Co-existing Substance Misuse and Mental Health Issues
Previous research demonstrates strong links between mental health and smoking, alcohol use and drug use. The co-existing substance misuse and mental health issues tool provides an overview of data around smoking, alcohol and drug use, in addition to mental health prevalence and service use.
Risk and related factors
Derby performs significantly poorer than the national average across a range of risk and related factors. These include the following:
- Socioeconomic deprivation - 34.6% of people live in the 20% most deprived areas of the country.
- Children in poverty – 20.5% of children under 16 live in low income households.
- Looked after children – 76.5 per 10,000 children under 18 are looked after by the local authority.
- Long-term unemployment – 0.26% of the working age population are in long-term unemployment.
- Violent crime – 18.8 violence against the person offences per 1,000 population.
- Domestic abuse incidents – 21.7 domestic abuse incidents recorded by the police amongst those aged 16 or over per 1,000 population.
- Statutory homelessness - 3.6 per 1,000 households have been identified as eligible, unintentionally homeless and in priority need.
Substance misuse prevalence
There is evidence for a higher level of substance misuse prevalence at a local level. In Derby, the estimated prevalence of opiate and/or crack cocaine use (14.2 per 1,000) is almost double that of the national and regional average. This is mirrored in the recent increase in hospital admissions for mental and behavioural disorders due to alcohol, which rose to 181.7 per 100,000 in 2016/17. The prevalence of smoking amongst adults aged 18 and over (18.9%) is significantly higher than the national and regional average, although it is important to note that this is based upon self-reported data within the Annual Population Survey.
Substance misuse treatment demand
Mental health problems are common amongst those in treatment for drug and alcohol use. The latest available data indicates that locally, the percentage of people in concurrent contact with mental health and substance misuse services for drug or alcohol use is comparable with the national and regional average.
Substance misuse treatment response
Client outcome data provides an important indication of the needs of the treatment population. Derby performs comparably with the national average for the successful completion of drug treatment amongst opiate users. In 2016, 7.0% of opiate users left drug treatment successfully and did not re-present to treatment within 6 months. The proportion of successful completions amongst non-opiate users (41.3%) and those in alcohol treatment (39.6%) is currently comparable with the national average. Derby performs significantly better than the national average across the following treatment response indicators:
- Successful quitters at 4 weeks - 2,926 per 100,000 smokers who successfully quit at the four-week follow-up.
- Successful quitters confirmed by carbon monoxide validation – 2,399 per 100,000 of self-reported smoking quitters are confirmed by carbon monoxide validation.
Mental health prevalence and services
Service usage provides an additional indication of mental health issues in the underlying population. Derby performs comparably with the national average across the following:
- Admissions for depression – 33.0 per 100,000 hospital admissions for unipolar depressive disorders amongst those aged 15 and over.
- Emergency admissions for neuroses – 19.7 per 100,000 population.
- New cases of psychosis – The estimated incidence rate is 25.7 per 100,000 population aged 16-64.
Derby performs significantly higher than the national average across the following service indicators:
- Social care mental health clients receiving services during the year – 675 per 100,000 population.
- Schizophrenia emergency admissions – 82.0 per 100,000 population.
- Emergency hospital admissions for intentional self-harm – 249.8 per 100,000 population.
Social care assessments are important in determining the additional care and support needs of clients with mental illness. These could be related to housing, employment or social inclusion. Locally, the rate of new social care assessments for mental health clients is the lowest in the region, and significantly below the national and regional average.
Substance misuse and mental health issues are inevitably linked with an increased risk of mortality. Derby performs significantly worse than the national and regional average in relation to:
- Alcohol-specific mortality – 16.6 per 100,000 deaths from alcohol-specific conditions amongst individuals of all ages.
- Smoking attributable mortality – 296.1 deaths attributable to smoking per 100,000 population aged 35+.