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Inequalities: North/South Divide And Antidepressants

Thursday, May 21st, 2009 Inequalities: North/South Divide And Antidepressants

According to the Mental Health Foundations (MHF) (02/05/09) analytical data, there is evidence of a significant geographical pattern emerging in antidepressant prescribing rates in Primary Care Trust (PCT) areas.

Notably the figures reveal that 22 of the 25 highest prescribing PCT areas are in the north of England, while 23 of the lowest 25 prescribers are in the London area.

Astoundingly, prescribing rates are also very varied, with the highest ranking PCT, Blackpool, prescribing at more than three times the rate of the lowest, Kensington and Chelsea.

Alarmingly, it is understood that within the twelve week period from July to September 2008, There was an estimated 295 prescriptions issued for every 1000 people in the area, while in Kensington and Chelsea the rate was 85 prescriptions per 1000.

Notwithstanding, prescription rates were also another indicator and were also compared to each area’s level of deprivation. The data shows that in many highly deprived areas there are relatively low levels of antidepressant prescribing, particularly in London. According to the charity, this does not mean that people living in those areas are not experiencing depression and anxiety.

Possible explanations have been offered and they are as follows:

The levels of availability for alternative treatments. It is understood that GP’s would prefer to offer alternative methods of treatment, more specifically talking therapies and exercise therapy to treat problems such as a anxiety. However, local availability is quite often restricted which indicates that some GP’s prescribe * antidepressants because it is the only option available to them.

Furthermore, it is understood that some clinical practices may tolerate an antidepressant culture more than others.

There are also cultural differences between some of the practices, more specifically around issues of ethnicity as they are less likely to report their health conditions when it comes to mental health problems.

According to the Chief Executive of the Mental Health Foundation, Dr Andrew McCulloch, who says, “Our analysis has uncovered a remarkable difference between the north and south of England when it comes to the prescribing of antidepressants. Stereotypes about it being ‘grim up north’ are not enough to explain the difference as some of England’s most deprived areas are in London, where prescribing rates can be seen to be much lower.

This pattern definitely needs further investigation, and PCT managers may want to look at their own position in the table and ask a few questions. People should be offered a range of treatment options for depression and other common mental health problems, not just antidepressants, which can have unpleasant side effects for some people.”

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