Table 1.
Mental healthcare indicators in the year after first fit note in the population who received a fit note between 1 January 2014 and 30 April 2016
| Whole population | Antidepressant prescription (1993–2017) |
IAPT contact (2008–2017) |
Secondary mental healthcare contact (1995–2017) | No mental health indicator | ||||||
| n (%) |
n (%) | OR adjusted† (95% CI) | n (%) | OR adjusted† (95% CI) |
n (%) | OR adjusted† (95% CI) |
n (%) | OR adjusted† (95% CI) |
||
| Total | 32 233 | 6288 (19.5) | 3179 (9.9) | 2785 (8.6) | 23 082 (71.6) | |||||
| Gender | Male | 13 779 (42.7) | 2512 (18.2) | 1 | 1159 (8.4) | 1 | 1468 (10.7) | 1 | 9964 (72.3) | 1 |
| Female | 18 454 (57.3) | 3776 (20.5) | 1.2 (1.1 to 1.3)* | 2020 (11.0) | 1.3 (1.2 to 1.5)* | 1317 (7.1) | 0.6 (0.6 to 0.7)* | 13 118 (71.1) | 0.9 (0.9 to 1.0) | |
| Age group (years) | 16–30 | 8257 (25.6) | 1445 (17.5) | 1 | 862 (10.4) | 1 | 731 (8.9) | 1 | 6024 (73.0) | 1 |
| 31–45 | 12 941 (40.2) | 2561 (19.8) | 1.2 (1.1 to 1.3)* | 1360 (10.5) | 1.1 (1.0 to 1.2) | 1194 (9.2) | 1.0 (0.9 to 1.2) | 9160 (70.8) | 0.9 (0.8 to 1.0) | |
| 46–60 | 11 035 (34.2) | 2282 (20.7) | 1.2 (1.1 to 1.3)* | 957 (8.7) | 0.9 (0.8 to 1.0) | 860 (7.8) | 0.8 (0.7 to 0.9)* | 7898 (71.6) | 1.0 (0.9 to 1.1) | |
| Ethnicity | White British | 9105 (28.3) | 2244 (24.7) | 1 | 1150 (12.6) | 1 | 1053 (11.6) | 1 | 5839 (64.1) | 1 |
| White Other | 7891 (24.5) | 1472 (18.7) | 0.7 (0.7 to 0.8)* | 760 (9.6) | 0.7 (0.7 to 0.8)* | 567 (7.2) | 0.6 (0.5 to 0.7)* | 5797 (73.5) | 1.5 (1.4 to 1.7)* | |
| Black African | 4729 (14.7) | 628 (13.3) | 0.4 (0.4 to 0.5)* | 277 (5.9) | 0.4 (0.4 to 0.5)* | 259 (5.5) | 0.4 (0.4 to 0.5)* | 3826 (80.9) | 2.6 (2.3 to 2.8)* | |
| Asian | 1909 (5.9) | 340 (17.8) | 0.7 (0.6 to 0.8)* | 133 (7.0) | 0.5 (0.4 to 0.8)* | 128 (6.7) | 0.5 (0.4 to 0.8)* | 1442 (75.5) | 1.7 (1.4 to 2.1)* | |
| Black Caribbean | 4129 (12.8) | 751 (18.2) | 0.6 (0.6 to 0.7)* | 399 (9.7) | 0.7 (0.6 to 0.8)* | 354 (8.6) | 0.7 (0.6 to 0.8)* | 2992 (72.5) | 1.6 (1.4 to 1.7)* | |
| Mixed | 1945 (6.0) | 396 (20.4) | 0.8 (0.7 to 0.9)* | 217 (11.2) | 0.8 (0.7 to 1.0) | 212 (10.9) | 0.9 (0.8 to 1.0) | 1346 (69.2) | 1.3 (1.2 to 1.5)* | |
| Other | 1104 (3.4) | 209 (18.9) | 0.7 (0.6 to 0.8)* | 115 (10.4) | 0.8 (0.6 to 1.0) | 66 (6.0) | 0.5 (0.4 to 0.6)* | 818 (74.1) | 1.6 (1.4 to 1.9)* | |
