Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2023/4

This statement aims to provide users with an evidence-based assessment of quality of the statistical output included in this report.

It reports against those of the nine European Statistical System (ESS) quality dimensions and principles appropriate to this output. In doing so, this meets NHS England’s obligation to comply with the UK Statistics Authority (UKSA) Code of Practice for Statistics, and the following principles in particular:

• Trustworthiness pillar, principle 6 (Data governance) which states “Organisations should look after people’s information securely and manage data in ways that are consistent with relevant legislation and serve the public good.”
• Quality pillar, principle 3 (Assured Quality) which states “Producers of statistics and data should explain clearly how they assure themselves that statistics and data are accurate, reliable, coherent and timely.”
• Value pillar, principle 1 (Relevance to Users) which states “Users of statistics and data should be at the centre of statistical production; their needs should be understood, their views sought and acted upon, and their use of statistics supported.”
• Value pillar, principle 2 (Accessibility) which states “Statistics and data should be equally available to all, not given to some people before others. They should be published at a sufficient level of detail and remain publicly available.”

The National Study of Health and Wellbeing in England: Adult Psychiatric Morbidity Survey was assessed in May 2016 by the UK Statistical Authority (UKSA) for compliance with the Code of Practice and the publication was recommended for continued designation as National Statistics.

The Adult Psychiatric Morbidity Survey (APMS) series provides data on the prevalence of treated and non-treated mental health conditions in England's adult population (age 16 and over).

The APMS 2023/4 is the fifth in a series of national mental health surveys. Each survey involved interviewing a large, stratified probability sample of the general population, covering people living in private households. The two-phase survey design involved an initial interview with the whole sample, followed up with a structured assessment carried out by clinically trained interviewers with a subset of participants.

The survey was commissioned by NHS England, funded by the Department of Health and Social Care (DHSC), and carried out by National Centre for Social Research, the University of Leicester, and City St George's, University of London.

This dimension covers the degree to which the statistical product meets user needs in both coverage and content.

The data published are used by the Department of Health and Social Care, NHS organisations, charities, academics, the public and the media. Uses of the data include:

• informing and monitoring policy
• monitoring the prevalence of health or illness and changes in health or health related behaviours;
• informing the planning of services
• writing media articles

Universities, charities and the commercial sector use the data for health and social research. The survey data are also used for teaching purposes and by students in their work.

NHS England regularly consults the APMS Steering Group (consisting of Department of Health and Social Care (DHSC), Department for Work and Pensions (DWP), academics and charities to try and ensure most users’ needs are met. In 2021, a public consultation was held to inform the content and outputs of the 2023/4 survey.

This dimension covers, with respect to the statistics, their proximity between an estimate and the unknown true value.

The figures in this publication come from surveys, which gather information from a sample rather than from the whole population. The sample is designed to be as accurate as possible given practical limitations such as time and cost constraints. Results from sample surveys are always estimates, not precise figures. This can have an impact on how changes in the estimates should be interpreted.

As the number of people available in the sample gets smaller, the variability of the estimates that we can make from that sample size gets larger. Estimates for small groups are less reliable and tend to be more volatile than for larger aggregated groups. For some of the low prevalence disorders the uncertainty in how reflective the estimates produced are of the resident population is relatively large compared to size of the estimate. For these disorders particularly the prevalence estimate must be understood to sit inside confidence intervals, giving a range of likely true prevalence values for the population.

As the data are based on a sample (rather than a census) of the population, the estimates are subject to sampling error. The APMS 2023/4 used a clustered, stratified multi-stage sample design and in addition, weights were applied when obtaining survey estimates. One of the effects of using the complex design and weighting is that standard errors for survey estimates are generally higher than the standard errors that would be derived from an unweighted simple random sample of the same size. The calculation of standard errors shown in the tables, and comments on statistical significance have been included in the report, all of which have considered the clustering, stratification and weighting of the data.

In general, attention is drawn to differences between estimates only when they are significant at the 95% confidence level, thus indicating that there is less than 5% probability that the observed difference could be due to random sampling variation when no difference occurred in the population from which the sample is drawn.

A total of 6,912 adults (aged 16 and over) were interviewed during phase one of the 2023/4 survey. 880 phase two interviews were carried out by clinically trained research interviewers employed by the University of Leicester. Details of the sample design and survey methods and sampling errors and design effects are in the publication’s Methods documentation which accompanies this publication.

