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Depression is regarded as common and widespread, but remains a condition about which few people have any great understanding. The Lundbeck Mental Health Barometer 0
INTRODUCTION Since its inception in 00 the Lundbeck Mental Health Barometer has researched Irish peoples attitudes towards depression, anxiety and mental health as well as the stigma and misunderstanding that pervades in this area. As specialists in psychiatry, Lundbeck is committed to education and raising awareness through the provision of information which will enhance the perception of people living with mental health issues in the community. The Barometer shows us that friends and family would listen and be sympathetic to someone with depression, but still view the GP as the best person to provide assistance. However, most people still find it difficult to discuss depression with a healthcare professional. This research also confirms there is still a lack of understanding about depression and mental health in Ireland. In order to remove the stigma of depression we must undertake to educate about it what causes it, who is affected by it and how it can be overcome. Only by bringing this conversation into the open can we hope to bring about real understanding of this condition. We hope that this report will serve as a useful source of information for you. Ms Eithne Boyan Managing Director Lundbeck (Ireland) Ltd. The Lundbeck Mental Health Barometer 0
EXECUTIVE SUMMARY Depression remains a widespread condition in Ireland, experienced by % of the population directly at some stage, with almost 1 in knowing someone close to them, whether family or a friend, who has experienced it. The level of direct experience of depression is very slightly down year on year, but it remains one of the most commonly experienced conditions since the survey began six years ago. Wider societal knowledge of individuals suffering with depression is now felt to exist, with a significant increase in broader awareness having occurred about three years ago. While this wider knowledge of individuals with depression is claimed, suggesting that fewer may conceal their condition, there is no greater understanding of the precise causes of depression or of the true nature of the condition itself. General attitudes to depression remain troubling. It is regarded as very common and widespread, but remains a condition about which few have any great understanding. In addition, a growing number of people would be reluctant to discuss depression with a doctor or health professional. Embarrassment about depression is rising, particularly amongst young people. Few seem to be well informed about how depression is treated. Many are alarmed at the possibility of a friend or family member making a disclosure about depression to them and this is particularly the case amongst younger adults. While the stigma attaching to depression is felt to have reduced somewhat over the years, it remains a highly stigmatising condition. Quite remarkably, other conditions such as heart disease and diabetes, which may result from being less vigilant in relation to one s health, are not considered to be in any way stigmatising. A worrying and consistent trend has been noticed in the recent years of this Lundbeck Barometer. There is a growing association of depression with youths, the unemployed and particularly, with men rather than with women. This tends to endorse a somewhat simplistic notion that depression is a function of the recession, caused by the economy, rather than being an illness. This also tends to mask the broader appreciation that depression can be experienced by anyone, particularly by women and by older people. Indeed when we study the profile of those within the sample who have had experience of depression, many more of them are women than men, although there remains this growing perception that depression is becoming a male rather than a female phenomenon. On a more positive note, it is encouraging that a substantial proportion of people who had depression, or had familial experience of depression, said that those within their immediate circle would have been kept aware of their, or their loved one s, condition. Greater openness about depression does indicate that there is the potential for attitudes to the condition to change, but it remains clear that the wider population is fearful of depression, and has at best a limited understanding of how to deal with it or what causes it. Their principle attitudes appear to be shaped by trepidation, and there is no great evidence of a growth in empathy or understanding at a societal level, nor of a sense that it is a topic about which many could hold a well informed discussion. The Lundbeck Mental Health Barometer 0
