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

Participation in gambling activities can lead to a wide range of harms, including experience of gambling disorder.

APMS 2023/4 used the 9-item Problem Gambling Severity Index (PGSI) which measures behavioural symptoms of gambling disorder and experience of some adverse consequences of gambling. Scores on the measure are grouped into different levels of risk from gambling, up to and including likely experience of problem gambling. This chapter focuses on those with a PGSI score of 3 or more (3+), which indicates that the participant was experiencing at least moderate risk gambling.

• Overall, 1.6% of adults experienced at least moderate risk gambling (PGSI score of 3+). 0.4% of adults experienced problem gambling (as indicated by a PGSI score of 8+).
• Men (2.2%) were more likely than women (1.0%) to score 3+ on the PGSI. Prevalence varied by age, and was highest among 25 to 34 year olds (3.5%) and lowest among those aged 75 and over (0.3%).
• PGSI score was strongly associated with problem debt. Adults who were seriously behind on debt repayments or who have had their utilities cut off were more likely to have a PGSI score of 3+ (5.1%) than those not in debt (1.2%).
• PGSI score was associated with mental health. People with a common mental health condition were more likely to have a PGSI score of 3+ (2.6%) than those without such a condition (1.3%). Three in ten (30.1%) of those with a PGSI score of 3+ were receiving treatment for a mental health or emotional problem. A quarter (25.5%) reported taking psychotropic medication and 7.0% were receiving psychological therapy.
• Few with signs of gambling harm were recognised by healthcare services. Among those with a PGSI score of 3+, one in three (35.0%) reported that they felt that they had experienced problem gambling, yet only one in fifteen (6.3%) with a PGSI score of 3+ reported that a professional had diagnosed them with gambling problems. 
• Most people experiencing moderate risk gambling had never used services or support specifically related to gambling. While a quarter (25.0%) of adults with a PGSI score of 3+ reported having used some form of gambling-specific treatment or service, this mostly comprised of self-exclusion tools such as blocking software. One participant (1.0%) reported having ever used specialist gambling treatment services or peer support such as Gamblers Anonymous.

Participation in gambling activities can lead to a wide range of harms including financial difficulties, negative effects on physical and mental health, and relationship breakdown (Langham et al. 2016). These adverse consequences range in severity and include experience of gambling disorder, a recognised behavioural addiction (World Health Organization (WHO) 2018).

Gambling behaviours were last included in the APMS series in 2007 and were measured then using the Diagnostic and Statistics Manual of Mental Disorders IV (DSM-IV) (McManus et al. 2009; Wardle et al. 2020). Other studies, like the Health Survey for England and the Gambling Survey for Great Britain have included the Problem Gambling Severity Index (PGSI) to measure adverse consequences from gambling (NHS England 2023; Wardle et al. 2024b). The PGSI has some advantages over the DSM-IV in that it was specifically developed to be used in population settings (like general population surveys). The PGSI conceptualises gambling behaviours as existing on a spectrum of severity, ranging from no risk to the experience of problem gambling (see Section 7.2 Definitions and assessments). A growing body of evidence shows that those who are below the threshold for the experience of problem gambling can also experience harms and that some in the subthreshold group experience a high level of harm (Browne and Rockloff 2018; Browne et al. 2020; Volberg et al. 2021). Using the PGSI, as APMS 2023/4 does, allows for examination of the wider spectrum of gambling behaviour. However, this means that APMS 2007 and APMS 2023/4 findings are not directly comparable.

Gambling activity, and in particular experience of adverse consequences from gambling, is a major public health concern and of great policy interest (Wardle et al. 2024a; Marionneau et al. 2022). Better understanding of the extent and nature of adverse consequences from gambling is needed to inform strategies to minimise and prevent harm (Ukhova et al. 2024).

The National Institute for Health and Care Excellence (NICE) recently published guidance on identification, assessment and management of gambling-related harms (NICE 2025). This included recommendations for healthcare professionals and social care practitioners to ask about gambling across a wide range of settings. The NICE guidelines also recognise the role health and social care professionals can play in raising awareness of and increasing use of treatment and support services for gambling and in advising the public that recovery is possible. As of December 2024, the NHS has 15 specialist gambling treatment clinics with service use having increased 130% over the preceding year. Between April and September 2024, nearly 2000 referrals were made to these services, compared with 800 referrals for the same period in 2023 (NHS England 2024).

