This page provides key information to explain what common mental health disorders are and will help build your understanding of its complexity as a risk factor to suicide.
- What are common mental disorders?
- Why are CMDs important to consider in the context of suicide prevalence?
- Prevalence of CMDs
- ZSA Suicide Prevention Resource Map - key takeaways
- Life course of CMDs
- Predisposing factors of CMDs
- Consequences of CMDs
- Impact of COVID-19
- National guidelines for practice
- Key approaches
- Case studies
- ZSA Suicide Prevention Resource Map - related indicators
Common Mental Health Disorders (CMDs) is an umbrella term referring to a variety of depression and anxiety related disorders. These include depression, generalised anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and social anxiety disorder (NICE, 2011).
Even though CMDs can have a significant detrimental impact on an individual’s wellbeing and functioning in every day life, they are not usually encompassed under the term ‘Severe Mental Illness’ (SMI), with the exception of severe depression.
To read more, see our Facts for Action for severe mental illness.
It is also important to make the distinction between a person’s psychological wellbeing and the presence of a mental illness. Mental illness goes beyond the natural fluctuation of psychological wellbeing, whereby a person’s thoughts, feelings and behaviours are significantly affected and impact their every day functioning as a result (ICD-11, 2020).
To read more about psychological wellbeing, see our Facts for Action for well-being.
People that have a mental health disorder are at a higher risk of self harm, having suicidal thoughts and completing suicide compared to the general population (McManus et al., 2016).
Depression is most commonly related to a high risk of suicide (NICE, 2011) and 60% of people that die by suicide have depression. How people experience symptoms of depression is key in their suicide risk. For example, feelings of hopelessness, low mood, and anxiety present the highest risk for suicide (Centre for Suicide Research, 2020).
Self-harm (with or without suicidal intent) is a strong predictor of completed suicide. Once a person has self-harmed, the likelihood that they will die by suicide increases 50 to 100 times compared to someone who has never self-harmed. More than 50% of people who die by suicide have previously self-harmed (Samaritans, 2017).
Recent research has identified that PTSD has a significant contribution to suicide risk, particularly in women. For example, women with PTSD were seven times more likely to die by suicide, compared to men who were four times more likely (University College of London, 2020).
It is important to recognise the symptoms early and receive appropriate treatment in order to reduce the impact they have on people’s lives.
It is commonly cited that one in four adults will experience mental health problems as some point in their life.
Survey data from the Office for National Statistics (ONS) collected in 2014 found that around one-in-six adults met the criteria for a common mental health disorder (ONS, 2018). The same survey also revealed that 39% of adults with anxiety or depression were accessing mental health treatment, which had increased from 24% compared to the previous survey in 2007.
The House of Commons (2021) briefing paper on mental health statistics for England identified that:
- One in six people aged 16+ reported having symptoms of a common mental disorder.
- 5.9% reported generalised anxiety disorder, 3.3% reported depression, 2.4% reported phobias, 1.3% reported OCD, 0.6% reported panic disorder and 7.8% was not specified.
- People with a Black and Black British ethnicity had the highest prevalence of CMD at 22% compared to 17% White British and 14% White other.
- People that were economically inactive had the highest prevalence of CMD at 33%.
Public Health England Fingertips dashboard (PHE,2022) include a source of indicators across a range of health and well-being themes. Their latest data release has identified that in England:
- 16.9 per 100,000 people aged 16 and over have a prevalence of a common mental health disorder.
- 10.2 per 100,000 people aged 65 and over have a prevalence of a common mental health disorder.
- 12.3 per 100,000 people have recorded prevalence of depression (an increase from 11.6 in 2019/20)
- 13.7 per 100,000 people have recorded prevalence of depression and anxiety
The prevalence of individual common mental health disorders varies (Mind, 2020):
- Mixed anxiety and depression: 8 in 100 people
- Generalised anxiety disorder (GAD): 6 in 100 people
- Post-traumatic stress disorder (PTSD): 4 in 100 people
- Depression: 3 in 100 people
- Phobias: 2 in 100 people
- Obsessive-compulsive disorder (OCD): 1 in 100 people
- Panic disorder: fewer than 1 in 100 people.
Research has also found that prevalence differs between men and women. The ONS survey data also found that 19% of women reported CMD symptoms compared to 12% of men. Additionally, more women (10%) reported symptoms as being more severe compared to those reported by men (6%) (ONS, 2016). Women were also found to be twice as likely to be diagnosed with anxiety (Remes et al., 2016).
