Use of NHS mental health and learning disability services
Last updated 10 October 2019 - see all updates
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1. Main facts and figures
- in 2014/15, about 1 adult in 28 used mental health and learning disability services in England
- adults in the Black broad ethnic group and Black Caribbean specific ethnic group were the most likely to use mental health and learning disability services, out of all ethnic groups for which ethnicity was reliably recorded
- adults in the Other broad ethnic group and the Other Black specific ethnic group had the highest rates for using mental health and learning disability services – however, these are considered to be overestimates because ‘other’ categories may have been used by default where someone’s specific ethnicity wasn’t known
- adults in the Chinese ethnic group were the least likely to use mental health and learning disability services
- the actual rates for using these services among people in the ethnic groups not labelled as ‘other’ may be underestimated, particularly those within the Black ethnic groups
Things you need to know
Rates for people in the specific ethnic groups labeled as 'other' are thought to be over-estimated – in particular the Other Black and Any Other ethnic group – and should be treated with caution. Rates at which the remaining specific ethnic groups used services are likely to be under-estimated, particularly for Black ethnic groups. This is because in many cases the patient’s exact ethnicity wasn’t known. In such cases the ‘other’ ethnic categories may have been used as a default.
The Gypsy and Traveller of Irish Heritage and Arab ethnic groups are not separately identified in the data submissions from NHS providers of mental health and learning disability services. Because of this it is not possible to provide specific rates for these groups.
The population figure for the White group includes the Gypsy or Irish Traveller population and the Other ethnic group includes the majority of the Arab population. While Arab patients are sometimes recorded in another ethnic category, the extent to which they are contributing to the rates for the Other ethnic group is unknown.
These estimates have been adjusted to allow comparisons to be made between ethnic groups as if they had the same age profile - by age-sex standardisation. This is helpful as ethnic groups can have very different age profiles (that is, the number of people of different ages, which can further differ between men and women) and because the prevalence of mental health disorders is also related to people’s age and sex. As a result, the estimates do not tell you the actual proportion of people in each ethnic group who used NHS-funded secondary mental health and learning disability services. To allow for this adjustment to be made, this analysis only covers people aged 18 and older, with a known gender and ethnicity, who were treated by or in contact with NHS-funded secondary mental health and learning disability services at some point in 2014/15.
No adjustment has been made to these figures to account for differences in need or severity of mental health symptoms between different ethnic groups. As such any differences shown may be related to differences in need, availability of services, or other related factors. The potential causes of any differences cannot be identified or inferred from this analysis.
As with any data source, errors may have been made when collecting, preparing or interpreting the data. The greater the number of people included for each ethnic group, the more reliable the value for that group. Data is collected on a smaller number of service users from ethnic minority groups than from the White British ethnic group. Therefore figures for ethnic minorities are less reliable than the figures presented for White British people.
During 2014/15 only a small number of independent (non-NHS) healthcare providers submitted data on NHS funded patients.
What the data measures
This data measures the number of adults using NHS-funded secondary mental health and learning disability services during 2014/15. Secondary care here refers to specialist treatment or therapy for a mental health problem. It does not include non-specialist treatment, such as a prescription delivered by a GP.
The number is presented as a rate per 100,000 adults in each ethnic group. The data is collected from the Mental Health Minimum Dataset (MHMDS) through monthly submissions. It includes NHS-funded services from independent providers.
People who had more than one period of care are counted once.
The ethnic categories used in this data
The 16 categories used in this data are those listed in the 2001 Census. The categories are broadly the same as those used in the 2011 Census, with the following exceptions:
- the 2001 Census categorised Chinese people within 'Other ethnic group'.
- the 2001 Census did not list Gypsy and Irish Travellers or Arab people.
