Consultation findings

Of the consultation survey respondents who answered the section on prior awareness of the survey, half (50%) had heard of the APMS series before taking part (Table 2). Of those who had previously heard of APMS, two-thirds (68%) had used published reports, data tables and/or journal papers, a quarter (24%) had been involved with producing publications using data (for example as the co-author on a paper), and a fifth (21%) had direct experience of analysing the archived dataset itself.

Table 2 previous awareness and use of APMS

Source: APMS 2022 consultation survey 

Focus group, guided feedback, and Academic Network participants had all heard of the APMS prior to the consultation, except for those who participated in the lived experience focus group. Government and third sector organisation representatives and those who worked in a service provision capacity tended to have made use of the report and some had also used the data. Participants with academic affiliations had mostly used the data for secondary analysis projects

Consultation survey respondents and focus group participants noted the value of the APMS for research, policy, and practice.

In summary, respondents highlighted the following strengths. 

Government departments use APMS mental health prevalence data to plan mental health services. For example, DHSC and NHS used it to estimate changing demand for Improving Access to Psychological Therapies (IAPT) services, in particular what the increased prevalence of anxiety and depression between the 2007 and 2014 surveys meant for mental health treatment targets and service resourcing. PHE used the data to model and understand local area mental health and alcohol dependence prevalence, and made the results of this modelling available for local government use in service planning and monitoring at the regional and authority level. DWP and DHSC commissioned work using the data to understand the needs of particular subgroups (for example, people in receipt of specific welfare benefits or those with particular conditions or impairments). A number of departmental and cross-government strategies and policy documents, such as the Women's Mental Health Taskforce , cite APMS findings, especially in relation to establishing prevalence, temporal trends, or inequalities. Mental health third sector organisations described using APMS data to profile the population and understand the changing needs of the people that they represent.

There was consensus that APMS data is a valuable resource as it collects information that would otherwise not be known. For example, government and third sector organisations relied on APMS for representative suicide attempt and self-harm prevalence estimates. Focus group participants acknowledged that many people who have made suicide attempts or engaged in self-harm behaviours are not known to formal health services or experiences are not fully recorded in patient records. APMS provides important information about help seeking behaviours following suicide and self-harm which is not available from any other source. Furthermore, participants noted that APMS provides valuable data on the proportion of people with symptoms to have a formal diagnosis and/or receive treatment. Participants sometimes highlighted that the survey was either the only (or best quality) source of data that covered the relationship between mental health and a specific topic, such as debt, discrimination, or domestic violence.

Another strength of the survey series was that because the questionnaire covers different types of mental health conditions (as well as different physical health conditions) it is an ideal data source for measuring the prevalence and nature of comorbidities. For example, the survey has been used to help government policymakers consider whether treatment services should consider particular conditions and substance or gambling behaviours together or separately. Focus group participants suggested that the inclusion of a chapter on comorbidities was a strength of the survey reports and should be expanded on further in the APMS 2022 report.

The consultation highlighted limitations of the survey and its outputs. In summary, these included.

The relatively small sample size (around 7,500-8,000 survey participants each wave) is widely cited as a major limitation. It particularly limited analyses on low prevalence mental health conditions (such as psychosis and autism) and low prevalence population subgroups (such as minority ethnic groups and those in receipt of particular benefits). It was noted that the seven-year interval between surveys was large, impacting on the frequency with which temporal trends could be updated and the ability to understand the point at which shifts in prevalence had occurred. The response rate was also flagged, and the importance of maintaining this to ensure that the sample remained representative and the survey remained authoritative.

Almost all survey and focus group participants who had worked directly with the data or who had wanted to work directly with the data, expressed frustration at the data access process for the 2014 survey. Consultation participants understood that NHS Digital had to function within a particular legal framework, including the General Data Protection Regulations. However, many believed the data request process was disproportionate and limited the use of this important dataset. Those who had tried to access the 2014 data, reported the process was complex to navigate and time consuming. It has caused delays to research projects and in some cases planned work was not possible.

During the consultation participants suggested that the data access process needs to be reviewed and made more efficient for data users, suggestions to improve the data access process included:

• a faster, more efficient, process
• allow organisational access to the dataset for use in multiple ways 
• arrange pre-approval for organisations, ahead of the data being archived
• data could be accessed via an established Trusted Research Environment
• having different data file formats for the main statistics programmes (for example csv, tsv, R, Stata and SPSS)

International consultation participants were particularly keen for APMS to be included in the Global Health Data Exchange. This data exchange was considered valuable for global and country comparisons of mental health prevalence.