This report provides an overview of gambling among adults in England, along with associations with sociodemographic characteristics and treatment and service use.

Gambling in the past 12 months

In the self-completion section of the phase one interview, participants were shown a list of example gambling activities and asked whether they had spent money on any of them in the past 12 months. Participants responding ‘yes’ to this question, or ‘yes’ to a further check question on whether they had gambled even ‘very occasionally’, were classed as people who had gambled in the past 12 months.

The examples of gambling activities provided were:

• buying lottery tickets or scratchcards
• betting with a bookmaker on any event or sport, including online
• online casino, slots, poker or bingo, playing slots/fruit machines/machines in a bookmakers
• bingo at a bingo hall
• table games at a casino
• playing football pools
• private betting, playing cards or games for money with friends, family or colleagues.

Online gambling

Participants were asked whether they had spent any of their own money gambling online, for example buying lottery tickets online, online instant win games, betting online or via an app, and playing games like bingo or online slots either online or via an app. Participants who had gambled online may also have participated in in-person gambling activities.

Problem Gambling Severity Index (PGSI)

The PGSI was designed for use among the general population rather than in a clinical context. It was developed, tested and validated within a general population survey of over 3,000 Canadian residents (Ferris and Wynne 2001).

The PGSI consists of nine items relating to experiences such as ‘chasing losses', ‘gambling related health problems’ and ‘feeling guilty about gambling’. The questions measure both behavioural symptoms of gambling disorder and certain adverse consequences from gambling. The PGSI was asked of everyone who had gambled in the past 12 months, capturing the current experience of each of these items.

Answer options were ‘never’, ‘sometimes’, ‘often’ and ‘always’. These response options differ slightly from the standard PGSI answer options of ‘never’, ‘sometimes’, ‘most of the time’ and ‘almost always’. Sensitivity analyses comparing data from APMS and the Health Survey for England 2018 (which used the standard format) indicate that the different wording may have very slightly underestimated the proportion of people experiencing at least moderate risk gambling in APMS. For example, we estimate that the use of standard response options on APMS may have increased the proportion of people with a PGSI score of 8+ by around 0.06 percentage points.

Responses to the nine questions were summed, and a score ranging from 0 to 27 computed. Scores were grouped into the following categories:

• PGSI score 0 - indicating a person who gambles (including heavily) but does not report experiencing any of the nine symptoms or adverse consequences asked about. In population prevalence analysis, participants who had not gambled in the past 12 months were also given a PGSI score of 0. For some analysis in this chapter, those who had not gambled in the past 12 months are included separately allowing comparisons to be made between those who had not gambled at all and those who had gambled but had a PGSI score of 0.
• PGSI score 1 to 2 - indicating low risk gambling, by which a person is unlikely to have experienced adverse consequences from gambling but may be at risk if they are heavily involved in gambling.
• PGSI score 3 to 7 - indicating moderate risk gambling, by which a person may or may not have experienced adverse consequences from gambling but may be at risk if they are heavily involved in gambling.
• PGSI score 8 to 27 - indicating problem gambling, by which a person will have experienced adverse consequences from their gambling and may have lost control of their behaviour. Involvement in gambling can be at any level but is likely to be heavy.

Due to small base sizes (<40) in the PGSI score of 8+ group, subgroup analysis in this chapter focuses on those scoring 3 or more (PGSI 3+ hereafter). This combined group (PGSI 3+) includes those experiencing moderate risk gambling (who may have experienced adverse consequences from gambling or are at greater risk of experiencing adverse consequences if they are heavily involved in gambling) and those who have definitely experienced adverse gambling consequences (PGSI score of 8+).

PGSI scores among all adults, by age and gender

The majority of adults had not gambled in the past 12 months (57.4%, 95% CI 55.7, 59.2) or had gambled but had a PGSI score of 0 (38.2%, CI 36.5, 39.9). A further 2.8% (CI 2.3, 3.5) had a PGSI score of 1 or 2, indicative of low risk gambling.