The 2001 categories are therefore as follows:
- English/Welsh/Scottish/Northern Irish/British
- Any Other White background
Mixed/Multiple ethnic groups:
- White and Black Caribbean
- White and Black African
- White and Asian
- Any Other Mixed/Multiple ethnic background
- Any Other Asian background
- Any Other Black/ African/ Caribbean background
Other ethnic group:
- Any Other ethnic group
2. By ethnicity
|Ethnicity||Number per 100,000|
|Mixed White/Black African||3,795|
|Mixed White/Black Caribbean||3,581|
|Chinese and other||6,771|
Download table data for ‘By ethnicity’ (CSV) Source data for ‘By ethnicity’ (CSV)
Summary of Use of NHS mental health and learning disability services By ethnicity Summary
This data shows that:
- in both the Black broad ethnic group and the Black Caribbean specific ethnic group, nearly 4,800 adults per 100,000 of the population used mental health or learning disability services – the highest rates excluding the Any Other and Other Black ethnic groups, for which results are not reliable
- Chinese people were the least likely to use mental health and learning disability services, at 1,544 adults per 100,000
- people in the broad Black or the Black Caribbean specific ethnic groups were both 3 times more likely to use mental and learning disability services than Chinese people, and they were also significantly more likely to do so than White British people
- the specific ethnic groups that were most likely to use mental health or learning disability services were Black Caribbean, Bangladeshi and Pakistani (if the various ‘other’ ethnic groups aren’t counted)
- those least likely to use mental health or learning disability services were from the Chinese, Mixed White and Asian, and Indian ethnic groups
The Mental Health Minimum Dataset (MHMDS) and Mental Health and Learning Disabilities Dataset (MHLDDS) are mandatory monthly returns generated by providers of NHS-funded adult secondary services in the course of delivering those services to people of any age in England. This analysis is limited to adults.
These statistics are based on data collected through submissions during the financial year 2014/15. They provide a comprehensive picture of people who used adult secondary mental health and learning disability services.
This data is based on submissions made using version 4.12 of the Mental Health Minimum Dataset (MHMDS) between April and August 2014 and version 1.13 of the Mental Health and Learning Disabilities Dataset (MHLDDS) between September 2014 and March 2015 (referred to here as the dataset). The changes between the MHMDS and the MHLDDS reflect the expansion in scope of the dataset to include people using NHS-funded or part-funded learning disabilities services for the first time.
The analysis also uses Census 2011 population data for each ethnic group. In a small number of cases, a person did not have their ethnicity recorded in the dataset. This means that the ethnicity totals may not add up to the national totals.
Patients are counted only once regardless of how many providers they have been in contact with.
Providers of mental health and learning disability services have 2 opportunities to submit a month's data, known as primary and refresh windows. Published data will always be based on a refresh submission unless it was not provided, in which case the primary submission is used. Not all providers of secondary mental health and learning disabilities services successfully provided a submission in each month of 2014/15 which means these figures have been undercounted to some extent.
Ethnic group is a required piece of information in the MHMDS dataset. This means that wherever healthcare providers hold or collect this information about a person, it should be included in their submission to NHS Digital.
All providers of NHS funded specialist mental health and learning disability services for adults (including people aged 65 and over) should submit the MHLDDS. However, during 2014/15 only a small number of independent sector providers made submissions.
Numerator: Number of people by ethnic group with an open spell of care with NHS funded adult secondary mental health and learning disability services at any point between 1 April 2014 and 31 March 2015
Denominator: population of adults in England who identify with the same ethnic background
The confidence intervals for the estimate of the standardised rates per 100,000 population for each ethnic group are available in the ‘download the data’ section.
The number of White British adults using adult mental health and learning disability services in 2014/15 was 3,634 per 100,000 of the population. This is a reliable estimate based on the people using these services that year, but it is not possible to be 100% certain of the true rate for use of mental health and learning disability services for this population.
It’s 95% certain, however, that the rate for White British adults using mental health and learning disability services lies somewhere between 3627.8 and 3640.2 per 100,000 of the population. In statistical terms, this is a 95% confidence interval. This means that 95 times out of 100 the estimate would fall between the lower and upper bounds of the confidence interval. But 5 times out of 100 it would fall outside this range.
The smaller the number of adults contacting these services, the more uncertain the estimate and the wider the confidence interval. For example, there were fewer Black Caribbean adults using the services than White British adults, so we can be less certain about the estimate of 4,796 per 100,000 for the Black Caribbean group. This greater uncertainty is expressed by the wider confidence interval of between 4728.4 to 4863.2 per 100,000 of the Black Caribbean population.
Suppression rules and disclosure control
Due to the large underlying populations no disclosure control or suppression rules were applied. Due to the large underlying populations no disclosure control or suppression rules were applied.
Figures have been rounded to 1 decimal point.
Quality and methodology information
4. Data sources
Mental Health and Learning Disabilities Dataset (MHLDDS)
Mental Health and Learning Disabilities Statistics
Type of data
Type of statistic
Purpose of data source
The Mental Health Minimum Dataset (MHMDS) has information about adults who are in contact with mental health and learning disability services. It uses clinical and operational data for purposes other than direct patient care.
5. Download the data
This file contains the following: ethnicity, year, geography, value, denominator, confidence intervals, numerator