Which population groups are at risk and why?
This section will focus on core epidemiological issues that take account of fixed risk factors (such as age, gender, ethnicity, family history) and modifiable risk factors (such as behaviour). The wider determinants of health (such as housing, transport and environment) are also considered.
Age
Young people aged 16-24 are currently at most risk of poor mental health. The prevalence of common mental health problem rose from 17.5% in 2007 to 25.8% in 2023-24. Due to increased social and academic pressure, economic insecurity, impact of social media, cuts to youth services and post-pandemic effects1.
Middle-aged adults (45-59) are at most risk of depression with the highest rates of severe depressive symptoms. Due to career pressures, financial responsibilities, caregiving for children and ageing parents and relationship strains 2, 3.
Gender
An adult psychiatric morbidity survey found that one in five women had a common mental disorder (compared to one in eight men)4.
A meta-analysis review found that 43.9% of mental health risk estimates were higher in females (28.5% in males) due to higher rates of internalising disorders and suicide attempts and ideation were higher. Men had higher rates of externalising disorders (e.g. substance abuse, antisocial behaviour) and suicide deaths were higher in men5.
Socioeconomic status
Adults living in poverty or low-income households are at the greatest risk of developing mental health problems, particularly common mental health disorders6.
A UK Household Longitudinal Survey found the impact was greater for women than men7.
Poverty, debt, unemployment and low education are key drivers of poor mental health that interact with discrimination, housing insecurity and social exclusion8.
Adults in the most deprived areas of England have a common mental health conditions prevalence of 262% compared to 16.0% in the least deprived areas. Problem debt doubles the risk of mental health problems (39% vs 18.4%)1.
Qualifications
Adults with no formal qualifications are at most risk of poor mental health, adults aged 25-64 with no qualifications were more than five times more likely to rate their health as “poor” compared to those with a degree or equivalent9.
Lower educational attainment is associated with job insecurity and low income; limited access to mental health services; higher exposure to stressors; and reduced coping skills and health literacy.
Mental health
Individuals with common mental health conditions are more likely to experience co-occurring conditions such as self-harm, PTSD and ADHD10.
Neurodiverse individuals are at increased risk of psychological distress, especially in educational settings11.
Ethnicity
Black ethnic groups, particularly Black Caribbean, Black African and Black British individuals are at most risk of poor mental health outcomes especially in terms of severe mental illness, detention under the Mental Health Act and inequitable access to care12.
A meta-ethnography found that Black individuals are underrepresented in primary care and overrepresented in crisis pathways13.
Barriers include lack of culturally appropriate services, communication barriers, distrust of mental health systems and stigma and discrimination14.
Prisoners
Over 90% of prisoners in the UK have a diagnosable mental disorder according to a study published by Cambridge University Press15.
A 2023 national survey found that 13.4% of male prisoners and 28.5% of female prisoners were on mental health caseloads16.
Prisoners face limited access to screening and referrals, poor continuity of care and under-resourced mental health teams which is compounded by stigma, institutional neglect and lack of integration with NHS services17.
Sexual Orientation
LGBTQ+ individuals face significantly higher risks due to discrimination, social isolation and trauma and stigma18.
Vulnerable Children
A study of Adverse Childhood Experiences found that individuals who experienced ACE were more likely to experience poor mental health in adulthood19, 20.
Childhood maltreatment leads to long-term changes in brain structure which increases vulnerability to mental illness, trauma and poor physical health in adulthood21.
Substance Misuse
Individuals are at significantly increased risk, in 2021 63% of adults starting substance misuse treatment had a mental health need22.
There is a bidirectional relationship between substance misuse and mental health problems23.
Mental health problems and substance misuse is particularly prevalent among homeless individuals, people in the criminal justice system and racialised and LGBTQ+ communities24.
Employment
The British Journal of Psychiatry reported unemployed adults had significantly higher odds of low mental wellbeing. Adults aged 35-54 in lower socioeconomic brackets were particularly vulnerable25.