England’s Adult Psychiatric Morbidity Survey: providing evidence for a public health approach
S McManus, S Morris, S Tromans, Z Morgan, T BrughaAbstract
Background
Since 1993 the Adult Psychiatric Morbidity Survey (APMS) series has provided England’s accredited Official Statistics on the prevalence of mental health conditions in adults living in the community.
Methods
APMS uses a probability sample of adults (16+) in private households in England. Its repeated cross-sectional design (1993, 2000, 2007, 2014, 2024) has comparability in methods and measures so trends can be described. It includes robust assessments/screens for a conditions including anxiety disorders and depression, alcohol and drug dependence, self-harm and suicidality. Questionnaire spans social determinants including adverse childhood experiences, housing and financial strain, employment, caring responsibilities, violence, discrimination, loneliness, physical health and disability, and contact with health, social care and criminal justice services.
Results
Past-week common mental disorder prevalence rose from 15.5% in 1993 to 22.6% in 2024, with steep rises in women aged 16–24 (15.4% in 1993; 25.8% in 2024). Self-harm quadrupled 2000 to 2024. While use of mental health treatment increased among those with mental health need, most (55.4%) affected adults did not receiving any. APMS evidenced population changes in mental health recognition, sexuality, and deprivation and ethnic inequalities. APMS informed UK strategies and policies: National Health Service Long Term Plan, 2023 Suicide Prevention Strategy for England, Women’s Health Strategy, Major Conditions Strategy, and Public Health Outcomes Framework indicators.
Conclusions
By combining robust psychiatric assessment with measures of social and economic context, APMS delivers evidence to inform prevention, shape commissioning and address the wider social determinants of mental health. Greater frequency would aid pinpointing shifts in trends, larger and boosted samples would support intersectional analyses, and harmonisation with European surveys would strengthen cross-national policy.