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WELL? WHAT DO YOU THINK?

CHAPTER FOUR. PEOPLE'S VIEWS OF THEIR OWN MENTAL HEALTH AND WELL BEING

Describing good mental health

4.1 A list of 15 words or phrases was used to assess how people viewed good mental health - respondents were invited to select between one and five options from a prompted list. Table 4.1 shows the rank order of responses, in descending order. The rank order of issues did not vary greatly by group but there were considerable variations in the actual scores. Young people, for example, were notably concerned about happiness and confidence. The over 75s, by contrast, were relatively more likely to mention coping and tolerance. Correspondence Analysis at this question confirmed that age was a more powerful discriminator than either sex or social class - see Annex F for more details. Further down the rank order, the idea of being successful had a positive message for ethnic minority respondents.

Table 4.1: Here are some words and phrases people have used to describe good mental health. Which do you think are the five words or phrases that best describe good mental health for you?
Base: all = 1381

	All %	Highest percentages
Happy	67	16-34 years 77% Females 71% High mental health/vitality score 75%
Healthy	59	High mental health/vitality scores 68%
In control	54	Male 16-54 61% Social class AB 59% Income over 26k 61%
Confident	52	16-24 years 69%
Loved	49	Female 55%
Calm	48	Stress-free 62%
Coping	40	Over 75s 51%
Tolerant	32	Over 75s 46%
Understood	21	Social class DE 24% Not working 25% Long term limiting condition 25% Moderate/large amount of stress 24% Little control over MH 26%
Resourceful	16
Successful	13	Ethnic minorities 37%
Connected/part of something	12	AB 18%
Challenged	7	Male 16-54 10%
Attractive	3

Positive and negative effects on mental health and well being

4.2 The questionnaire went on to ask, without prompting, about factors that might have a positive impact on the respondent's mental health or well being. The idea of support (from family members and partners in particular) scored strongly, followed by good health, social and leisure activities, a good income and work. 'Environmental' factors (such as the weather and holidays) also made the top dozen responses, along with issues of stress and being in control. The main differences in attitudes by age are highlighted in Table 4.2 (in bold italics). For example, people over the age of 75 were particularly concerned about being healthy and respondents under the age of 25 were keen to emphasise the value of leisure activities and a social life and support from friends. The Correspondence Analysis confirmed that age was the key discriminator of views on positive effects on mental health. However, it is not possible to tell whether people's views change as they grow older, or whether factors such as the language, education and social conditioning of different generations influence their responses to questions of this type.

Table 4.2: Thinking now about other things which might affect your health, what sorts of things have a positive or good effect on your mental health and well being?
Base: all = 1381 (Top 12 mentions)

	All %	16-24 %	25-34 %	35-44 %	45-54 %	55-64 %	65-74 %	75+ %
Support from/relationship with other family members	35	36	39	34	35	36	36	25
Support from/relationship with spouse/partner	22	17	29	28	22	23	20	6
Being healthy	21	16	23	19	19	24	21	32
Leisure activities/social life	19	35	14	19	15	15	17	18
Having enough money/good income	18	12	25	24	22	13	14	10
Work/working	16	22	24	20	18	12	7	1
Support from/relationship with friends	14	29	15	11	9	15	9	12
Good weather	12	6	10	11	10	14	19	13
Avoiding stress	10	5	13	10	15	8	8	7
Being in control	9	5	14	8	8	8	9	9
Holidays/breaks	7	3	9	6	9	10	10	2
Being calm	6	6	5	5	8	10	4	9

4.3 On the other side of the coin, reported stress, physical illness and lack of money emerged as having particularly negative associations for mental health and well being. Many of the most common responses at this question were reversals of the answers given at the previous 'positive' question, including problems in relationships, bad weather and work pressures. Again, the analysis showed significant differences in views by age and these are highlighted in italics in Table 4.3 - the 25-54 year old age group were more concerned about stress, lack of money and work than people in the other age bands. Older people (and women in general) were more likely to mention physical illness having a negative impact on mental health and well being. Again, Correspondence Analysis confirmed the importance of age in interpreting responses to this question although, once more, it is not clear whether this is due to the age or generational differences.

