The Social Context of Mental Distress

It has been recognised through surveys and statistics that during childhood it is more common for males to experience a mental disorder. However, during adulthood it has been found that women are more prone to mental illnesses. Many people wonder who is most prone to mental distress, does it depend on where you come from? Your race, age or background? The information below will hopefully answer some of those questions but if you would like further information please visit Mind as they have many more useful fact-sheets and statistics.

Which gender is most likely to experience mental and emotional distress?

Statistically, women are more likely than men to experience mental and emotional distress (where psychotic elements are not present). Research by the Office for National Statistics (ONS) shows that 20 per cent of all adult women between the ages of 16 to 65 have ‘significant mental health problems’, as compared with 14 per cent of men between these ages. [23] Gender differences in mental health have been widely debated, and a number of explanations are commonly given: that these reflect the greater stresses that many women face in society, that women are more likely to admit to mental health problems and seek help, and that psychiatrists are much more likely to diagnose women as suffering from a mental health problem than men.[24]

For psychosis, which affects 0.5 per cent of the population, there are no significant gender differences in prevalence rates. However, for schizophrenia, the onset of illness is, on average, later in women and women are more likely to make a full recovery.[25] [26].

(Statistics from Mind.org.uk)

Employment is an important factor when it comes to mental distress because some illnesses disrupt the sufferer's normal way of life. If their problem is seriously affecting their work then it is likely they will not be able to continue working, or may have to limit the type of work they do. In some situations, individuals suffering from a form of distress, such as anxiety believe their working environment has triggered their abnormal feelings.

What are the implications of mental health problems for employment?

Lost employment amounts to 37 per cent of the total cost of mental health problems in England (Ł11.8 billion).[1] People who experience mental distress have the highest rate of unemployment amongst people with disabilities. The government labour force survey shows that 71 per cent of those giving mental health problems as their main disability receive state benefits and are out of work and only 19 per cent are employed. Out of 16 classifications of different types of disability, those with mental health problems were the most likely to be unemployed.[2] Another study found that 86 per cent of people diagnosed with schizophrenia and living in the community were unemployed. [3]

Research shows that stress in the workplace can affect health, causing psychological problems like depression and anxiety[4] About half a million UK employees believe that they have some form of work-related stress, including anxiety and depression.[5] Of adults who have worked, 6 per cent (about 2.2 million people) suffer from some form of ill health that they believe was caused or aggravated by work. The most commonly reported conditions are musculo-skeletal disorders, followed by stress and depression.[6] In fact, one study found that three in ten employees will have a mental health problem in any one year, mainly depression and anxiety.[7] Another study showed that 27 to 37 per cent of the working population experienced ‘minor psychiatric disorders’[8]. Research by the Health and Safety Executive found that 182,000 cases of stress or depression are either caused, or made worse, by work each year.[9]

In a study in 1993, 31 per cent of workers reported significant levels of stress as a result of their work, and 24 per cent felt that stress had increased during the past 5 years.[10]

Over the past 20 years, sickness absence due to mental distress has increased by 20 per cent.[11] In 1995, it was estimated that 91 million working days are lost due to mental health problems every year. Mental health problems accounted for 15 per cent and 26 per cent of days of certified incapacity in the early 1990s in men and women respectively.[12] In spite of this, one study found that only 12 per cent of organisations had a policy on mental health, although 95 per cent had said that mental ill health was a concern to their organisation.[13]

How many people are carers of people with mental health problems?

According to the Carers’ National Association, the number of informal carers is steadily falling, from 6.8 million in 1990 to 5.7 million in 1995, as a result of social and demographic trends. This figure is however still very large, representing approximately 1 in 8 adults. Approximately eight of ten carers spend over 50 hours caring for a sick person, while 63 per cent of carers say that they cared for over 100 hours a week.[14] The majority of carers (58 per cent) are women, and women are more likely to carry the main responsibility for caring, where there is more than one person with some responsibility.[15]

Around half of those with severe mental illness live with family or friends, and are likely to receive considerable support from them.[16]

The Carers National Association has estimated that home care saves the country at least Ł34 billion a year.[17]

According to one survey, carers receive little acknowledgement or support from doctors or other health professionals. Questionnaires were sent to 5000 members of the Carers National Association and 3031 people replied. Seventy per cent said that they spent at least seven hours each day caring for another person at home. Many respondents were elderly and more than half had substantial psychological or physical ill-health of their own.[18] It is estimated that a third of informal care for people over 65 is provided by people over 70. [19]

In the same survey, GPs were seen as having the power to make a difference to carers lives. However, only 14 per cent said that their GP had ever visited to see how they were managing.[20]

The prevalence of caring in ethnic minority communities is not known.