Overall, 1.6% of adults (CI 1.2, 2.1) were identified as experiencing at least moderate risk gambling, with a PGSI score of 3 to 27. This group is made up of 1.2% (CI 0.8, 1.7) with a PGSI score of 3 to 7 (indicative of moderate risk gambling), and 0.4% (CI 0.2, 0.6) with a PGSI score of 8+ (indicative of experiencing adverse consequences from their gambling and potential loss of control of behaviour).

Men (2.2%, CI 1.5, 3,0) were more likely than women (1.0%, CI 0.6, 1.7) to have a PGSI score of 3+.

The proportion of adults with a PGSI score of 3+ varied by age being more common among younger age groups: 2.0% (CI 0.7, 5.7) of those aged 16 to 24 and 3.5% (CI 2.2, 5.5) of those aged 25 to 34 had a PGSI score of 3+, compared with between 0.9% (CI 0.4, 1.7) and 1.5% (CI 0.9, 2.7) of those aged 35 to 44 and 0.3% (CI 0.1, 1.0) of those aged 75 and over. While the proportion scoring 3+ appeared to be lower in 16 to 24 year old men (1.7%, 0.4, 7.0) than women of the same age (2.4%, 0.5, 10.1), the base sizes for these subgroups were small and confidence intervals overlapped greatly.

For more information: Table 7.1 and Table A1 for confidence intervals

PGSI scores among adults who had gambled in the past 12 months, by age and gender

PGSI scores among those participating in any gambling

About two fifths (42.6%) of adults reported taking part in some form of gambling in the past 12 months.

Among those who had gambled, most had a PGSI score of 0 (89.7%), indicating no experience of adverse consequences, and 6.6% had a score of 1 or 2, indicating low risk gambling. The remaining 3.7% scored 3 to 27, indicating experiencing at least moderate risk gambling. Of these, 0.9% had PGSI scores of 8+.

The proportion of those who had gambled with a PGSI score of 3+ varied by age, ranging from 8.1% for those aged 16 to 34 to 0.9% for those aged 75 and over. Mean PGSI scores followed a similar pattern, decreasing with advancing age (0.6 for those aged 16 to 34; 0.1 for those aged 75 and over).

PGSI scores among those participating in online gambling

Overall, 28.9% of adults who had gambled in the past 12 months reported gambling online (including purchase of National Lottery tickets online). Of these, the majority had a PGSI score of 0 (87.0%) and a further 8.4% were identified as experiencing low risk gambling with a PGSI score of 1 or 2. Almost one in twenty (4.6%) of those who gambled online had a PGSI score of 3+, indicating that they experienced at least moderate risk gambling. Of these, 1.2% had a PGSI score of 8+.

Among those who had gambled online, PGSI scores of 3+ were more common among men (5.9%) than women (3.0%). PGSI scores of 3+ were also more common among younger adults who had gambled online. One in ten adults aged 16 to 34, who had gambled online, had a PGSI score of 3+ (9.5%). This decreased with age to 1.5% for those aged 75 and above.

For more information: Table 7.2 

PGSI score of 3+ by other characteristics

Ethnic group

In age-standardised analyses based on all adults, the proportion with a PGSI score of 3+ varied by ethnic group, being highest among those in the Mixed/multiple or other ethnic group (3.5%, 95% CI 1.2, 10.2) and lowest among Asian/Asian British (0.4%, CI 0.1, 1.5) and Black/Black British (0.5%, CI 0.2, 1.8) adults.

These estimates may be affected by subgroup differences in the level of engagement in gambling. The ethnic groups least likely to have a PGSI score of 3+ were also the least likely to gamble. For example, 81.3% (CI 75.6, 85.9) of Asian/Asian British adults had not gambled, compared with 52.3% (CI 50.3, 54.4) of White British adults. Mean PGSI scores among those who gambled in the past 12 months were similar (0.3) for both White British and Asian/Asian British groups meaning that among those who did gamble, PGSI scores were similar. It should be noted that the confidence intervals for some estimates were wide and overlapping, so apparent differences between ethnic groups should be treated with caution.

For more information: Table 7.3 and Table A2 for confidence intervals

Employment status

There were no statistically significant differences in the proportion of adults with PGSI scores of 3+ by employment status (age-standardised). 

For more information: Table 7.4

Problem debt

In age-standardised analyses, being seriously behind on at least one debt repayment or having utilities cut off was associated with PGSI scores of 3+. 7.4% of men and 3.5% of women with problem debt had a PGSI score of 3+, compared with 1.7% of men and 0.8% of women without problem debt. See the APMS 2023/4 Methods documentation for more information on how problem debt was derived.