Mental health issues are more likely to affect young people who identify as LGBT+ than those who do not (Lucassen et al., 2017). People who identify as LGBT+ are at increased risk of developing anxiety disorders (Plöderl & Tremblay, 2015; Bouman et al., 2017) and symptoms of depression are more common and severe in young people who identify as LGBT+ (Irish et al., 2019). Research has also found that people who identify as LGBT+ are more likely to have suicidal thoughts, and attempt suicide, than those who do not identify as LGBT+ (King et al., 2008; Bailey et al., 2014).
Ethnic minority groups
In general, research has highlighted that black women are more likely to experience a common mental illness such as anxiety disorder or depression and black men are more likely to experience psychosis (ONS, 2018 ).
However, white people receive treatment for mental health issues than people from ethnic minority backgrounds and they have better outcomes. This is due to barriers to support for ethnic minority communities, such as lack of services available, shame and stigma within communities and cultural attitudes towards mental health (Rethink Mental Illness, 2021).
There are also other groups where there is a higher prevalence of common mental health disorders, whereby they are more exposed to higher levels of stress such as undergoing study, such as students in higher education. A survey from the Insight Network (2019) identified that in university students:
- The most common diagnoses were depression and anxiety disorders (10.2% and 8.4% of the sample)
- 50.3% reported some thoughts of self-harm and about 1 in 10 students (9.4%) admitted that they thought about self-harm often or always.
- Students who identified as female were significantly more likely to report mental health difficulties than males
- University year was significantly associated with reports of mental health difficulties. CMD’s were lowest in first year, increased significantly in second year, and peaked significantly in third year students.
Substance misuse in people with mental health conditions or serious mental illness is a common occurrence, as substances are often used as an accessible coping mechanism to manage stress. In particular, alcohol has been identified as a common response to mental health problems, with 86% of people using alcohol treatment services have a co-morbid mental health problem (Public Health England, 2017).
For more information, visit our Facts for Action series on Substance Misuse.
Our ZSA Suicide Prevention Resource Map developed with the NHS Benchmarking Network includes a metric of the prevalence of depression within individual Clinical Commissioning Groups (CCGs) across England for 2019/20.
This data shows that there is a higher prevalence for depression predominantly in the North West, and within some areas in the West Midlands and across the South of England. Data for emergency hospital admissions for intentional self-harm in local authority areas shows pockets of high incidence across England, with multiple local authorities recording high incidences in the North West, North East and South West.
The data below relates to data from 2016-2019 and is sourced from the NHS Benchmarking Project for substance misuse unless stated otherwise*
- Depression prevalence (18+) varies from 7.3% in NHS North West London CCG to 19.8% in NHS Blackpool CCG, with a median average of 13.1%.
- Average score for how anxious those responding to the annual population survey reported feeling yesterday varies from 3 in Rutland to 4 in Hackney, with a median average of 3.
*All data from NHS Benchmarking Network projects is subject to change dependent upon permissions being receiving from provider organisations to have their data included in the map. The information reported reflects the data available as at 16/08/22.
CMD’s are most likely to develop in teenage and early adult years, which is a period that represents a “physical, emotion, social and psychological development” (Care Quality Commission, 2017). For example, 75% of mental illness (excluding dementia) starts before age 18 (Kessler et al., 2005).
Early adulthood is a key to social development, and young adults are faced with certain challenges in this period, which can lead to the development of CMD’s. There are many factors that influence this, such as Adverse Childhood Events, poverty and low socio-economic status, parental mental health, or poor educational attainment. Other factors include being:
- Looked after children
- Young carers
This is not to say that all children and young people who experience stress at a young age, will go on to develop mental health problems, but instead this heightens their risk. This vulnerability is thought to be likely contributed to by a combination of social and biological factors, with research finding a 30 to 40% likelihood due to genetic predisposition, and 60 to 70% due to environmental factors (BPS, 2018).
Early intervention in young adult years can be effective in reducing life-course impairment, however, young adults are currently less likely to receive treatment than other age groups. If left unresolved, mental health problems can have a profound and lasting negative impact into adult life, with 50% of young adults with a mental health problem had been first diagnosed between the ages of 11 and 15 (Fraser & Blishen, 2007).
One in six of adults have had a common mental health disorder, such as anxiety and depression, and three quarters of mental health problems are established by the age of 24 (ONS, 2018 ).