ATTITUDES TO DEPRESSION There is an almost universal view that depression can have a very negative impact on a person s life and indeed on their ability to cope in everyday situations. More than nine in ten consider that depression is common in Ireland, but despite this almost nine in ten are also of the view that depression is not that well understood. Thus there is a growing perception that depression is a widespread condition, but no genuine improvement or detailed understanding of it exists. What is perhaps slightly worrying is that there is an increasing view that depression is a difficult condition to talk about to a doctor or health professional. Rather than this view eroding, as broader awareness of depression becomes apparent, it has in fact grown. There remains a widespread view that men and women probably deal with depression in a different way with more than four in five endorsing this view to some extent. ATTITUDES TO DEPRESSION: 00-0 Depression is very common in Ireland Depression is not well understood by many people Men and women probably deal with depression differently Depression is a difficult condition to talk to a doctor or a health professional about People of my age group would be embarrassed to discuss depression with others Depression is readily treated with medication Depression is a state of mind and not really an illness at all Depression can have a very negative impact on a person s life 00 00 00 00 0 0 00 00 00 00 0 0 00 00 00 00 0 0 00 00 00 00 0 0 00 00 00 00 0 0 00 00 00 00 0 0 00 00 00 00 0 0 00 00 0 0 Strongly agree Generally agree 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 Depression can impact on a person s ability to cope in everyday situations 00 00 0 0 1 The Lundbeck Mental Health Barometer 0
ATTITUDES TO DEPRESSION Another worrying sign is the rise in the number saying that people of their own age group would be embarrassed to discuss depression with others. At present six in ten agree with this to some extent, signifying no particular improvement on this basis over the past six years. It is also somewhat worrying that a lower proportion of people are of the view that depression is readily treated with medication. % feel that it probably is while 1% doubt this. Whilst there seems to be a broadening awareness of depression, there does not appear to be a clear understanding of the condition. It is still regarded as a mystery to many and this effects the ability to understand depression and its treatment. Younger people remain a particularly inhibited group when it comes to depression. In the first survey in 00 about % of under s suggested that people of their own age group would be embarrassed to discuss depression with others. The corresponding level in the 0 survey indicates that % of under s are embarrassed. Thus, while awareness may have grown there seems to be no lessening of inhibition in relation to the condition. A new statement was introduced this year - If I thought someone close to me was suffering from depression, I would want to know. Roughly half (%) agreed with this, with women and those between and much more likely to endorse this sentiment. However %, more than two in five people, disagreed saying they would not want to know. More worryingly just % of under 's agree that they would like to know about a close friend suffering from depression. There is clearly a sense of embarrassment or concern that discussing it would be too personal or awkward. Looking at the totality of attitudes to and beliefs about depression, it appears that depression is somewhat objectified and feared: few are able to personalise the condition or want to face up to the prospect of having to deal with it themselves or in someone close to them. PEOPLE OF MY AGE GROUP WOULD BE EMBARRASSED TO DISCUSS DEPRESSION WITH OTHERS X AGE Base: Adults Aged 1+ All Adults 0 U s 0-0 - 0 0-0 + 0 Strongly Agree 0 1 1 1 1 Generally Agree Do not really Agree Strongly Disagree Don t know 1 1 1 1 1 1 1 0 1 1 1 1 0 1 1 1 The Lundbeck Mental Health Barometer 0
PEOPLE WITH DEPRESSION Perception versus reality The study reveals that there is a widespread view that depression is very common in youths or teens and indeed the unemployed. Equally there is a growing view that depression is very common in men, with % now suggesting this, in comparison with just 1% in 00. Over the same time period the numbers suggesting it is very common in women have risen only slightly, now standing at the lower level of 1% (versus % for men). It is an almost inescapable conclusion that depression is in some way seen as a function of unemployment primarily and particularly amongst the semi or unskilled groups and at the younger end of the social spectrum. It is seen to impact more on men than it does on women. GROUP ASSOCIATED WITH HAVING DEPRESSION Unemployed Youths / Teens 0 0 0 0 Men 0 0 Older people / ageing population 0 0 Women Parents Full time workers 0 0 0 0 0 0 Very Common 1 1 1 1 1 1 1 1 1 1 1 1 1 1 QuiteCommon Not at all common Don t know 1 1 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 Very common Vs 00 +1% +% +% +1% +% +% -1% Interestingly the occurrence of depression is perceived as being less common in the elderly, despite the reality that depression is common in old age. The worry is that the consolidation of these factors suggests that depression is predominantly a result of unemployment in youth, leading some to think of it as an economic consequence, rather than as a health condition with a solid psychological or physiological basis. This simplification of depression probably prevents a more valid appreciation of what it involves, leading more to simplistic views as to how it might be treated, and indeed perhaps to some suspicion that those suffering from it are not genuinely ill. The Lundbeck Mental Health Barometer 0
