The most depressed neighborhoods in England are all in the north and the midlands, with nearly a quarter of patients at some GP Surgeries seeking help for the condition, research by the Guardian shows.
Yet it is in these areas where psychiatrists are most scarce, with more than twice as many practitioners in London as in Yorkshire per head of population. Proportionately, more specialist psychiatric research and treatment is so in the capital.
England, shows a strong London versus everywhere else divide when it comes to mental health in England.
Of the 15 neighborhoods with the highest prevalence of depression, 12 were in London, with the other three being the Isles of Scilly and two affluent pockets of Kent. The lowest rate was around London Zoo, in Westminster, London, where a three-bed flat can cost £ 3.5m and just 3.1% of NHS patients were depressed.
Conversely, of the 15 neighborhoods with the highest prevalence of depression, 12 out of 15 were in the poorest pockets of the north-west of England. The other three were at Sutton Hill, Telford & Wrekin; Kidderminster Town, in Wyre Forest, Worcestershire; and Dinnington South, at Rotherham, South Yorkshire.
The highest rate was in Brinnington, a suburb of Stockport, in Greater Manchester, where 23.6% of patients were depressed. In the previous six weeks it was reported that 61% of patients had been depressed or had suffered from the condition.
All of the areas where depression is disproportionately poor and have above-average levels of people living alone, in poor physical health, unemployed and / or on benefits: all well-established risk factors for mental health disorders, according to the Adult Psychiatric Morbidity Survey.
In Bidston, in Birkenhead, Merseyside, which has the second highest prevalence of depression in England (20.2%), more than half of children live in poverty. Neighborhoods where there are a lot of smokers are also known to be more troubled by depression. In Brinnington, 30% of the population smoke, twice the England average. In Bidston, 26.7% of pregnant women smoke.
Wendy Burn, the president of the Royal College of Psychiatrists, urged the government to put the money in the most deprived parts of England. "They should be putting more money into tackling social deprivation rather than putting more money into treating depression (for) housing and doing all these things," she said.
Areas where more people receive jobseeker's allowance are more likely to have high rates of depression, the Adult Psychiatric Morbidity Survey. In the Brinnington and Central of Stockport, 9.9% of the population claim that benefit, compared with the English average of 3.3%.
Recent benefit changes, especially the replacement of disability-living allowance (PIP) have exacerbated mental health problems, said Burn: "If you have mental health problems you are more likely to loose your benefits than physical health problems . "
Researchers from York University found that they had a psychiatric condition 2.4 times more likely than those with diabetes, back pain or epilepsy to lose their entitlement when transferring from DLA to PIP.
Despite being overrepresented in London, there are proportionally more psychiatrists in the capital than anywhere else in England. London (north, central and east) has the most psychiatrists per 100,000 population (27.7), followed closely by the rest of the capital.
The figures, based on the September 2018 workforce stats from NHS Digital and the latest ONS population data for all clinical commissioning groups, were just 15.2 psychiatrists per 100,000 population in the north-west, 12.7 in Yorkshire and Humber, 15.4 in the West Midlands and 15 in the east Midlands. Bottom of the table was Wessex, with 12.5.
Burn says the recruitment problems emerge early on because psychiatrists overwhelmingly want to live in London, partly for lifestyle reasons and partly because there are more specialist training opportunities. "Twenty-five percent of the psychiatrists are in London – there's a big skew with that," said Burn, who practices psychiatry in Leeds. "When we recruit our young psychiatrists there is always competition for London."
London has more psychiatric specialist centers, said Burn, for example, the Institute of Psychiatry, Europe's largest center for research and postgraduate education in psychiatry, psychology, basic and clinical neuroscience.
"There is a long tradition of specialist health services being based in London, not just mental health," said Burn. It's both good and bad. "Think of Great Ormond Street, which treats really tricky child cases from people all over the country. You probably get better care somewhere that is very specialized but you have come to many miles away from home. "
Paradoxically, mental health spending per head in 2018-19 (including dementia and learning disabilities) shows that spending in the north of England for this current financial year is planned at £ 208, compared to £ 153 in the south-east.
The figures, based on the latest ONS population data for all local commissioners, found £ 177 in the South-West, £ 182 in the Midlands and East, and found a planned spend of £ 177 £ 187 in London. That could be because Londoners go private for mental health treatment. Research has suggested they are more reluctant than people in other regions to seek help for depression from their GP, said Burn.
Highest estimated neighborhood prevalence of depression
1. Brinnington, Stockport, Greater Manchester: 23.6%
2. Bidston Hill, Wirral, Merseyside: 20.2%
3. Partington, Trafford, Greater Manchester: 19.4%
4. Fleetwood North East, Wyre, Lancashire: 19.3%
5. Sutton Hill, Telford & Wrekin: 18.9%
6. Middleton Wood Side, Rochdale, Greater Manchester: 18.6%
7. Tranmere, Wirral, Merseyside: 18.5%
8. Fleetwood North West, Wyre, Lancashire: 18.4%
9. Kidderminster Town, Wyre Forest, Worcestershire: 18.3%
10. Dinnington South, Rotherham, South Yorkshire: 18.2%
11. Milnrow East and Newhey, Rochdale, Greater Manchester: 18.1%
12. Woodchurch, Wirral, Merseyside: 18%
13. Birkenhead Central, Wirral, Merseyside: 17.9%
14. Belah, Carlisle, Cumbria 17.8%
15. Milnrow West & Kingsway, Rochdale, Greater Manchester: 17.8%
Lowest estimated neighborhood prevalence of depression
1. Townshend & Zoo, Westminster, London: 3.1%
2. Isles of Scilly: 3.2%
3. Southall Green, Ealing, London: 3.5%
4. Hainault East, Redbridge, London: 3.6%
5. Hainault West, Redbridge, London: 3.6%
6. Knightsbridge, Belgravia, Westminster, London: 3.6%
7. Mullion & St Keverne, Cornwall: 3.17%
8. Wimbledon Common, Merton, London: 3.7%
9. Wembley West, Brent, London: 3.8%
10. St John's Wood, Westminster, London: 3.8%
11. Istead Rise & Meopham, Gravesham, Kent: 3.8%
12. Joydens Wood, Dartford, Kent: 3.8%
13. Alperton East, Brent, London: 3.9%
14. Ilford North West, Redbridge, London: 3.9%
15. Queensbury East, Harrow, London: 3.9%
(t) Health (t) NHS (t) Society (t) London (t) Poverty