The experience of CMD’s may vary, and men are more likely to experience detrimental impacts in life as a result of CMD. For example, one in eight men are likely to have a CMD, men are more likely to die by suicide, have lowest ratings of life satisfaction and are more likely to become dependent on alcohol (Mental Health Foundation, 2021)
A common perception of ageing is that older adults experience higher levels of mental health, however, older people are no more prone to mental health problems than younger adults.
Depression is the most common mental health problem in this age group. It is estimated that it affects 22% of men and 28% of women aged 65 or over and 40% of older people in care homes (Age UK, 2016). Additionally, Anxiety disorders affect 1 in 20 older people.
Psychosocial factors can have a significant contribution to the development of CMD’s in older adulthood. These include:
- Social isolation
- Life events
- Poor physical health or disability
However, older adults experience barriers to mental health services. The Royal College of Psychiatrists (2018) identify that there is an age inequality in older peoples mental health care. They report that:
- Young people with depression are more likely to be referred to mental health services compared to older adults with depression.
- Older people are five times as likely as younger age groups to have access to talking therapies but six times as likely to be on medication.
- Depression in older adults can present in the form of physical symptoms rather than emotional symptoms. This can often be mistaken as dementia, or cognitive decline, leading to mental health needs of older adults being unrecognised.
This highlights that although mental health rates are similar as other age groups, less access to treatment increases the inequalities in this age group.
Figure 1 – Factors that influence the development of mental health (Goldie, 2015).
There is no single cause of the development of CMD’s, but in fact, it is a combination of biological, social, and psychological factors. Biological factors play an important role in the onset by leaving people vulnerable to develop CMD’s. Examples of biological factors include genetics, brain changes and brain chemistry (National Institute of Health, 2007); however, social, and environmental factors have been widely noted that they are a key contributor to the onset of CMD’s. There are many different social and environmental factors; therefore, we will include the key factors in this FFA, such as Adverse Childhood Experiences, life stressors, substance misuse and social environments such as living in poverty.
Other factors include:
- Discrimination and Stigma
- Being a carer.
- Significant trauma such as being in the armed forces or a victim of a violence crime
- Physical health problems.
- Chronic pain.
For more information about inequalities in mental health, visit the GOV.UK report.
Adverse childhood experiences
Adverse childhood experiences are defined as traumatic events that occur in childhood, which involve violence, abuse, neglect and environmental factors which undermine children’s sense of safety, such as substance misuse, mental health and parental separation (Centres for Disease Control and Prevention, 2021). When children are exposed to chronic stressful events, their neurodevelopment can be disrupted. As a result, the child’s cognitive functioning and/or ability to cope with negative or disruptive emotions may be impaired, therefore increasing the risk of developing a CMD. Adverse Childhood Experiences significantly increase the negative outcomes in adulthood and it increases the likelihood of developing a CMD by four times (Early Intervention Foundation, 2020).
Negative life events can also impact on the development of CMD’s, although vulnerabilities will vary between individuals. Stressful life events include unemployment, financial problems, family conflict, bereavement, and any life stressors that have a negative impact, which significantly increase the risk of depression and anxiety (World Health Organisation, 2014).
As discussed in our Facts for Action series on Substance Misuse, this increases the likelihood of mental health issues, with co-morbidities between substance misuse and mental health being very common. However, the misuse of substances may exacerbate symptoms of mental health, as chemical interactions can trigger initial symptoms of those with a predisposition for the condition (Sacks, Ries & Ziedonis, 2005).
In the UK, there is a strong relationship between deprivation and CMD’s, with CMD being a response to and a driver of poverty and deprivation. Across the UK, both men and women in the poorest fifth of the population are twice as likely to be at risk of developing mental health problems as those on an average income (GOV.UK, 2019). However, people who live in deprived areas are more likely to need mental healthcare but less likely have access to support, leading to higher prevalence of CMD’s.
People with a common mental health disorder often face stigma and discrimination with public perception that there is a link between mental health and being a danger to others. As a result, this creates barriers for people with CMD’s in healthcare, employment, and treated differently by public services such as the police (British Association for Psychopharmacology, 2015).
Impact of mental health illnesses also extend beyond people’s personal lives and into the workplace. As one-in-six of working age adults have symptoms associated with poor mental health (McManus et al., 2016). An independent review of mental health and employers report that people with a long-term mental health condition are twice as likely to lose their jobs than those without (Stevenson & Farmer, 2017).