Young carers

It is estimated that there are between 20,000 and 50,000 children and young people caring for members of their own family.[21] In 1998, the Carers National Association carried out a survey of young carers and the following represents a brief summary of their findings.[22]:

According to the Carers National Association, 29 per cent of all young carers are providing care for someone with a mental health problem.

The average age of young carers is 12 and 86 per cent of young carers are of compulsory school age.

Fifty seven per cent are girls, 43 per cent boys. Girls are more likely to be involved in all aspects of care, especially domestic tasks and intimate care.

Fifty four per cent of young carers live in lone parent families.

Twelve per cent are caring for more than one person.

Fifty eight per cent of care recipients are mothers. This is more marked than in lone parent families.

More carers from minority ethnic communities care for members of their extended family and more girls than boys are carers in minority communities.

A fifth of young carers are missing school and 28 per cent show signs of educational difficulties. This rises to a third of those of secondary school age.

Twenty five per cent of young carers and their families receive no outside support services other than their contact with the young carers project.

Only 11 per cent of young carers have been assessed under any legislation and only 5 per cent have been assessed under the Carers Recognition and Services Act 1995.

There are no significant differences between young carers who have been assessed and those who haven’t in relation to age, gender, ethnicity or caring tasks.

Those caring for someone with a mental health problem are more likely to be assessed, particularly under the Children Act.

Is there a higher prevalence of mental distress within Black and minority ethnic communities?

Ethnic origin has only recently begun to be recorded in official statistics, including hospital episode statistics and figures for detentions under the Mental Health Act. According to the ONS, administrative problems mean that these figures are not yet reliable. However, much existing research shows that certain groups, notably African Caribbean and Irish people, are over-represented within psychiatric hospitals.

The Mental Health Task Force Project showed that African Caribbean males were over-represented amongst those formally detained at in-patient units and were more likely to be ‘taken to a place of safety’ under the Mental Health Act 1983. It was also shown that they were up to three times more likely to be sectioned than their white counterparts.[27] In addition, the high numbers of African Caribbean people being diagnosed with schizophrenia is well documented in the research. One report states that African Caribbean men have 4.3 times, and women 3.9 times, the rate for first admission with a diagnosis of schizophrenia than white people.[28]. However, one study shows that the rates of schizophrenia are lower in Barbados than among African Caribbeans living in the UK. This could indicate that social and environmental factors, such as unemployment, living alone and poverty, could explain the difference in admission rates.[29] Psychiatrist Suman Fernando states that young African Caribbean men are up to ten times more likely to be sectioned than their white counterparts.[30]

Of all groups, Irish people living in Britain have the highest rates of admission to psychiatric hospitals. They are more than twice as likely to be hospitalised for mental distress than their native-born counterparts. [31]

The findings for mental health problems in Asian people are not consistent. Some studies show higher hospital admission rates for this group than for the British born white population. However, the balance of evidence from hospital admission rates, GP consultation rates and community surveys, suggests that Asian people have rates of psychiatric morbidity equal to or lower than the white indigenous population.[32]

Accurate statistics relating to Chinese and Vietnamese communities are currently not available.

Note: For more detailed statistical information on race and mental health, see Mind’s fact sheet ‘Mental Health Statistics 3: Race, Culture and Mental Health’, available from Mind’s Information Unit.

What are the issues in relation to mental health in elderly people?

Dementia and depression are the two main mental health problems affecting older people. Research has shown that over 6 per cent of people over the age of 65 suffer from dementia and about 15 per cent are affected by depression severe enough to require treatment. Among those aged over 85, the rate for dementia is as high as one in four.[33]

Research in the London Borough of Lewisham showed that about 25 per cent of older clients of community care services were depressed, compared with about 12.5 per cent of those not receiving services, but fewer than 10 per cent of people with depression were receiving any treatment for it.[34]

(Statistics from Mind.org.uk)

These statistics suggest that in some cases social context can affect a person's mental well being, but this depends on an individuals situation. If you would like to find more information about different areas of distress, please visit our Types of Distress section.