PEOPLE WITH DEPRESSION Perception versus reality In querying those with direct personal experience of depression it again emerges that men and youths or teens are the groups most commonly felt to be experiencing depression at present. When asked who is most affected by depression % believed that men were most impacted while only 1% believed it impacted women. This is of course somewhat surprising, as within the sample itself just 1% of those with depression are male, versus % being female. DEPRESSION: MOST COMMON FOR WHOM? DEPRESSION: MOST COMMON FOR WHOM? All Adults Ever experienced personally Youth/teens Youth/teens 1 1 Unemployed 0 Unemployed 1 0 Other people/ Ageing Men 1 00 00 0 0 Other people/ Ageing Men 1 1 00 00 0 0 The Lundbeck Mental Health Barometer 0
BROADER KNOWLEDGE OF DEPRESSION EXPERIENCE As in previous years a question was addressed to all with direct or indirect experience of depression, to determine the extent to which many, some, or just a few, may have been aware of a person s experience of the condition at the time of its occurrence. It is thought that understanding how broadly known or appreciated one s experience of a condition actually was, provides some measure of greater social acceptability of the condition. Were it known to fewer, one might assume that the person had endeavoured to conceal the condition, or indeed that their family may have done so. In relation to this issue there was a substantial change in responses about three years ago. From 00 up to 00 inclusive roughly 1% to 0% of those with direct or indirect experience of depression indicated that many or some would have been aware of the depression in the individual concerned. However, between 00 and 00 the numbers indicating that many or some would have been aware of the individual s experience grew from about 0% to more than 0% (% in 00) and stands at the same level again in 0. The proportion now indicating that none would have been aware of someone s experience of the condition has reduced to 1%, having been almost four times this level at %, in the initial 00 survey. Roughly the same number, at approximately a quarter of those questioned, indicate that very few would have been aware, and this level has remained quite static since the commencement of the original survey. This would indicate that a substantial shift occurred in relation to general openness to admit to, or discuss, depression with a family member or a friend. Such openness could constitute an important change in attitudes towards depression. Women remain marginally more open in regard to depression than men. Interestingly, a greater number of over 0's reported experience of depression, either direct or indirect, whereas previously there had been a tendency for older respondents to be less forthcoming about it. The Lundbeck Mental Health Barometer 0
BROADER KNOWLEDGE OF DEPRESSION EXPERIENCE The current incidence of depression amongst the adult population stands at roughly %. In other words, 1 in every adults admits to experiencing depression, or has done so at some stage in the past. This makes depression the third most common of the conditions reviewed by this study, at roughly half the level of arthritis and two-thirds that of asthma. PERSONAL EXPERIENCE OF AILMENTS OVER TIME Base: Adults Aged 1+/,,000 Arthritis Asthma Depression Anxiety...,000...,000 Heart Disease Cancer 1 1 None of these % 00 % 00 % 00 % 00 % 0 % 0 00 00 00 00 0 0 By projecting up the percentage achieved in this survey the researchers estimate that a group of just over,000 currently have depression or have experienced depression in the past. About % or,000 currently have anxiety. DEPRESSION EXPERIENCE X DEMOGRAPHICS GENDER AGE CLASS AREA Total Male Female 1- - - 0- + ABC1 CDE F Urban Rural % % % % % % % % % % % % % 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 Family/Friend 0 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 Personally 0 1 0 1 1 1 0 1 1 1 1 1 1 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 F/F or Personally 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 The Lundbeck Mental Health Barometer 0