| Black Other | 1421 (4.4) | 248 (17.5) | 0.6 (0.5 to 0.7)* | 128 (9.0) | 0.7 (0.6 to 0.8)* | 146 (10.3) | 0.9 (0.7 to 1.1) | 1022 (71.9) | 1.5 (1.3 to 1.7)* | |
| Quintiles of area- level deprivation | 1 Low deprivation | 4577 (14.2) | 879 (19.2) | 1 | 461 (10.1) | 1 | 366 (8.0) | 1 | 3332 (72.9) | 1 |
| 2 | 5480 (17.0) | 1036 (18.9) | 1.0 (0.9 to 1.1) | 563 (10.3) | 1.1 (0.9 to 1.2) | 416 (7.6) | 1.0 (0.8 to 1.1) | 3950 (72.2) | 0.9 (0.8 to 1.1) | |
| 3 | 5866 (18.2) | 1150 (19.6) | 1.1 (1.0 to 1.2) | 596 (10.2) | 1.1 (0.9 to 1.2) | 546 (9.3) | 1.2 (1.0 to 1.4) | 4171 (71.2) | 0.9 (0.8 to 1.0) | |
| 4 | 7704 (23.9) | 1533 (19.9) | 1.1 (1.0 to 1.2) | 708 (9.2) | 1.0 (0.8 to 1.1) | 678 (8.8) | 1.2 (1.0 to 1.4) | 5473 (71.1) | 0.9 (0.8 to 1.0) | |
| 5 High deprivation | 8606 (26.7) | 1678 (19.5) | 1.1 (1.0 to 1.2) | 851 (9.9) | 1.1 (0.9 to 1.3) | 749 (8.7) | 1.2 (1.0 to 1.4) | 6156 (71.6) | 0.9 (0.8 to 1.0) | |
| Number of fit notes | 1–3 | 18 888 (58.6) | 2262 (12.0) | 1 | 1318 (6.7) | 1 | 955 (5.1) | 1 | 15 295 (81.0) | 1 |
| 4+ | 13 345 (41.4) | 4026 (30.2) | 3.4 (3.2 to 3.6)* | 1861 (14.0) | 2.4 (2.2 to 2.7)* | 1870 (13.7) | 3.2 (3.0 to 3.5)* | 7787 (58.4) | 0.3 (0.3 to 0.3)* | |
| Number of LTCs (excluding mental disorders) | 0 | 16 464 (51.1) | 2984 (18.1) | 1 | 1644 (10.0) | 1 | 1332 (8.1) | 1 | 10 546 (84.4) | 1 |
| 1 | 9456 (29.3) | 1910 (20.2) | 1.2 (1.1 to 1.2)* | 959 (10.1) | 1.1 (1.0 to 1.2) | 862 (9.1) | 1.2 (1.1 to 1.4)* | 5516 (83.4) | 0.9 (0.8 to 0.9)* | |
| 2 | 4071 (12.6) | 836 (20.5) | 1.2 (1.1 to 1.3)* | 371 (9.1) | 1.0 (0.9 to 1.1) | 383 (9.4) | 1.5 (1.2 to 1.7)* | 2283 (83.2) | 0.8 (0.8 to 0.9)* | |
| 3 | 1574 (4.9) | 370 (23.5) | 1.4 (1.2 to 1.6)* | 143 (9.1) | 1.1 (0.9 to 1.3) | 130 (8.3) | 1.4 (1.1 to 2.6)* | 862 (81.6) | 0.7 (0.6 to 0.8)* | |
| 4 | 668 (2.1) | 188 (28.1) | 1.8 (1.5 to 2.2)* | 62 (9.3) | 1.1 (0.8 to 1.5) | 78 (11.7) | 2.0 (1.6 to 2.6)* | 307 (74.7) | 0.6 (0.5 to 0.7)* | |
| Depression ‡ | No | 23 867 (74.1) | 2439 (10.2) | 1 | 1385 (5.8) | 1 | 1219 (5.1) | 1 | 19 686 (82.5) | 1 |
| Yes | 8366 (26.0) | 3849 (46.0) | 7.2 (6.6 to 8.0)* | 1794 (21.4) | 4.4 (4.0 to 4.9)* | 1566 (18.7) | 4.5 (4.0 to 5.0)* | 3396 (40.6) | 0.1 (0.1 to 0.2)* | |
*P<0.05.
†Odds ratio adjusted for age, gender, ethnicity, deprivation and non-mental health long-term conditions.
‡Quality Outcomes Framework Depression recorded in the primary carenotes.
IAPT, Improved Access to Psychological Treatment; LTCs, long-term conditions.;