Table 4.3: What, if any, things have a negative or bad effect on your mental health and well being?
Base: all = 1381 (Top 12 mentions)

	All %	16-24 %	25-34 %	35-44 %	45-54 %	55-64 %	65-74 %	75+ %
Stress	25	21	33	31	31	18	15	10
Illness (physical)	22	6	18	20	23	33	26	31
Not enough money/low income	20	23	31	22	22	13	12	6
Problems in relationship with other family members	16	14	17	20	19	20	12	7
Bad weather	14	8	13	12	10	17	22	16
Work/working/having too much work	14	13	22	21	20	9	1	0
Problems in relationship with spouse/partner	9	7	14	7	7	7	4	4
Not being in control	8	0	8	10	10	10	6	7
Not working	6	6	11	11	4	2	1	1
Problems in relationships with friends	6	12	5	7	4	5	5	4
Lack of sleep	5	4	7	7	6	5	3	4
Poor social life/not much to do/lack of facilities	4	9	4	3	5	2	5	4

Three things to make a difference to own mental health and well being

4.4 People were asked, again without prompting, to identify the three things that would make the biggest difference to their own mental health and well being. Generic issues were increased finance (mentioned by 39%) and good health (mentioned by 33%), followed by reduced stress (17%) and improved quality of life (14%). Work was mentioned both in the context of wanting a job and wanting to stop working. One in ten of the people in the sample mentioned a lottery win as the thing that would make the biggest difference to their mental health and well being. The Correspondence Analysis found that age was the strongest discriminator at this question but there were also variations by sex, so figures 4.1 and 4.2 show responses broken down by a combination of these variables.

Figure 4.1: What would be the three main things that would make the biggest improvement to your own mental health and well being? (1)
Base: all = 1381 (Limited to those mentioned by 7+%)

Figure 4.2: What would be the three main things that would make the biggest improvement to your own mental health and wellbeing? (2)
Base: all = 1381 (Limited to those mentioned by 7+%)

4.5 Financial issues were an important concern for men in general and for both men and women in the 16-34 age group. One man in five between the ages of 35 and 54 spontaneously mentioned winning the lottery as a major way of improving their mental health and well being. Health issues were more of a worry to older people, while people in the middle-aged group emphasised stress-related issues.

4.6 Women aged under 35 and men under 55 were notable for pointing out work issues as an area for improvement. Those people in work were more likely to cite financial issues than those who were not working. People with personal experience of a mental health problem were more likely than other groups to mention relationships with partners and other family members (20% compared with 10%).

Level of control over things affecting mental health

4.7 While only one person in seven said that they had complete control over the things that affect their mental health, well over half thought that they had a good deal of control. Around a quarter of the people in the sample felt that they had some control over this issue and 7% thought that they had little (5%) or no control (2%).

4.8 There were some clear differences by age, with those aged 25-54 having lower claimed levels of control than either younger or older people.

Table 4.4: Thinking generally about all the things that affect your mental health, how much control do you feel you have over them?
Base: all = 1381

	All %	16-24 %	25-34 %	35-44 %	45-54 %	55-64 %	65-74 %	75+ %
Complete control (4)	14	14	9	11	12	13	23	23
A good deal of control (3)	57	65	56	56	56	61	53	56
Some control (2)	21	14	25	25	2	19	17	13
A little control (1)	5	4	7	5	6	4	4	6
No control at all (0)	2	1	3	3	1	3	2	1
Mean score	2.8	2.9	2.6	2.7	2.7	2.8	2.9	2.0
Don't know	1	2	0	0	*	1	0	2

4.9 Those people with high vitality/mental health scores also performed strongly at this measure - 90% of the top group in the vitality classification claimed to have complete or a good deal of control over the factors that affect their own mental health. Exactly 50% of those who had experienced a mental health problem said that they had complete/good control over these factors, compared with 80% of those with no such experience.

Government spending priorities for improving mental health of the Scottish population

4.10 From a prompted list of six items (plus an "other specify" category), people in the sample were asked to pick the three most important areas for the government in Scotland to prioritise spending in order to improve the mental health of the Scottish population. Improving services and providing support at difficult times were the most commonly mentioned ideas, followed by improving understanding of mental health and dealing with poverty. Much smaller proportions of people in the study sample mentioned improving trust and respect in local communities, or helping to put an end to discrimination.

Table 4.5: If the government in Scotland had to prioritise spending on just three areas that might improve the mental health of the Scottish population, which three from this card do you think are the most important?
Base: all = 1381

	All %	ABC1 %	C2DE %	Experience of mental health problem %	No experience of mental health problem %
Improve services for people who develop mental health problems	66	72	61	69	63
Support people at difficult times of their life	64	61	66	63	64
Help people to understand about mental health	52	56	48	54	45
Help to put an end to poverty	51	43	57	49	54
Improve trust and respect in local communities	30	32	27	30	30
Help to put an end to discrimination	24	24	24	24	25

4.11 Views were generally quite consistent across the sample groups, but Table 4.5 shows that those respondents from lower socio-economic groups were particularly concerned about ending poverty, while those in groups A, B and C1 were more likely to advocate improved services. Those with some experience of mental health problems (personally or in someone close to them) were relatively interested in helping people to understand about mental health.

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