BROADER KNOWLEDGE OF DEPRESSION EXPERIENCE Those experiencing depression are concentrated more heavily in middle age and particularly between the ages of and. It is suggested that they are more likely to be from a CDE** group than an ABC1* background. Equally they are marginally more likely to be female, and again although the difference is slight, this picture has been constant in each of the six years of the survey. ANXIETY EXPERIENCE X DEMOGRAPHICS Family/Friend Personally F/F or Personally GENDER AGE CLASS AREA Total Male Female 1- - - 0- + ABC1* CDE** F Urban Rural % % % % % % % % % % % % % 0 0 0 0 1 1 1 1 1 0 * 0 1 0 1 0 * 1 1 0 0 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Although the incidence of anxiety is somewhat lower in the current year than it was last year, standing at percentage points, compared with the previous year s %, it should be noted that the incidence of anxiety amongst to s is slightly higher, and indeed the highest seen to date in the annual barometer for Lundbeck. It is suspected that the uplift in individual experience of anxiety may correlate with the continuation or deepening of the current recession. * ABC1 - Higher managerial, administrative or professional, intermediate managerial, administrative or professional, supervisory or clerical and junior managerial, administrative or professional. ** CDE - Skilled manual workers, semi and unskilled manual worker, casual or lowest grade workers, pensioners and others who depend on the welfare state for their income. The Lundbeck Mental Health Barometer 0
One in eight respondents know someone close to them, whether family or a friend, who has experienced depression. 1 The Lundbeck Mental Health Barometer 0
WIDER OR FAMILIAL EXPERIENCE OF CONDITIONS The survey also asks about broader experience of these various conditions, for example amongst one s family or immediate peer group. The levels for such broader, peer group or family experience of either depression or anxiety have both reduced in the current survey, standing at 1% in respect of depression, down from 1% in 00. The broader experience of anxiety is currently % and down from the previous year s considerably higher 1%. As in the context of the personal experience of anxiety, the broader familial or peer group experience is at its highest level to date amongst to s, although the overall national incidence has marginally declined. This would tend to suggest that the broader or societal experience of anxiety is impacting upon those who may be at an earlier phase in their working lives and indeed who may have taken on greater financial burdens prior to the recession. Wider Experience of Ailments Over Time Base: Adults Aged 1+/,,000 Family/Friend Family/Friend or Personally Asthma 0 Asthma 0 1 Cancer 1 1 Cancer 1 Heart Disease 1 Heart Disease 0 Arthritis 0 Arthritis Diabetes 1 1 1 Diabetes 1 1 1 Depression 1 1 1 1...,000 Depression 1 1 1 1...,000 Alzheimer s Disease Alzheimer s Disease * Anxiety Parkinson s Disease Schizophrenia 1...,000 None of these 0 % 0 % % % Anxiety Parkinson s Disease Schizophrenia * * 1 1...,000 None of these 0 % 0 % 1% % 00 00 0 0 The Lundbeck Mental Health Barometer 0 1
S T I G M A The relative stigma of depression, schizophrenia, Alzheimer s disease and other conditions has been examined since 00. Over time, the claimed stigma of each of these has reduced notably, although with the majority still suggesting that both schizophrenia and depression confer at least some or a lot of social stigma. The majority feel that anxiety confers a little or no social stigma nowadays. Although the perceived stigma associated with many of these mental health conditions has reduced it should be stressed that they contrast substantially with more mainstream physical diseases and conditions such as cancer, heart disease, arthritis, asthma and indeed diabetes. Although many may exercise some form of value judgement in respect of conditions such as diabetes or heart disease, the vast majority regard neither of these as conferring any social stigma. Stigma appears to be consigned predominantly to mental illness, rather than conditions such as cancer or arthritis that are well understood. To some extent this ties in with the view that depression is a state of mind and not really an illness at all. About a quarter of the population continues to endorse this view and it remains as common as it was in the initial survey in 00. This indicates that there is a lack of knowledge about the physiological nature of depression. Whereas people understand that conditions such as cancer and arthritis are diseases that people involuntarily suffer from, the myth that depression is a state of mind and not a genuine medical disease still persists. PERCEIVED SOCIAL STIGMA Base: All Adults aged 1+ /,,000 A lot of social stigma attached 1 1 Schizophrenia Depression Alzheimers Parkinson s 1 Anxiety 0 Cancer 1 Heart Disease Arthritis Diabetes Asthma Some social stigma attached A little social stigma attached 0 1 1 0 No social stigma attached Don t know A lot vs 00-1 n/a - - - - - = -1-1 -1 1 The Lundbeck Mental Health Barometer 0
