What is the Adult Psychiatric Morbidity Survey?

The Adult Psychiatric Morbidity Survey (APMS) is one of the most important and robust sources of data on population-level adult mental health in England. The 2023/4 survey is the fifth in the series, following previous surveys in 1993, 2000, 2007 and 2014 – enabling us to monitor mental health over time.

APMS aims to measure how common a range of mental health conditions, including common mental health conditions such as depression and anxiety, posttraumatic stress disorder, psychotic disorder, bipolar disorder, and conditions like autism and other health-related behaviours such as alcohol and drug dependence. Beyond prevalence, APMS examines how conditions overlap, screening for comorbidity with other mental health conditions, and limiting physical health conditions as well as mental health treatment and service use. It also tracks trends over time, offering a valuable insight into long-term trends. Finally, APMS can highlight inequalities, examining differences in mental health across groups, including region, levels of deprivation, and experience of problem debt.

Why is this survey so important?

• Shapes national strategy - APMS data were used as evidence in the government’s ‘No Health Without Mental Health’ strategy, setting objectives to improve mental health and wellbeing in England.  
• Expands access to care - APMS prevalence data on common mental health conditions helped highlight unmet treatment needs, with data underpinning the development of NHS Talking Therapies. APMS is able to capture those not in receipt of mental health service use or treatment, as the sample is not based on those in contact with health services.
• Used by researchers to highlight hidden issues - Findings that one in 20 adults was closely related to a serious assault victim in England were used as evidence in Parliament to advocate for better support for these individuals.
• Prevalence estimates for autism underpin national autism strategies - The National Autism Strategy for Children, Young People and Adults (2021–2026) explicitly states that robust prevalence data is essential for planning services and monitoring progress. NHS England’s autism data strategy notes that GP records currently identify only about 60% of the number suggested by APMS, highlighting APMS as the gold standard for estimating unmet need.
• A trusted resource - Searching for the ‘Adult Psychiatric Morbidity Survey’ on Google Scholar returns over 15,300 results.

How did we collect the data?

We carried out data collection between March 2023 and July 2024, aiming to talk to adults with a wide variety of characteristics. Using a random probability sample, interviewers from the National Centre for Social Research knocked on thousands of doors in rain, wind, snow and heatwaves, to ensure that our findings truly represented the population. With hard work and additional sample issued, our interviewers carried out 6,912 interviews. Interviews lasted an average of 90 minutes, with some as long as 3 hours!

The questionnaire was sensitive and detailed, including structured assessments and screening instruments for conditions like depression, anxiety and other rarer conditions like bipolar disorder and autism. This was followed by demographic, general health, service use and risk factor questions such as adverse childhood experiences. For the first time, a remote option was offered, but most people chose to take part in their own homes - a credit to our interviewers.

Some participants who met eligibility criteria for autism, psychosis or eating disorders in the interview  were invited for follow-up clinical assessments by specialists employed by the University of Leicester. This involved assessments for autism (using the Autism Diagnostic Observation Schedule - ADOS ¹  - a semi-structured clinical examination assessing whether behaviour is consistent with an autism diagnosis), psychosis and eating disorders (using the Schedules of Clinical Assessment in Neuropsychiatry - SCAN ² ). In total, 880 clinical assessments were conducted. This was the first clinical assessment of eating disorders collected at population level.

What did we find out?

We have uncovered so many fascinating insights, and we have only analysed part of the data, meaning there is plenty more to explore! Here are some of the key findings which really stood out to us:

Common mental health conditions are rising

Since 2007, the number of 16 to 64 year olds identified with a common mental health condition has increased from 17.6% to 22.6% in 2023/4, with women reporting higher rates than men at both points. The largest increase was among young adults aged 16 to 24, where prevalence rose from 17.5% to 25.8%.

Self-harm is becoming more prevalent

Lifetime reports of non-suicidal self-harm among 16 to 74 year olds have nearly tripled, from 3.8% in 2007 to 10.3% in 2023/4.  

Inequalities persist in mental health

Mental health problems are more common among people living in deprived areas those struggling with debt, and those who are out of work. For example, 26.2% of adults living in the most deprived areas have a common mental health condition, compared to 39% among adults with problem debt. This is similar for those not in employment (40.0% in unemployed adults and 38.8% in economically inactive adults).

Read the full report here.