Abstract

In a given week, one in five adults in England take antidepressants or medication for anxiety. Despite the large variance between regions, there is little understanding of why certain regions have highly elevated prescription levels. We adopted a psycho-social model to investigate spatial prescription patterns by analysing 4.1 billion general, 95 million anxiety-specific, and 178 million depression-specific prescriptions issued in England between 2015 and 2019. We found three possible explanations for why certain regions have highly elevated mental health prescription levels per capita. Areas with elevated levels tended to be: i) smaller ii) be contextually privileged (i.e., short distance to GP); but, more interestingly, iii) affected by high work barriers. By then controlling for these three explanatory variables and matching the prescription data with England’s largest personality survey, we found strong evidence for a potential alternative to mental health drug prescriptions: social activity. Indeed, areas with large proportions of residents scoring high on the extraversion activity facet displayed significantly less anxiety and depression prescriptions. This result offers new evidence and urges the adoption of schemes similar to the social prescribing scheme recently piloted by NHS England in which doctors refer patients to non-medical treatments such as local volunteer groups (e.g., community gardens, community businesses, art and craft centres), reducing both costs and pressure on doctors.