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The British Journal of Psychiatry (2004) 185: 378-384
© 2004 The Royal College of Psychiatrists

Trends in service use and treatment for mental disorders in adults throughout Great Britain

Traolach S. Brugha, PhD, MRCPsych

Department of Health Sciences, University of Leicester, London

Paul E. Bebbington, PhD, FRCPsych

Department of Mental Health Sciences, Royal Free and University College Medical School, London

Nicola Singleton, MSc

Social Survey Division, Office for National Statistics, London

David Melzer, MB, BCh

Department of Community Medicine, Institute of Public Health, University of Cambridge, London

Rachel Jenkins, FRCPsych

WHO Collaborating Centre, Institute of Psychiatry, London

Glyn Lewis, PhD, FRCPsych

Division of Psychiatry, University of Bristol, London

Michael Farrell, MRCPsych and Dinesh Bhugra, PhD, FRCPsych

Institute of Psychiatry, London

Alison Lee, MSc and Howard Meltzer, PhD

Social Survey Division, Office for National Statistics, London, UK

Correspondence: Dr T. S. Brugha, Brandon Mental Health Unit, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK. Tel: 0225 6295; fax: 0225 6235; e-mail: tsb{at}le.ac.uk

Declaration of interest None. Funding detailed in Acknowledgement.

Background Trends in health treatments and outcomes in the general population may be used to monitor achievement of health targets.

Aims To investigate changes in mental health services and treatment in Britain over a 7-year period.

Method National surveys of psychiatric morbidity were completed in 1993 and 2000 in households throughout Great Britain. Standardised interviews were used to establish psychiatric case status and service and treatment utilisation in adults aged 16–64 years.

Results Use of psychotropic medication doubled in those designated as psychiatric cases. In the non-case-status population antidepressant use rose from 0.16% in 1993 (95% CI 0.07–0.25) to 2.02% in 2000 (95% CI 1.69–2.35). However, the overall prevalence of neurotic and psychotic disorder hardly changed from 1993 to 2000. Use of specialised ‘talking treatments’did not increase significantly, except in the non-case group.

Conclusions Treatment with psychotropic medication alone is unlikely to improve the overall mental health of the nation. A policy based almost exclusively on treatment of identified cases should be augmented by preventive approaches.