Positive mental health and mental health problems are two separate facets of health.
• Mental health problems are very common and, on many measures, are getting worse.^{[7 ]}
• As the population has got older on average, the number of people living with dementia has increased.
• There are substantial inequalities across deprivation groups in the proportion of people reporting anxiety and depression symptoms (see Figures 5 and 6). Anxiety is more common among women than men in all groups but gender differences in the risk of depression are not consistent across deprivation groups.
• Many aspects of modern life have been suggested as contributors to mental health problems, including loneliness and economic insecurity.^[8]
• A public mental health approach requires us to look at the factors that are changing the experiences of mental health across the whole population, focusing on the prevalence of cases rather than the causes of cases or the provision of services.