Survey of Mental Illness in General Practice

Abstract

This survey of mental illness was carried out in 261 practices in Great Britain, largely by members and associates of the College of General Practitioners, with a population at risk of about a million persons. Some 9,000 patients qualfied for inclusion in the survey, and this means in round figures that almost 1% of the population was found to be mentally disabled. Looking at the figures as a whole, the most common diagnosis was the manic-depressive psychosis, which accounted for a quarter of the cases. If reactive depressions were added the figure became a third of the case load. Even this total does not include the short severe depression treated by their own doctors at home, as there was no place for such cases in the survey. Over the year 55 cases of suicide were recorded, and 528 attempts. Mental illness increases in prevalence with each decade, to reach a peak in senility. Manic-depressive psychosis was as common as senile dementia in old age. Mania was more common among the aged, as were paranoid states, especially among old women. Alcoholic addiction as estimated in general practice was twice as common in Scotland as south of the border. Some 7,477 persons were mentally ill on 1 November 1961, when the survey began. If this prevalence figure is compared with figures from the Ministry of Health for mental hospital beds occupied on 31 December 1960, the nearest date for which figures were available, then it seems that at the time of the survey there were just over twice as many mentally disabled persons in the community as in the mental hospitals. There were, however, three mentally retarded persons in mental-defective institutions for every 2 such persons in the community. Of the new cases which occurred in the survey year, some 75% were referred to a psychiatrist. Of the more chronic cases which had occurred before the survey started, some 45% were referred during this particular year. Taking the figures as a whole, about a half saw a psychiatrist during the survey year, and a half were cared for by the family doctor alone.