Common Mental Disorders lead to physical health inequalities, and often experience co-morbidity with physical health disorders. For example, 30% of people with a long-term physical health condition have developed a CMD, compared to 40% of people with CMD developing a physical health condition (Naylor et al., 2012).
In addition to this, depression is a major contributor to suicide and coronary heart disease (Correll et al., 2017) and CMD’s have significant links to coronary heart disease, type 2 diabetes, and respiratory disease, which can lead to premature deaths.
Individuals with mental health are at a high risk of misusing substances in harmful ways and it is commonly hypothesised that individuals with common mental disorders (depression, anxiety, bipolar or PTSD) may use alcohol or drugs as self medication. This is a common occurrence as substances are often used as an accessible coping mechanism to manage stress. This is supported by research identifying that 86% of people using alcohol treatment services have a co-morbid mental health problem (Public Health England, 2017).
Research found that over the COVID-19 lockdown there was an increase in poorer mental health across the general population (Understanding Society, 2020). People with pre-existing mental health illnesses, physical health conditions and those that live in deprived areas were highlighted as key risk groups.
People with pre-existing mental health illnesses, physical health conditions and those that live in deprived areas were highlighted as key risk groups. It has been forecast that up to ten million people, the equivalent of nearly 20% of the total population, will need new or addition support for their mental health needs as a result of the COVID-19 pandemic (Centre of Mental Health, 2020).
The Strategy Unit (2020) has undertaken work to forecast the potential increase in demand for mental health services. The Strategy Unit forecasted a 33% increase in overall demand between 2021 and 2023.
There has been a direct impact on the development of Common Mental Disorders as a result of the COVID-19 pandemic. For example, Data from the UK Longitudinal Survey measuring psychological distress (anxiety and depression) found that even though there was an initial 8.1% rise in symptoms, these reduced and returned to similar levels in September 2020 (Public Health England, 2021).
Mental worsened between October 2020 and January 2021, with one in five adults experiencing symptoms of depression in early 2021, which is double that of pre-pandemic figures (ONS, 2021).
At risk groups
Certain groups have found to not recover to the same extent as the general population. A recent large longitudinal study of 70,000 adults living in the UK found that mental health worsened again between October 2020 and January 2021, with anxiety and depression being the highest amongst young adults, women, ethnic minority groups, those living with a physical or mental health condition, those living with children, and people with lower household incomes (Fancourt et al., 2021).
Older adults were also struggling, with 28.5% of older adults (out of 5,146) participating in a longitudinal study reported experiencing clinically significant depressive symptoms late in 2020, compared to 12.5% before the pandemic (Zaninotto et al., 2021).
Illness from COVID-19
Those made severely ill by COVID-19 itself and their family members were found to experience symptoms of PTSD, putting a third of family members at moderate or high risk of developing PTSD (Centre for Mental Health, 2020).
The link between substance misuse and mental health has been exacerbated by the COVID-19 pandemic. Although a necessary measure to mitigate the devastating effects of COVID-19 on public health, evidence indicates that periods of self-isolation have influenced acute and prolonged negative mental health consequences, which in turn, has increased the likelihood of substance misuse (The Health Foundation, 2020). See our Facts for Action series on Substance Misuse.
Reduced access to care
Reduced access primary care services as a result of lockdown restrictions early on in the pandemic (prior to rapid implementation of online services) had a significant impact on people being able to receive support and treatment (NHS Providers, 2020). Evidence suggests that compared to before the pandemic, people are now more likely to experience higher baseline levels of anxiety and depression before seeking help from primary care services (Bauer-Staeb et al, 2021).
There were also secondary impacts of the COVID-19 lockdown, meaning that people went through economic adversities, loss of jobs and housing problems, which lead to an increase in CMD’s in the population. Groups affected by socioeconomic inequalities have been more likely to experience anxiety, panic, hopelessness, loneliness, and to report not coping well with the stress of the pandemic (Mental Health Foundation, 2021).
As a key point, research also highlights the impact that increased unemployment will have on suicide rates (NHS Confederation, 2020). The economic crisis in 2008 illustrates this with rates worsening from 2009 and peaking in 2012 (Nordt et al., 2015).
NHS Long Term Plan
The NHS Implementation Plan (2019/21) and NHS Long Term Plan (2023/24) New and integrated primary and community services should remove thresholds to ensure people can access the care, treatment and support at the earliest point of need, so that they can live as well as possible in their communities. They set out that the NHS will:
- 2023/24 The NHS ensure that they will provide high quality, evidence-based mental health services to an additional 2 million people.
