Mental health

1. Key messages

Many indicators of mental health and emotional well-being point to a worsening of these conditions in the Belgian population. The percentage of people with depressive feelings, anxiety disorders, and/or severe sleep problems has lately shown a strong increase. More people report that they have (had) suicidal thoughts, although the figures for attempted suicide remain constant. A parallel increase in the use of antidepressants is identified, while the use of sleeping pills or tranquillizers remains constant or even decreases.
In general, the indicators of mental health and emotional well-being show a better situation in the Flemish Region than in the other two regions of the country.
Except for the indicators on suicidal behaviours, all indicators related to psychological problems occur more often in women than in men. An important point of attention seems to be women in the 15-24 age group, where a significant increase in depressive and anxiety disorders is observed.
All examined mental health indicators are linked to the educational level. Emotional disorders, suicidal behaviours and use of psychotropic medicines were more frequent in the lowest educated groups compared with the higher educated.

2. Background

Mental health is the capacity of each and all of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity [1] Due to the high frequency of mental problems in western societies and the significance of their costs in human, social and economic terms, mental health is now regarded as a public health priority. In Belgium, the Health Interview Survey is one of the main sources of systematic data on mental health parameters in the general population aged 15 or older [2]. Among the various dimensions of mental health that are monitored in this survey, we focus on the following three indicators:

  • Indicators of specific psychological problems, based on the self-report psychometric instrument SCL-90-R (Symptom Checklist-90-R)
  • Indicators concerning suicidal thoughts and attempts
  • Indicators concerning the use of psychotropic medicines

However, it should be noted that the evaluation of mental health problems in the population through a health survey has a number of limitations. These are mainly related to the fact that the estimates are based on screening instruments for psychological problems or on the reporting of the individuals themselves, and thus are not obtained by clinical diagnostic tools, which are often more nuanced. Nevertheless, the results of general population health surveys are generally in line with the findings of specific mental health surveys.

3. Psychological disorders

The assessment of specific psychological disorders indicated that, in 2013, 15% of the population older than 15 was experiencing depressive disorders, 10% had anxiety disorders, and 30% reported severe sleeping problems. