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WELL WHAT DO YOU THINK (2004): THE SECOND NATIONAL SCOTTISH SURVEY OF PUBLIC ATTITUDES TO MENTAL HEALTH, MENTAL WELL-BEING AND MENTAL HEALTH PROBLEMS
CHAPTER FIVE: MENTAL HEALTH AND WELL-BEING
5.1 This chapter examines findings from the GHQ12 component of the survey which was used to gauge possible levels of psychiatric morbidity among the population. The chapter also considers the factors that respondents feel have a positive or negative affect on their mental health.
THE GHQ12
5.2 This survey included the GHQ12, which is a well-established screening instrument designed to detect possible psychiatric morbidity in the general population. Each item in the GHQ12 consists of a question asking whether the respondent has recently experienced a particular symptom or feeling (e.g. happiness, anxiety, sleep disturbance) on a scale ranging from 'less than usual' to 'much more than usual'. The GHQ12 was completed by the respondent by entering the information directly into the computer, maintaining privacy and emulating the usual pen-and-paper mode of data collection.
5.3 Ninety-three percent of respondents completed this section, similar to the proportion achieved by MORI in the Scottish House Condition Survey in 2002, when the questionnaire was completed using pen and paper. Respondents' answers to the 12 items were collated using the GHQ scoring method, as described in
A Users Guide to the General Health Questionnaire (Goldberg and Williams, 1991)
. A score of 1 or 0 was allocated for each item depending on whether the respondent had been experiencing the symptom or behaviour described. For example, respondents would score 1 if they had recently felt under
constant strain 'more than usual' or 'much more than usual' and a 0 if they had recently experienced feeling under
constant strain 'not at all' or 'no more than usual'.
5.4 These scores were then summed to give a total GHQ12 score for each respondent, which ranged from zero to 12. The composite scores were recoded into a binary variable, 0-3 and 4+. Scores 0-3 were coded as no/few signs of possible mental health problems ('low GHQ12 score'), and scores of 4+ were labelled as indicating possible mental health problems ('high GHQ12 score'). Throughout this report, these two groups, developed through analysis of the GHQ12 module of the survey, are used as key analysis variables.
5.5 As table 5.1 overleaf shows, the GHQ12 group scores in this survey are almost identical to those recorded in the 2002 Scottish House Condition Survey (SHCS), although a significantly higher proportion of people surveyed in the SHCS 2002 scored 0 than in this survey. Table 5.2 shows the frequencies of responses to the individual GHQ12 items from the present study and the 2002 SHCS.
5.6 Responses to the GHQ12 battery indicated that women were more likely than men to have high GHQ12 scores (17% vs. 13%), however these differences were not statistically significant. This is consistent with the findings from
The Scottish Health Survey (Scottish Executive 2000) where 18% of women and 13% of men had high GHQ12 scores. According to this 1998 survey, women in Scotland were similar in this respect to women in England. There were no other statistically significant sub group differences on the GHQ12.
Table 5.1: Frequency of sample scoring GHQ12 scores
GHQ12 Score
| SHCS 2002 | Mental Health 2004 |
Base: All respondents who answered the GHQ12 | (16,537) | (1,300) |
Total points scored on GHQ12 | % | % |
0 | 59 | 50 |
1 | 12 | 16 |
2 | 7 | 10 |
3 | 4 | 6 |
4 | 4 | 3 |
5 | 3 | 3 |
6 | 2 | 3 |
7 | 2 | 2 |
8 | 2 | 2 |
9 | 1 | 1 |
10 | 1 | 1 |
11 | 1 | 1 |
12 | 2 | 2 |
GHQ12 score grouped |
0-3 | 82 | 82 |
4+ | 18 | 18 |
TOTAL | 100 | 100 |
Source: MORI
Table 5.2: Frequencies of responses to individual GHQ12 questions
Q Have you recently…
| SHCS 2002 | Mental Health 2004 |
Base: All respondents who answered the GHQ12 | (16,537) | (1,300) |
| % | % |
…been able to concentrate on whatever you're doing? |
Better than usual | 4 | 7 |
Same as usual | 81 | 76 |
Less than usual | 13 | 16 |
Much less than usual | 3 | 2 |
…lost much sleep over worry? |
Not at all | 33 | 29 |
No more than usual | 50 | 50 |
Rather more than usual | 13 | 16 |
Much more than usual | 4 | 4 |
…felt you were playing a useful part in things? |
More so than usual | 8 | 12 |
Same as usual | 79 | 75 |
Less useful than usual | 10 | 10 |
Much less than usual | 3 | 3 |
…felt capable of making decisions about things? |
More so than usual | 7 | 11 |
Same as usual | 84 | 80 |
Less so than usual | 7 | 8 |
Much less capable | 1 | 1 |
…felt constantly under strain? |
Not at all | 24 | 22 |
No more than usual | 55 | 52 |
Rather more than usual | 17 | 20 |
Much more than usual | 5 | 5 |
…felt you couldn't overcome your difficulties? |
Not at all | 36 | 35 |
No more than usual | 53 | 51 |
Rather more than usual | 9 | 11 |
Much more than usual | 2 | 2 |
…been able to enjoy your normal day-to-day activities? |
More so than usual | 5 | 8 |
Same as usual | 75 | 74 |
Less so than usual | 15 | 14 |
Much less than usual | 4 | 4 |
…been able to face up to your problems? |
More so than usual | 5 | 9 |
Same as usual | 85 | 81 |
Less able than usual | 8 | 8 |
Much less able | 2 | 2 |
…been feeling unhappy and depressed? |
Not at all | 40 | 42 |
No more than usual | 43 | 38 |
Rather more than usual | 13 | 16 |
Much more than usual | 4 | 4 |
…been losing confidence in yourself? |
Not at all | 47 | 49 |
No more than usual | 40 | 36 |
Rather more than usual | 10 | 12 |
Much more than usual | 3 | 3 |
…been thinking of your self as a worthless person? |
Not at all | 64 | 67 |
No more than usual | 28 | 25 |
Rather more than usual | 5 | 7 |
Much more than usual | 2 | 1 |
…been feeling reasonably happy, all things considered? |
More so than usual | 10 | 14 |
About the same as usual | 79 | 75 |
Less so than usual | 8 | 10 |
Much less than usual | 3 | 2 |
Source: MORI
positive effects on mental health and well-being
5.7 Respondents were asked to mention, without prompting, factors that might have a positive impact on their own mental health. As in 2002, having a supportive relationship with family, a partner or friends (49%) was the most commonly cited positive influence on mental health
8. Other perceived positive influences included leisure activities, hobbies and a social life (29%), followed by work and working patterns (20%), exercise (17%) and having enough money or a good income (17%). These factors are similar to those mentioned in 2002, however, more people selected 'being healthy' in 2002 than in this survey (21% vs. 9%). This latter change may reflect the introduction of a new response category, 'exercise', in 2004.
5.8 As table 5.3 illustrates, perceived positive influences on mental health varied significantly by age. Older people were less likely to say that work or working patterns affected their mental health than those who were under the retirement age, which is as one might expect, but older people were also less likely to cite concerns about having enough money or a good income as influences than were younger age groups. On the other hand, older age groups were more likely than younger age groups to say that getting enough sleep, being healthy or freedom from pain had positive influences on their mental health and well-being. These differences are consistent with findings from the 2002 survey.
Table 5.3: Positive effects on mental health and well-being
Q Thinking now about things which might affect your health, what sorts of things, if any, have a positive or good effect on your mental health and well-being?
| All | 16-24 | 25-34 | 35-44 | 45-54 | 55-59 | 60-64 | 65-74 | 75+ |
Base: All respondents | (1,401) | (131) | (201) | (257) | (237) | (118) | (115) | (187) | (155) |
| % | % | % | % | % | % | % | % | % |
Supportive relationships with family / partner / friends | 49 | 55 | 57 | 56 | 44 | 49 | 44 | 39 | 34 |
Leisure activities /hobbies /social life | 29 | 39 | 26 | 27 | 29 | 29 | 35 | 29 | 24 |
Work/working/work patterns | 20 | 20 | 32 | 23 | 25 | 23 | 10 | 4 | 1 |
Exercise | 17 | 20 | 22 | 19 | 15 | 15 | 11 | 10 | 11 |
Having enough money/good income | 17 | 17 | 23 | 22 | 17 | 12 | 11 | 11 | 6 |
Enough rest/sleep | 2 | 3 | 2 | 1 | 1 | 3 | 3 | 2 | 6 |
Being healthy | 9 | 4 | 13 | 8 | 9 | 8 | 12 | 11 | 10 |
Freedom from pain | 4 | 2 | 2 | 3 | 4 | 8 | 7 | 4 | 10 |
Source: MORI
Negative effects on mental health and well-being
5.9 Respondents were next asked to consider factors that might have a negative effect on their mental health. Physical illness (17%), not having enough money or being on a low income (17%) were the main factors mentioned, closely followed by work, work patterns or having too much work to do (15%). In 2002, stress was the most commonly-mentioned negative influence, but this summary item was not included in the survey in 2004 as the purpose of the item was to identify the factors causing people stress, rather than the prevalence of the condition. New codes were included in the 2004 survey to address this issue.