- Meet NHS Talking Therapies* referral to treatment time and recovery standards: 50% recovery rate; 75% of people accessing treatment within 6 weeks waiting time; and 95% of people accessing treatment within 18 weeks waiting time.
- Access to NHS Talking Therapies services will be expanded to cover a total of 1.9m adults and older adults.
- Local areas will also be expected to plan to meet the needs of their local population to address inequalities in access (for example, to improve access for older people by promoting initiatives in care homes) and to consider what changes may need to be made to improve access and outcomes for young adults.
* Improving Access to Psychological Therapy (IAPT) services are being renamed in 2023 as NHS Talking Therapies, for anxiety and depression. Find out more on the NHS England website.
For more information on NHS framework for mental health, See our Facts for Action series on Severe Mental Illness.
The National Institute for Health and Care Excellence (NICE) use the best available evidence to develop recommendations and guidelines that guide decisions in health, public health and social care. These guidelines can also be directly relevant to the assessment and treatment of mental health disorders.
- Generalised anxiety disorder and panic disorder in adults: management
- Social anxiety disorder: recognition, assessment and treatment
- Depression in children and young people: identification and management
- Depression in adults: recognition and management
British Psychological Society (BPS) guidelines
The British Psychological Society (BPS) provide a series of guidelines to help clinicians work in a psychologically informed way. As part of this, the BPS work alongside NICE in developing guidelines for the treatment of common mental health disorders. The BPS have also produced reports that have contributed to making fundamental changes to the way mental health is viewed by society, and subsequently managed and treated within mental health services.
- Understanding depression – why adults experience depression and what can help (Cooke, 2020)
Social prescribing, also sometimes known as community referral, is a means of enabling health professionals to refer people to a range of local, non-clinical services to support their health and wellbeing. Examples include volunteering, arts activities, group learning, gardening, befriending, cookery, healthy eating advice and a range of sports.
Recognising that people’s health and wellbeing are determined mostly by a range of social, economic and environmental factors, social prescribing seeks to address people’s needs in a holistic way. It also aims to support individuals to take greater control of their own health by preventing poor mental health in line with a population health approach.
For more information, see the King's Fund page on Social Prescribing.
Mental Health is influenced throughout life by a range of social, economic and environmental factors, alongside behavioural risk factors. The prevention approach focuses on life stages and considers transitions and settings where mental health, physical health and personal wellbeing can be promoted.
One prevention approach is Public Health England: Health Matters Life Course. This provides actions to address the wider determinants of health which will help improve overall health, and mental health and wellbeing. For more information, visit the Public Health England: Health Matters web-page.
This is in line with the ZSA’s approach to the prevention of mental ill health, self harm and suicide, supporting individuals, communities and leaders to use data and technology to enable change and transformation to services.
We aim to provide a range of transformational information, practical tools, and resources to support individuals, organisations and communities tackle the causes of suicide. We believe that to enable system change we must close the gap between data and action. As an organisation, we actively champion the use of data and technology to understand population need and to transform services with the aim of improving population mental health and wellbeing, ultimately supporting the delivery of our basic principle that suicide is preventable.
Use of digital resources
Torok et al (2020) has recently published a systematic review and meta-analysis of randomised control trials to investigate the effectiveness of digital interventions.
They found that self-guided digital interventions that targeted helping people with suicidal thoughts were particularly effective. As a result they recommend that these digital resources should be promoted widely especially where there is minimal access to health services. This is important for at risk and forgotten populations such as people from an ethnic minority background and older adults. As the Covid-19 pandemic has increased demand for crisis services and reduced access, the use of digital resources in more important than ever.
it is widely recognised that social factors such as housing, education, employment and social connection can have a significant impact on health and wellbeing. In response to this we are seeing emerging examples of new services that seek to work within a social model to address such factors and prevent (further) deterioration in health promoting recovery and a life beyond mental health service prevention. Such services align with both the prevention and recovery approach and work to integrate public, private, voluntary and community sector services.
