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Neighbourhood Determinants of the Common Mental Disorders

Contact details

David Fone, Professor of Health Sciences Research, Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, 4th Floor Neuadd Meirionnydd, Heath Park, Cardiff  CF14 4YS

Telephone: 029 20 687241; Email: Foned@cf.ac.uk


Prof Frank Dunstan, Prof Keith Lloyd, Dr Ann John, Dr Mark Kelly, Dr Giles Greene, Dr Daniel Farewell and Ms Lynn Jessop


Mental health is an important indicator of individual and population health status. The most common symptoms of poor mental health in the general population are anxiety and depression, which make up the bulk of the ‘common mental disorders’. These have a population prevalence of 15% to 30%, depending on the case definition used. They constitute a major public health burden of reduced physical and social functioning, higher mortality and lost productivity, accounting for up to one-third of sickness absence from work.

Our central research question is whether the consistently observed geographical variation in the prevalence of the common mental disorders reflects variation in levels of individual risk factors for poor mental health or whether there are area-level, or contextual, effects on mental health that operate directly or indirectly through social, psychological and biological mechanisms related to factors in the social and physical environment. The current evidence from research investigating contextual explanations for the variation in population mental health status remains inconclusive. We are also investigating more robust statistical methodologies for the analysis of neighbourhood effects on mental health.

Summary of activity

Three studies have been formally adopted to run on the MHRN-C:

Welsh Assembly Government /Medical Research Council Health Research Partnership Award 2007

Fone DL, Dunstan FD, Lloyd K. Neighbourhood determinants of the common mental disorders: the Caerphilly Health and Social Needs Longitudinal Study. April 2008 – July 2010. £260,580 80% FEC. H07-3-30

John A, Lloyd K, Fone DL, Dunstan FD, Lyons R, Ford D, Thomas R. MINISAIL: Using routine data to estimate service need for Common Mental Disorders in Primary Care. April 2008 – May 2012. £52, 813.60 80% FEC. H07-3-33

NISCHR National Institute for Social Care and Health Research. Welsh Assembly Government Translational Health Research Platform Award

Fone DL, Dunstan FD, Lyons RA, Lloyd K, White J, John G. Risk of hospital admission and cause-specific mortality associated with common mental disorder: the Caerphilly Health and Social Needs electronic cohort study. April 2009 – December 2012. £174,671.


  • Fone DL, Dunstan FD, Williams G, Lloyd K, Palmer SR. Places, people and mental health: A multilevel analysis of economic inactivity. Social Science & Medicine 2007:64:633-645.
  • Fone DL, Dunstan FD, Lloyd K, Williams G, Watkins J, Palmer SR. Does social cohesion modify the association between area income deprivation and mental health? A multilevel analysis. International Journal of Epidemiology 2007; 36:338-345.
  • Fone DL, Lloyd K, Dunstan FD. Measuring the neighbourhood using UK benefits data: a multilevel analysis of mental health status. BMC Public Health 2007, 7:69.
  • Fone DL, Dunstan FD, John A, Lloyd K. Associations between the common mental disorders and the Mental Illness Needs Index in community settings: a multilevel analysis. Br J Psych 2007:191:158-163.
  • Kelly MJ, Dunstan FD, Lloyd K, Fone DL. Evaluating cutpoints for the MHI-5 and MCS using the GHQ-12: A comparison of five different methods. BMC Psychiatry 2008, 8:10.