In the Face of Fear - Mental Health Action Week 2009

For Mental Health Action Week 2009, we've launched the report - In the Face of Fear. The report is about how fear and anxiety affect our health and society, and what we can do about it.

• 77% of people believe people in general are more frightened and anxious than they used to be.

• 77% say that the world has become a more frightening place in the last 10 years.

• 29% say that fear and anxiety have stopped them from doing things they wish they had done.

• 1.7% more of the population of England (15.0%, compared to 13.3%) were experiencing an anxiety-related common mental health disorder in 2007, compared to 1993. This is a percentage rise of 12.8% over 14 years. 800,000 more UK adults would have qualified for the diagnosis of an anxiety disorder in 2007 than in 1993.

• 49% of people get anxious about money, with 66% experiencing some degree of fear or anxiety about the current financial situation.

• In the Mental Health Foundation survey women consistently report experiencing more fear and anxiety than men. They are more than twice as likely as men to say they feel frightened or anxious a lot of the time (11%, compared to 5 5% of men). They are also more likely to report increasing fear (43% compared to 3 30% of men). 20% of women compared with 14% of men say they wish they could be less fearful or anxious in their everyday life.

• The Government’s surveys (Household Psychiatric Morbidity Surveys) have found that women experience more symptoms of anxiety than men – the 2000 survey found that they are more likely to experience sleep problems, worry, obsessions, phobias, and compulsions, and the 2007 survey found that women are considerably more likely to experience anxiety disorders than men and that women’s mental health in general may be deteriorating . There has been an increase in common mental disorders from 19.1% of women in 1993 to 21.5% in 2007, with a 20% increase in women aged 45-64.

• Younger people also consistently report greater fear than older people. 77% of 18-34 year-olds say they feel frightened or anxious at least some of the time, compared to 65% of over 55s, and more than twice as many in the younger age group would describe themselves as a ‘generally anxious or fearful person’ (13% compared to 6%). We need to find discrete and targeted ways to address the fear experienced by both these women and young people.

• Anxiety UK, the country’s largest anxiety disorders charity, has reported a doubling of calls to its telephone helpline during the period January/February 2009.

• 63% of those who say people are more frightened or anxious than they used to be say it is because of the current economic situation, 61% say because of a loss of solidarity and community, 60% say because the media makes people frightened, 60% say because the world has become a more dangerous place, 60% say because of fear of terrorism, 59% say because of the risk of crime, 54% say because of a loss of certainty and security, and 54% say because of an increase in the availability of information about threats to safety.

• Londoners are more likely to feel anxious a lot of the time - 14%, compared to 8% nationally.

• Those with anxiety-related disorders are more likely to be single, divorced or separated, and be earning less money, as well as living on their own or as a lone parent, be poorly educated, economically inactive, to have moved house three or more times in the last two years, and live in urban areas.

• Just 25% of those with a common mental health problem are currently receiving treatment for it. This falls to just 15% of people with mixed anxiety and depression – the most common anxiety-related diagnosis. While people with mental health problems in general often do not seek help, this is especially the true for those with an anxiety disorder.

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Recommendations

There are a number of steps we can take to develop a less fearful society and deal with fear and anxiety as it arises. The Mental Health Foundation recommends:

1. A mental health promotion strategy that addresses fear and anxiety. We need to target the whole population with education and awareness-raising to improve people’s ability to recognise and manage feelings and thoughts and how they affect behaviour. The Social and Emotional Aspects of Learning strategy is an important vehicle for educating older children, but it will not work if they are to grow up in homes and enter workplaces that are fear-driven and not emotionally literate.

2. Parents transmit fear and anxiety to their children and can learn how to ensure their children understand fear, have a useful and proportionate relationship with fear, and can manage it in difficult situations. We need more roll-out of parenting programmes that take emotional literacy into account.

3. Free provision of information about fear in the form of self-help books, leaflets, webcasts, video and bibliotherapy. This should include tools for relaxation methods and mindfulness-based techniques.

4. All NICE-recommended therapies for anxiety disorders including CBT, and Computerised CBT including Fearfighter should be available in all Primary Care Trusts.

5. More research is needed to keep improving evidence-based approaches to treating anxiety disorders.

6. Reducing institutionally-driven fear. Policy-making is not just an issue for national Government. We must identify steps that can be taken by local health, social care, education, criminal justice and voluntary organisations, as well as employers and schools, to promote a less fearful culture and ensure these are taken. However, there needs to be recognition within Government of the importance of fear. Governments should take account of the harmful effects of fear induced by the policies they make and promote. Perhaps most importantly they should stop unnecessarily using the language of fear as an instrument to promote their own policies and approaches.

7. A commitment to investment in Improving Access to Psychological Therapies beyond 2011, to ensure that every Primary Care Trust is equipped to deliver evidence-based therapies to all those who need them.

8. Exploring the causes of proportionately higher levels of reported fear among women and young people, and investigating steps to target these groups specifically.