Antidepressant Prescribing at Six-Year High

Leo Hynett

The pandemic has undeniably taken its toll on the mental health of the nation. New NHS statistics have revealed that 1 in 8 people in England are currently taking antidepressants.

The number of people taking antidepressants has now risen for six consecutive years with a massive total of 83.4 million antidepressant drug items prescribed in 2021/22 – a 5% rise from the year before.

The pandemic is an obvious driver of this increased demand, but it is far from the sole cause. Current global events are weighing heavy on the mind, as is the rising cost of living and weather that makes climate change increasingly hard to ignore.

While it’s easy to get bogged down in all the negative potential reasons for this number climbing, there could be some positive ones too.

Changing figures

It is estimated that 56.5 million people in England are now taking antidepressants. However, this 5% rise in the number of antidepressant prescriptions has not been equal across society.

There was a rise of just over 8% in young people taking antidepressants; the number of 10 to 14-year-olds taking them rose from 10,994 to 11,878, and the number of 15 to 19-year-olds rose from 166,922 to 180,455. The number of women prescribed antidepressants was found to be almost double the number of men. This potential causes of this gender difference are complex; there is still a lot of stigma surrounding men speaking up about their feelings, which may cause them to downplay their symptoms to their GP if they do decide to seek support. This may also extend to how seriously health professionals consider their feelings when they present at the practice.

There was also a 40% rise in prescription rates for people in their 20s, an age demographic also grappling with added concerns about housing affordability and decisions about starting families amidst current economic and geopolitical instability.

The impact of the pandemic on these statistics remained clear:

‘In the 25-month period since the implementation of lockdown measures during the coronavirus (COVID-19) pandemic, between March 2020 and March 2022, there were an estimated 1.95 million more antidepressant prescription items issued than expected based on historical trends.’

However, while this increase may look substantial, it was not high enough to be classed as a statistically significant increase for the period. Interestingly, there was a statistically significant variation in the number of drugs prescribed for dementia – this figure was estimated to be 888,000 lower than expected.

Quarterly statistics from NHS Business Services Authority (NHSBSA) covering January-March 2022 saw ‘an estimated 21 million antidepressant drugs prescribed – a 0.78% decrease from the 21.2 million items in the previous quarter, and a 4.06% increase from the 20.2 million items compared with the same quarter in 2020/21.’

What’s behind the increase?

There is a possibility that this rise in prescribing stems from a lack of access to therapy during the height of the pandemic. Restrictions made it difficult for people to see their existing therapists and while many offered appointments via Zoom this is not effective – nor accessible – for everyone. Waiting lists rapidly increased, making getting a new therapist extremely difficult.

Without easy access to therapy, people who may previously have chosen not to use medication as a way to manage their low mood may have felt they had no other option.

In the case of mental health support, delays in treatment are far from a neutral action. The longer it takes for a patient to receive support, the more severe and complex their difficulties and their lives can become. Prescribers may therefore have felt they could offer more immediate – and thus more effective – relief to patients through medication as opposed to putting them on ever-increasing therapy waiting lists.

Are we getting better at seeking help?

The pandemic caused delays in many people coming forward for help. Over a year ago, the NHS Confederation acknowledged that visible waiting lists were likely only showing half of the picture. Many people chose not to visit GPs out of fear of catching Covid or due to concerns about overburdening the NHS, resulting in a ‘hidden’ backlog that meant figures far exceeded the publicly accepted statistics. Now that people are beginning to come forward, this hidden backlog is making itself known.

People may be finding it easier to come forward and ask for the help they need as conversations about mental health become progressively more normalised. Mental health has been a hot topic throughout the pandemic and people may simply be growing more open to the idea of seeking help with things they may otherwise have “soldiered through”. As such, this rise in medication use could be a welcome sign that people feel more able to seek the support they need than ever before.

The stigma around taking medication is also changing. Old notions of what antidepressants will do to a person are fading and being replaced with far more positive attitudes about how much medication can help. Over time, people have begun to realise that if someone has a broken leg they would not be denied (nor deny themselves) the use of crutches or painkillers, so why should this be any different when it comes to our mental health?

One lingering concern is the fact that covid cases are slowly but surely rising again; cases, hospitalisations, and deaths steadily increased throughout June. There are some concerns that these rising cases could drive a further increase in anxiety and depression among the general public, as well as potentially preventing people from visiting their GPs once more. If cases do continue to increase, it is essential that people are not allowed to slip out of view.

The initial waves of the pandemic may have required an ‘all hands on deck’ approach, but it is now clear that taking our hands off the wheel of the mental health sector is something we simply cannot afford.