For more information: Table 7.5

Area-level deprivation

There were no statistically significant differences in the proportion of adults with PGSI scores of 3+ by area level deprivation (age-standardised).

For more information: Table 7.6 

Region

There were no statistically significant differences in the proportion of adults with PGSI scores of 3+ by region (age-standardised).

For more information: Table 7.7

Comorbidity

Physical health conditions

In age-standardised analyses, adults with a limiting physical health condition were more likely to have a PGSI score of 3+ (2.6%) than those without a limiting physical health condition (1.3%).

Common mental health conditions

Adults with a common mental health condition were more likely to have a PGSI score of 3+ (2.6%) than those without a common mental health disorder (1.3%).

For more information: Table 7.8

Self-diagnosis and professional diagnosis of gambling problems

Participants were asked whether they thought they had ever experienced ‘gambling problems’. Those who responded yes were asked whether this had been diagnosed by a professional, and if so, whether diagnosed gambling problems had been present in the past 12 months.

Overall, 1.0% of adults reported that they felt they had experienced gambling problems at some point in their life (self-diagnosed), and 0.1% of adults stated that they had been diagnosed with gambling problems by a professional.

Adults with higher PGSI scores were more likely to report that they felt they had experienced gambling problems. Among those with a PGSI score of 3+, a third (35.0%) thought that they have had gambling problems (self-diagnosed) and 6.3% reported that gambling problems had been diagnosed by a professional. 1.4% reported the presence of diagnosed gambling problems in the past 12 months.

Among those who gambled but had a PGSI score of 0, 0.7% felt that they have experienced gambling problems and none reported that a professional had ever diagnosed them with gambling problems.

Among those who had not gambled in the past 12 months, 0.4% reported that they felt they have had gambling problems and 0.1% (or about one in four of those reporting having ever experienced gambling problems) stated that gambling problems had been diagnosed by a professional.

For more information: Table 7.9 

Treatment

Treatment and service use for mental or emotional problems

Participants were asked about use of different types of mental health treatment and services. Two types of mental health treatment were asked about: current medication and psychological therapy for a mental or emotional problem. Use of a range of health, community and day care services over the past year were also asked about. This treatment and service use could have been for any mental health condition and was not necessarily related to gambling.

Of those with a PGSI score of 3+:

• 30.1% reported that they were currently receiving treatment (psychological therapy and/or medication) for a mental or emotional problem (compared with less than 17% of those in all other PGSI groups).
• 33.1% reported having used a health care service for a mental health related reason (compared with 11.8% of those with a PGSI score of 0).
• 8.0% reported community care and 4.7% reported day care services used in the past year. Those with a PGSI score of 3+ were not significantly more likely to use such services than those in other PGSI groups.

Among those with a PGSI score of 3+, 25.5% reported they were receiving medication compared with 10.8% with a PGSI score of 0, while receipt of psychological therapy was similar (7.0% with a PGSI score of 3+, 4.8% with a PGSI score of 0).

For more information: Table 7.10

Types of psychotropic medication

Participants were asked which (if any) psychotropic medications they were taking for a mental health reason (not necessarily for symptoms relating to gambling behaviour). The most common medication types reported by all adults were those primarily used to treat depression (11.7%) and anxiety (10.7%). See Chapter 2 Mental health treatment and service use for more details.

Those with higher PGSI scores were more likely to report currently taking medication used to treat mental health conditions than those with lower PGSI scores (25.5% for those with a PGSI score of 3+; 10.8% for those with a PGSI score of 0).

Among those with a PGSI score of 3+ the most common types were those primarily used to treat depression (25.0%) or anxiety (20.7%).

For more information: Table 7.11

Treatment and support specifically for gambling problems

Participants who reported gambling in the past 12 months were asked whether they had ever received any treatment or support specifically related to gambling. The list of types of treatment and support that they were asked about included specialist gambling treatment services or peer support, gambling related counselling or talking therapy, self-exclusion (such as use of blocking software or blocking bank transactions), or other treatment or support.

