Mental health equity
Mental ill health and poor mental wellbeing are not evenly distributed in our society. As with other health inequalities, the unequal distribution of wealth, income and power remains a fundamental cause of inequalities in mental health and wellbeing.
People living in the most socio-economically deprived areas experience the poorest mental health and lowest levels of wellbeing. Adults in these areas are twice as likely to have common mental health problems as those in the most affluent areas, resulting in GP consultations involving mental health problems also being twice as prevalent.
Scottish suicide rates are four times higher and self-harm rates are twice as high in areas of the greatest deprivation than in areas of the least deprivation, with rates of suicide increasing with increasing levels of deprivation. Differences in attempted suicide are even greater, with nearly four times as many people reporting ever having attempted suicide in the most deprived areas compared to the least deprived.
We know that those who experience poor mental health and wellbeing also often have poor physical health and lower life expectancy. For example, those with severe and enduring mental health problems die on average 15–20 years younger than the general population.
People with mental health problems report experiencing stigma, disadvantage and discrimination when accessing services, and are at increased risk of poorer social, educational, health and employment outcomes. Those experiencing mental health problems are more likely to participate in risk behaviours which can have a negative impact on health and life expectancy, such as tobacco use alcohol and substance misuse.
The relationship between mental health and wellbeing and alcohol and substance misuse is complex and it is likely that causation runs in both directions: with worsening mental health leading to greater alcohol and substance use; and greater alcohol and substance use worsening mental health and wellbeing.