5.10 Again, people's perceptions appeared to be related to their age, as table 5.4 illustrates. Older people were less likely to say that issues relating to work had a negative effect on their mental health, probably because they were less likely to be in work themselves. On the other hand, they were more likely than younger people to say that physical illness, bereavement and lack of mobility negatively affected their mental health and well-being. Low income, and problems in relationships with a partner, family or friends were issues that younger people were more likely to mention. Again these findings are consistent with the results for 2002.
Table 5.4: Negative effects on mental health and well-being
Q And what, if any things have a negative or bad effect on your mental health and well-being?
Top 5 Mentions | All | 16-24 | 25-34 | 35-44 | 45-54 | 55-59 | 60-64 | 65-74 | 75+ |
Base: All respondents | (1,401) | (131) | (201)
| (257)
| (237)
| (118)
| (115)
| (187)
| (155)
|
| % | % | % | % | % | % | % | % | % |
Illness (physical) | 17 | 8 | 11 | 15 | 21 | 25 | 28 | 21 | 18 |
Not enough money/low income | 17 | 21 | 25 | 23 | 13 | 15 | 13 | 8 | 4 |
Work/working/work patterns/having too much work | 15 | 14 | 28 | 23 | 17 | 9 | 6 | 1 | - |
Problems in relationship with partner/family/friends | 14 | 12 | 21 | 20 | 14 | 12 | 12 | 8 | 5 |
Family problems | 13 | * | 12 | 18 | 14 | 23 | 15 | 13 | 10 |
Source: MORI
5.11 It is noticeable that the proportion of 16-24 year olds who identified family problems as having a negative effect on their mental health was significantly lower than for all other age groups.
Levels of control over factors affecting mental health
5.12 Having been asked to identify factors that had a positive and negative impact on their mental health and well-being, respondents were asked to consider how much control they felt they had over these aspects of their lives. Over two-thirds (66%) felt they had a good deal of control or complete control, compared to 9% who felt they had little or no control. Although the broad pattern of responses is similar between 2002 and 2004, as figure 5.1 illustrates, the proportion of adults feeling they are in control of the factors that affect their mental health was lower in 2004 than in 2002.
Figure 5.1: Levels of control over mental health trend since 2002
5.13 It was mainly among women that the sense of being in control differed between the two surveys. As table 5.5 shows, 71% of men said they had at least a good deal of control over factors affecting their mental health. This shows no change since 2002 when 72% of men said this. However, in 2002, 70% of women said they felt they had a good deal of control and this has fallen by 10 percentage points to 62% in 2004.
5.14 People aged 16-24 were more likely to think they had a good deal of control than all other age groups, and especially those aged 65+. Reinforcing the apparent significance of money as a factor influencing mental health, people who found it easy to manage or their household income were more likely to feel in control than those who had difficulty managing.
5.15 As might be expected, people who said that they had experienced a mental health problem themselves, or had a high GHQ12 score, were more likely to feel that they lacked control than those who had no such experiences.
5.16 The degree to which respondents were socially engaged in their communities was also correlated with the level of control they experienced. The most engaged respondents were significantly more likely to feel in control than less engaged groups.
Table 5.5: Perceived levels of control over factors affecting mental health
Q Thinking about all those things that might affect your mental health, how much control, if any, do you feel you have over them?
| Complete/good deal of control | Little/no control |
Base: All respondents |
| % | % |
All | 66 | 9 |
Male (594) | 71 | 8 |
Female (807) | 62 | 10 |
16-34 (332) | 74 | 5 |
35-44 (257) | 64 | 13 |
45-54 (237) | 57 | 12 |
55-59 (118) | 71 | 9 |
60-64 (115) | 66 | 8 |
65+ (342) | 62 | 9 |
Household income is easy/manageable (1,157) | 67 | 8 |
Household income is difficult to manage (195) | 51 | 18 |
Low GHQ12 score (1,104) | 90 | 52 |
High GHQ12 score (196) | 8 | 48 |
Most socially engaged (154) | 70 | 6 |
Least socially engaged (184) | 57 | 18 |
Source: MORI
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