Adults with higher PGSI scores were more likely to report receiving gambling treatment and/or services than those with lower scores. One quarter (25.0%) of adults with a PGSI score of 3+ had received support or treatment related to their gambling, compared with 0.9% of those with a PGSI score of 0.

Among those with a PGSI score of 3+, the most commonly reported treatment or support action was self-exclusion tools (such as blocking software or blocking bank transactions (14.6%)). The proportion of those with a PGSI score of 3+ having ever accessed formal gambling treatment and support services was lower, with 1.0% reporting use of specialist gambling support services including peer support, and 3.2% reporting use of gambling related counselling, therapist or other mental health services.

For more information: Table 7.12 

The estimated prevalence of problem gambling, 0.4%, is likely to be conservative. Overall, 0.4% of participants had a PGSI score of 8+, indicating the experience of problem gambling. This is broadly in line with estimates from the Health Survey for England (HSE) series. The HSE used slightly different PGSI response option wording and included two different instruments to estimate problem gambling, of which the PGSI produced somewhat lower estimates than the DSM-IV. Reporting of problem gambling from the HSE typically focused on people who were identified according to either instrument, as they capture a different range of behavioural symptoms and adverse consequences (NHS England 2023). APMS 2023/4 only includes the PGSI and thus the estimates presented here should be treated as conservative.

At least moderate risk gambling was evident in 1.6% of adults, as indicated by PGSI scores of 3+. The Gambling Survey for Great Britain showed that 40% of people who experienced one or more severe adverse consequences from gambling (relationship breakdown, crime, experience of violence or losing something of significant financial value) had PGSI scores of less than 8, demonstrating how experience of harms is more widely distributed across the PGSI spectrum (Wardle et al. 2024b). Sole focus on PGSI scores of 8+ misses the wider experience of these harms.

The results provide insight into gambling harms across the life course. APMS 2023/4 also shows a wider range of people who report ever having experienced adverse consequences from gambling. While estimates may seem low (0.7% for those with a PGSI score of 0 and 0.4% of those who had not gambled) these groups represent the majority of the population, further demonstrating that harms from gambling are more widely dispersed than a focus on those with a current PGSI score of 8+ alone may suggest.

There is substantial unmet need for gambling treatment and services. Data produced for the Office for Health Improvement and Disparities (OHID) suggested that anyone with a PGSI score of 3+ might benefit from at least brief interventions for gambling harms, with those with PGSI scores of 8+ potentially benefiting from more extensive cognitive behavioural therapies (OHID 2024). However, data from APMS 2023/4 shows that only a very small minority of people with these scores are accessing these kinds of services – less than 4% of people with a PGSI score of 3+ reported accessing talking therapies or counselling services for gambling. There remains substantial unmet need for gambling treatment and support services, with the most common support action among those with PGSI scores of 3+ being self-exclusion using tools such as blocking software or blocking bank transactions.

There is a need for a coordinated response to identify and support people experiencing gambling harms. While those with PGSI scores of 3+ were typically not receiving any support or treatment for gambling, some reported receiving support and treatment for other emotional or mental health issues. A third (33.1%) of those with a PGSI score of 3+ reported using health services for a mental or emotional issue. It is not clear whether these services were sought in relation to adverse consequences from gambling, for other mental or emotional issues, or for some combination of the two. Nonetheless, it is essential that service providers treating people for mental and emotional health issues are aware of concurrent gambling harms as this can complicate treatment outcomes. The National Institute for Health and Care Excellence (NICE) guidelines on gambling harm identification, assessment and management recognise this and recommend that mental and physical health services and gambling harm treatments services, including the support provided by local authorities and social care, are coordinated (NICE 2025).

Among people with PGSI scores of 3+ 35.0% recognised they had gambling problems but just 6.3% had a professional diagnosis. In terms of gambling specific treatment, 14.6% had used self-exclusion tools while 1.0% had received specialist gambling treatment or peer support, suggesting self-recognition of and proactive attempts to reduce gambling related harms. Gambling is often termed the 'hidden' addiction, with people not seeking support until they reach crisis point (Hing 2012; Itäpuisto 2019; Suurvali et al. 2009). Embedding the identification of gambling harms, as recommended by NICE, into health and social care service pathways is key to addressing the lack of service use identified within this report.