S T I G M A THERE IS LESS STIGMA ASSOCIATED WITH DEPRESSION NOWADAYS X AGE Base: Adults Aged 1+ All Adults % U s % - % - % 0- % + % Strongly Agree 1 1 1 1 0 1 Generally Agree 1 1 Do not really Agree Strongly Disagree Don t know 1 1 1 1 1 1 1 1 PERCEIVED SOCIAL STIGMA OF SUFFERING FROM ANXIETY X ANXIETY EXPERIENCE All adults 0 0 0 0 (00) (00) (00) (0) (01) () 0 () Family experience 0 () 0 () 0 () (1) (1) 0 () Personal experience 0 () 0 (1) 0 () (0) (1) Family or personal experience 0 () 0 () 0 (0) 0 () (1) (1) A lot of social stigma attached Some social stigma attached A little social stigma attached 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 No social stigma attached No social stigma attached 1 1 0 1 0 1 1 0 1 The erosion in the social stigma associated with both depression and anxiety, consistently noted over six years is equally in evidence amongst both individual sufferers and indeed amongst their friends and family. This is an encouraging change. The Lundbeck Mental Health Barometer 0 1
H O W W E R E A C T T O D E P R E S S I O N When asked to describe how one might react if a loved one said that they had depression we see that the greatest proportion (slightly more than half) suggests that they would be sympathetic. This response is more common amongst older adults and women. The next highest response is that one would just listen, and this is more typical of men than it is of women. Equally, almost twice as many men as women indicate that they wouldn t know what to say, although the levels remain low at 1% for men and % for women. Nonetheless this is very much a phenomenon of younger respondents and those from CDE** or farming backgrounds: those from ABC1* occupational grades are much more likely to indicate that they would be sympathetic. It seems people s ability to cope with a disclosure of depression, and to empathise or help someone who is making such a disclosure, is quite strongly influenced by ones age, background and particularly gender. PERSONAL REACTIONS TO DEPRESSION BASE: ADULTS AGED 1+ Embarrassed / Awkward All Adults Gender Age Class Male Female 1- - - 0- + ABC1 CDE F 1 Sympathethic 1 I would just listen 0 1 I wouldn t know what to say Don t know 1 1 1 1 1 1 The Lundbeck Mental Health Barometer 0 * ABC1 - Higher managerial, administrative or professional, Intermediate managerial, administrative or professional, supervisory or clerical and junior managerial, administrative or professional. ** CDE - Skilled manual workers, Semi and unskilled manual worker, casual or lowest grade workers, pensioners and others who depend on the welfare state for their income.
H O W W E R E A C T T O D E P R E S S I O N In the event of hearing that a friend or family member is suffering from depression, three quarters suggest that the GP would be the best person to initially provide help. This is followed by discussing the issue with family and friends, suggested by just under 1 in. DEPRESSION AMONG FAMILY & FRIENDS: WHERE TO GET HELP X DEMOGRAPHICS TOTAL GENDER EXPERIENCE AGE SOCIAL CLASS Male Female FAMILY 1- - - 0- + ABC1 CDE F 1 1 01 1 1 0 % % % % % % % % % % % % Pharmacist 1 0 1 1 1 1 1 0 1 0 GP 1 0 0 1 1 Website / Internet Depression help group Counsellor Friend / Family 1 1 1 1 1 1 1 1 1 1 1 Helpline (eg. Samaritans) 0 Other 1 1 Not stated / Don t know 1 1 1 1 1 1 Of those personally experiencing depression a slightly higher proportion indicate that it is the GP they would go to initially for assistance, followed by family and friends (at 1%). Few indicate that they would turn to the internet for help, and all those that do tend to be aged and under. PERSONAL DEPRESSION: WHERE TO GET HELP X DEMOGRAPHICS Base: Adults Aged 1+ /,,000 TOTAL GENDER EXPERIENCE AGE SOCIAL CLASS Male Female FAMILY 1- - - 0- + ABC1 CDE F 1 1 01 1 1 0 % % % % % % % % % % % % Pharmacist 1 1 1-1 - 1 1 1 1 GP 1 1 Website / Internet 0 1 Depression help group Counsellor Friend / Family 1 1 1 1 1 1 1 1 Helpline (eg. Samaritans) 1 - - 1 Other 1 1 1 Not stated / Don t know - 1 1 The Lundbeck Mental Health Barometer 0 1
Seventy percent of respondents think it's difficult to speak to a doctor about depression. 1 The Lundbeck Mental Health Barometer 0
T E C H N I C A L D E T A I L S A nationally representative, quota sample of adults aged 1 and over was interviewed. Fieldwork was undertaken between April nd and May rd and the results of the survey carry a statistical margin of error of plus or minus percentage points. In other words, 1 times out of 0 a percentage of, for example 1%, will fall within a range of between 1% and %, following on from accepted sampling theory. Interviewing was undertaken nationwide at randomly selected sampling points. Interviewers made contact with a population-representative quota sample of adults aged 1 and over. Each interviewer completed 1 or 1 interviews at their sampling point, with a predetermined proportion of men, women, young adults, middle aged adults and older adults, etc. Taken together, all of the sampling point s individual quotas, when cumulated en masse, add back to the national population structure based upon the 00 census of population (and industry agreed targets in respect of social demographics). The sample of corresponds with an adult population of,,000 and in some incidences projections have been made in the report to translate percentage incidences into thousands. The Lundbeck Mental Health Barometer 0
0 LU1// Lundbeck (Ireland) Ltd Riverwalk, Citywest Business Campus, Citywest, Dublin, Ireland Tel + 1 00 Email: ireland@lundbeck.com