The sample was designed to be representative of the population living in private households in England. People living in institutional settings such as residential care homes, offender institutions, prisons, in temporary housing (such as hostels or bed and breakfasts) or sleeping rough are outside the scope of the survey. This should be borne in mind when considering survey findings.

Timeliness refers to the time gap between publication and the reference period. Punctuality refers to the gap between planned and actual publication dates.

The fifth iteration of the APMS, due to take place 7 years after the 2014 survey, was delayed due to the COVID-19 pandemic.

A report about the survey findings and trend data tables are published as soon as possible following completion of fieldwork data collection, data validation and analysis. Fieldwork for the APMS 2023/24 took place in 2023 and 2024.

A decision was made to publish a follow-up on eating disorders as a supplementary study to ensure timeliness of the data.

This publication has not suffered any delay compared to the planned and preannounced release date.

Accessibility is the ease with which users are able to access the data, also reflecting the format in which the data are available and the availability of supporting information. Clarity refers to the quality and sufficiency of the metadata, illustrations and accompanying advice.

The 2023/4 reports have been published in HTML format, with tables provided in Excel format.  Methods and Survey documentation materials are available for download in pdf format.

Approved researchers seeking to undertake secondary analysis of the Health Survey for England will be able to apply for access via the UK Data Service, more information is available on the Population Health Data Access Webpage.

Coherence is the degree to which data, which have been derived from different sources or methods but refer to the same topic, are similar. Comparability is the degree to which data can be compared over time and domain.

This is the fifth survey in the APMS series. Certain core themes and methodologies have been kept consistent or comparable throughout the survey series to provide a consistent time series for core mental disorders.

Details of specific decisions made to enable comparability over time, such as the use of sex or gender as a cross break are in the publication’s Methods documentation which accompanies this publication.

The comparability of the results in this publication with other studies conducted nationally and internationally, where such studies are available, is discussed in each topic-specific chapter. These comparisons are mainly outlined in the Introduction and Discussion sections of each chapter, but also highlighted throughout where appropriate.

This dimension describes the extent to which different aspects of quality are balanced against each other.

Within this publication different aspects of quality have been balanced against each other to best meet the aims of the survey.

Due to the sensitive nature of the survey focus, it is possible that some question may be susceptible to social desirability bias, where the individual is tempted to give an answer which is more socially acceptable. Participants are assured that their answers will be kept private to reduce this temptation.

This dimension covers the processes for finding out about users and uses and their views on the statistical products.

From our engagement with customers, we know that there are many users and uses of these statistics. Details of these uses and users have been included in the ‘Relevance’ section of this Data Quality Statement, along with details of previous consultation on this survey series.

Regular consultation with customers and stakeholders is undertaken to ensure that developments introduced to this publication and other NHS England publications meet their requirements. 

NHS England tries to engage with users of these statistics to gain a better understanding of the uses and users and to ensure these statistics remain relevant and useful. We capture information on the number of unique page views the reports and tables receive, alongside coverage in the media.

NHS England is keen to gain a better understanding of the users of this publication and of their needs; feedback is welcome and may be sent to [email protected].

This dimension describes the effectiveness, efficiency and economy of the statistical output.

Data for the APMS 2023/24 were collected from the population living in private households in England. Due to the scale of this collection it is currently carried out once every seven years.

As with all previous surveys the APMS 2014 involved a stratified random probability sample of households. One adult aged 16 years or over was randomly selected for interview in each eligible household. Given the length of the interview process, interviewing one household member helped to reduce the burden placed on each household.

The two-phase survey design involved an initial interview with the whole sample, followed up with a structured assessment carried out by clinically trained interviewers with a subset of participants. The achieved sample for the first phase of the 2023/4 survey was 6,912 adults (aged 16 and over), a response rate of 29.4%. 1,742 of these were selected for the second phase interview, 887 (50.9%) of whom were interviewed. Full details of the survey methodology and associated burden can be found in the APMS 2023/4 Methods documentation.

The procedures and policy used to ensure sound confidentiality, security and transparent practices.

The data contained in this publication are National Statistics. The Code of Practice for Statistics is adhered to from collecting the data to publishing.

No personal/individual level information is contained in the report. Information is presented at a high level of aggregation. As for all NHS England publications the risk of disclosing an individual’s identity in this publication series has been assessed and the data are published in line with a Disclosure Control Method for the dataset.

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A Guide to Confidentiality in Health and Social Care

https://digital.nhs.uk/about-nhs-digital/our-work/keeping-patient-data-safe

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