Browne, M., & Rockloff, M. J. (2018). Prevalence of gambling-related harm provides evidence for the prevention paradox. Journal of Behavioral Addictions, 7(2), 410-422.

Browne, M., Volberg, R., Rockloff, M., & Salonen, A. H. (2020). The prevention paradox applies to some but not all gambling harms: Results from a Finnish population-representative survey. Journal of Behavioral Addictions, 9(2), 371-382.

Ferris, J., Wynne, H. (2001). The Canadian Problem Gambling Index: Final Report. Canada: The Canadian Centre on Substance Abuse.

Hing, N., Nuske, E., & Gainsbury, S. (2012). Gamblers at-risk and their help-seeking behaviour. Melbourne: Gambling Research Australia.

Itäpuisto M. (2019). Problem Gambler Help-Seeker Types: Barriers to Treatment and Help-Seeking Processes. Journal of gambling studies, 35(3), 1035–1045. Langham, E., Thorne, H., Browne, M. et al. Understanding gambling related harm: a proposed definition, conceptual framework, and taxonomy of harms. BMC Public Health, 16, 80 (2015).

Langham, E., Thorne, H., Browne, M., Donaldson, P., Rose, J., & Rockloff, M. (2016). Understanding gambling related harm: A proposed definition, conceptual framework, and taxonomy of harms. BMC Public Health, 16, 80.

Marionneau, V., Egerer, M., & Raisamo, S. (2022). Frameworks of gambling harms: a comparative review and synthesis. Addiction Research & Theory, 31(1), 69–76.

McManus S, Meltzer H, Brugha T, Bebbington P (eds). (2009). Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey. The NHS Information Centre for health and social care.

National Institute for Care and Excellence. (2025). Gambling-related harms: identification, assessment and management [NG248]. https://www.nice.org.uk/guidance/ng248

NHS England. (2023). Health Survey for England, 2021 part 2. https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2021-part-2

NHS England. (2024). NHS Gambling Referrals Data. https://digital.nhs.uk/supplementary-information/2024/nhs-gambling-referrals-data

Office for Health Improvement & Disparities. (2024). Gambling treatment need and support in England: main findings and methodology. https://www.gov.uk/government/publications/gambling-treatment-need-and-support-prevalence-estimates/gambling-treatment-need-and-support-in-england-main-findings-and-methodology

Public Health England and Office for Health Improvement & Disparities. (2023). Gambling-related harms evidence review: summary. https://www.gov.uk/government/publications/gambling-related-harms-evidence-review/gambling-related-harms-evidence-review-summary--2

Suurvali, H., Cordingley, J., Hodgins, D. C., & Cunningham, J. (2009). Barriers to seeking help for gambling problems: a review of the empirical literature. Journal of Gambling Studies, 25(3), 407–424.

Ukhova, D., Marionneau, V., Nikkinen, J., & Wardle, H. (2024). Public health approaches to gambling: a global review of legislative trends. The Lancet Public Health, 9(1), e57-e67.

Volberg, R. A., Zorn, M., Williams, R. J., & Evans, V. (2021). Gambling Harm and the Prevention Paradox in Massachusetts. ADDICTA: The Turkish Journal on Addictions, 8(3).

Wardle, H., Degenhardt, L., Marionneau, V., Reith, G., Livingstone, C., Sparrow, M., ... & Saxena, S. (2024a). The Lancet Public Health Commission on gambling. The Lancet Public Health, 9(11), e950-e994.

Wardle, H., John, A., Dymond, S., & McManus, S. (2020). Problem gambling and suicidality in England: secondary analysis of a representative cross-sectional survey. Public Health, 184, 11-16.

Wardle, H., Ridout, K., Tipping, S., Maxineanu, I., Wilson, H., and Hill, S. (2024b). Gambling Survey for Great Britain - Annual report (2023): Official statistics. https://www.gamblingcommission.gov.uk/report/gambling-survey-for-great-britain-annual-report-2023-official-statistics

World Health Organization. (2018). International Classification of Diseases 11th Revision (ICD-11). Geneva: 2018.

Please cite this chapter as:  

Bennett, M., Spencer, S., Hill, S., Morris, S., McManus, S., & Wardle, H. (2025). Gambling behaviour. In Morris, S., Hill, S., Brugha, T., McManus, S.  (Eds.), Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2023/4. NHS England.