Good practice example 5: The Life Rooms Social Model of Health, Mersey Care NHS Foundation Trust
- Number of people aged 15 to 64 using opiates or crack per 1,000 population
- Number of alcohol dependent adults per 1,000 population
- Average score for how anxious those responding to the annual population survey reported feeling yesterday
- Average score for how happy those responding to the annual population survey reported feeling yesterday
- Average score for life satisfaction those responding to the annual population survey reported feeling yesterday
Income and Deprivation
- Index of Multiple Deprivation - Local Authority Score
- Index of Multiple Deprivation - Proportion of Lower Super Output Areas (LSOAs) in the most deprived 10% nationally
- Proportion of people aged 16-64 years claiming Employment and Support Allowance (ESA), Incapacity Benefit (IB) or Severe Disablement Allowance (SDA)
- Proportion of households experiencing fuel poverty
- Gap in employment rate (%) for people with mental health conditions
- Proportion of residents who are employees in quality work
To find more service related indicators, see our Facts for Action for NHS Talking Therapies, Substance Misuse, Inpatients, Crisis Response and Community Mental Health Services.
 ICD-11 (2020). Mental, behavioural or neurodevelopmental disorders. Available at: https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f334423054
 McManus S, Hassiotis A, Jenkins R, Dennis M, Aznar C, Appleby L. (2016). ‘Chapter 12: suicidal thoughts, suicide attempts and self-harm,’ in McManus S, Bebbington P, Jenkins R, Brugha T. (eds) Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital. Available at: https://webarchive.nationalarchives.gov.uk/20180328130852tf_/http://content.digital.nhs.uk/catalogue/PUB21748/apms-2014-suicide.pdf/
 NICE (2011). Common mental health problems: identification and pathways to care. Available at: https://www.nice.org.uk/guidance/cg123/chapter/Introduction#ftn.footnote_1
 Samaritans (2017). Dying from inequality: socioeconomic disadvantage and suicidal behaviour. Available at: https://media.samaritans.org/documents/Samaritans_Dying_from_inequality_report_-_summary.pdf
 University College of London. (2020). PTSD contributes to suicide risk, particularly for women. Available at: https://www.ucl.ac.uk/news/2020/nov/ptsd-contributes-suicide-risk-particularly-women
 Office for National Statistics. (2018). Common mental disorders. Available at: https://www.ethnicity-facts-figures.service.gov.uk/health/mental-health/adults-experiencing-common-mental-disorders/latest#main-facts-and-figures
 House of Commons. (2021). Mental health statistics: prevalence, services and funding in England. Available at: https://commonslibrary.parliament.uk/research-briefings/sn06988/
 Mind. (2020). Mental health facts and statistics. Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental-health/how-common-are-mental-health-problems/
 Remes, O., Brayne, C., van der Linde, R., Lafortune, L. (2016). A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain and Behavior, 6, pe00497. Available at: https://doi.org/10.1002/brb3.497
 Lucassen, M., Stasiak, K., Samra, R., Frampton, C., Merry, S. (2017). Sexual minority youth and depressive symptoms or depressive disorder: A systematic review and meta-analysis of population-based studies. Australian and New Zealand Journal of Psychiatry, 51(8), 774-87. Available at: https://doi.org/10.1177/0004867417713664
 Plöderl, M. & Tremblay, P. (2015). Mental health of sexual minorities. A systematic review. International Review of Psychiatry, 27(5), 367–85. Available at: https://doi.org/10.3109/09540261.2015.1083949
 Bouman, W., Claes, L., Brewin, N., Crawford, J., Millet, N., Fernandez-Aranda, F., et al. (2017). Transgender and anxiety: A comparative study between transgender people and the general population. International Journal of Transgenderism, 18(1), 16-26. Available at: https://doi.org/10.1080/15532739.2016.1258352
 Irish, M., Solmi, F., Mars, B., King, M., Lewis, G., Pearson, R., et al. (2019). Depression and self-harm from adolescence to young adulthood in sexual minorities compared with heterosexuals in the UK: a population-based cohort study. Lancet Child Adolescence Health, 3(2), 91-98. Available at: http://dx.doi.org/10.1016/S2352-4642(18)30343-2
 King, M., Semlyen, J., Tai, S., Killaspy, H., Osborn, D., Popelyuk, D., et al. (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BioMed Central of Psychiatry, 8(1), 70. Available at: https://doi.org/10.1186/1471-244X-8-70
 Bailey, L., Ellis. S., McNeil, J. (2014). Suicide risk in the UK trans population and the role of gender transition in decreasing suicidal ideation and suicide attempt. Mental Health Review Journal, 19(4), 209-220. Available at: https://doi.org/10.1108/MHRJ-05-2014-0015
 Rethink Mental Illness. (2021). Black, Asian and Minority Ethnic (BAME) mental health. Available at: https://www.rethink.org/advice-and-information/living-with-mental-illness/wellbeing-physical-health/black-asian-and-minority-ethnic-mental-health/
 The Insight Network. (2019). University Student Mental Health Survey. Available at: https://uploads-ssl.webflow.com/561110743bc7e45e78292140/5c7d4b5d314d163fecdc3706_Mental%20Health%20Report%202018.pdf
 Public Health England. (2017). Better care for people with co-occurring mental health and alcohol/drug use conditions. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/625809/Co-occurring_mental_health_and_alcohol_drug_use_conditions.pdf
 Care Quality Commission (2017). Review of children and young people’s mental health services. Phase one report. Available at: https://www.cqc.org.uk/publications/major-report/review-children-young-peoples-mental-health-services-phase-one-report
 Kessler, R., Berglund, P., Demler, O., Jin, R., Merikangas, K. & Walters, E. (2008). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry, 62(7), 768. Available at: https://pubmed.ncbi.nlm.nih.gov/15939837/
 BPS (2018). BPS Supports new GLAD study of depression and anxiety. Available at: 30-40% of the risk for both depression and anxiety is genetic and 60-70% due to environmental factors. Available at: https://www.bps.org.uk/news-and-policy/bps-supports-new-glad-study-depression-and-anxiety
 Fraser, M., Blishen, S. (2007). Supporting Young People’s Mental Health. Available at: https://www.mentalhealth.org.uk/sites/default/files/supporting_young_people.pdf
 Mental Health Foundation. (2021). Mental health statistics: Men and women. Available at: https://www.mentalhealth.org.uk/statistics/mental-health-statistics-men-and-women
 Age UK (2016) Hidden in Plain Sight: The Unmet Mental Health Needs of Older People. Available at: https://www.ageuk.org.uk/brandpartnerglobal/wiganboroughvpp/hidden_in_plain_sight_older_peoples_mental_health.pdf
 Royal College of Psychiatrists. (2018). Age inequality in older people’s mental health care. Available at: https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr221.pdf?sfvrsn=bef8f65d_2
 Goldie, I. (2015) ‘No time like the present’. In Crepaz-Keay, D. (ed.) (2015). Mental Health today…And Tomorrow: Exploring current and future trends in mental health. pp. 3–16.
 Centres for Disease Control and Prevention. Preventing Adverse Childhood Experiences. Available at: https://www.cdc.gov/violenceprevention/aces/fastfact.html
 Early Intervention Foundation. (2020). Adverse Childhood Experiences. Available at: https://www.eif.org.uk/files/pdf/adverse-childhood-experiences-report.pdf
 World Health Organisation. (2014). Social determinants of mental health. Available at: https://apps.who.int/iris/bitstream/handle/10665/112828/9789241506809_eng.pdf
 Sacks, S., Ries, R. K., Ziedonis, D. M., & Center for Substance Abuse Treatment. (2005). Substance abuse treatment for persons with co-occurring disorders.
 GOV.UK. (2019). Mental health: environmental factors. Available at: https://www.gov.uk/government/publications/better-mental-health-jsna-toolkit/2-understanding-place
 British Association for Psychopharmacology. (2015). Mental Health Stigma. Available at: https://www.bap.org.uk/articles/mental-health-stigma/
 McManus S, Bebbington P, Jenkins R, Brugha T. (eds.) (2016) Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/556596/apms-2014-full-rpt.pdf
 Stevenson & Farmer (2017). Thriving at work: The Stevenson/Farmer review of mental health and employers. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/658145/thriving-at-work-stevenson-farmer-review.pdf
 Naylor, C., Das., Ross, S., Honeyman, M., Thompson, J. & Gilburt, H. (2016). Bringing together physical and mental health: A frontier for integrated care. The Kings Fund. Available at: https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/Bringing-together-Kings-Fund-March-2016_1.pdf
 Correll, C. et al. (2017). Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry, 16(2), 163-180. Available at: https://pubmed.ncbi.nlm.nih.gov/28498599/
 Public Health England. (2017). Better care for people with co-occurring mental health and alcohol/drug use conditions. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/625809/Co-occurring_mental_health_and_alcohol_drug_use_conditions.pdf
 Understanding Society (2020). Understanding Society Working paper Series. Available at: https://www.understandingsociety.ac.uk/research/working-papers
 Centre for Mental Health (2020). Covid-19 and the nation’s mental health: October 2020. Available at: https://www.centreformentalhealth.org.uk/publications/covid-19-and-nations-mental-health-october-2020
 The Strategy Unit (2020). Mental Health Surge Modelling app. Available at: https://strategyunit.shinyapps.io/MH_Surge_Modelling/ (accessed 29/04/2021)
 Public Health England (2021). Research and analysis: Important findings. Available at: https://www.gov.uk/government/publications/covid-19-mental-health-and-wellbeing-surveillance-report/2-important-findings-so-far
 Office for National Statistics (2021). Coronavirus and depression in adults: Great Britain: January to March 2021. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/coronavirusanddepressioninadultsgreatbritain/latest
 Fancourt, D., Bu, F., Mak, HW., Paul, E. & Steptoe, A (2021). Covid-19 Social Study: Results Release 35. University College London. Available at: https://b6bdcb03-332c-4ff9-8b9d-28f9c957493a.filesusr.com/ugd/3d9db5_3057a2dc50e34ded8d7057354b510ea2.pdf
 Zaninotto, P., Lob, E., Demakakos, P. & Steptoe, A. (2021). The immediate and longer-term impact of the COVID-10 pandemic on the mental health and wellbeing of older adults in England. MedRxiv. Available at: https://doi.org/10.1101/2021.04.30.21256385
 Centre for Mental Health (2020). Covid-19 and the nation’s mental health: Forecasting needs and risks in the UK July 2020. Available at: https://www.centreformentalhealth.org.uk/sites/default/files/publication/download/CentreforMentalHealth_COVID_MH_Forecasting2_Jul20_0.pdf
 The Health Foundation. (2020). Emerging evidence on COVID-19’s impact on mental health and health inequalities. Available at: https://www.health.org.uk/news-and-comment/blogs/emerging-evidence-on-covid-19s-impact-on-mental-health-and-health
 NHS Providers (2020). The impact of COVID-19 on mental health trusts in the NHS. Available at: https://nhsproviders.org/media/689590/spotlight-on-mental-health.pdf
 Bauer-Staeb, C., Davis, A., Smith, T., Wilsher, W., Betts, D., Eldridge, C., Griffith, E., Faraway, J. & Button, K. (2021). The early impact of COVID-19 on primary care psychological therapy services: A descriptive time series of electronic health records. EClinicalMedicine. Available at: https://doi.org/10.1016/j.eclinm.2021.100939
 NHS Confederation, NHS Reset (2020). Mental health services and Covid-19: Preparing for the rising tide. Available at: https://www.nhsconfed.org/-/media/Confederation/Files/Publications/Documents/Report_Mental-health-services-NHS-Reset_FNL.pdf
 Nordt, C., Warnke, I., Seifritz, E., et al. (2015). Modelling suicide and unemployment: a longitudinal analysis covering 63 countries, 2000–11. Lancet Psychiatry, 2, 239-45. Available at: https://doi.org/10.1016/s2215-0366(14)00118-7
 NHS (2019). NHS Mental Health Implementation Plan 2019/20 – 2023/24. Available at: https://www.longtermplan.nhs.uk/publication/nhs-mental-health-implementation-plan-2019-20-2023-24/
 NHS (2019). The NHS Long Term Plan. Available at: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf
 NICE. Digital therapies assessed and accepted by the Improving Access to Psychological Therapies Programme (IAPT). Available at: https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/improving-access-to-psychological-therapies--iapt-/submitting-a-product-to-iapt#published-IABs
 Cooke., A. (2020). Understanding depression – why adults experience depression and what can help. Available at: https://www.bps.org.uk/sites/www.bps.org.uk/files/Member%20Networks/Divisions/DCP/Understanding%20depression.pdf
 Torok, M., Han, J., Baker, S., Werner-Seidler, A., Wong, I., Larsen, M. E., & Christensen, H. (2020). Suicide prevention using self-guided digital interventions: a systematic review and meta-analysis of randomised controlled trials. The Lancet Digital Health, 2(1), e25-e36.
Content reviewed and updated on 25/08/22
Case study examples of best and innovative practice
Connect my community NHS
Connect My Community NHS is a project delivered by Lancashire and South Cumbria NHS Foundation Trust Community Asset Development Team. This project was put in place to sustain and develop a peer network across Central Lancashire, by connecting groups, projects, initiatives and individuals with other local assets in their community.
National Institute of Mental Health - scale-up hubs
The National Institute of Mental Health (NIMH) developed a network of global research Hubs called ‘NIMH Scale-Up Hubs” to increase the reach, accessibility, quality, costs and effectiveness of mental health services.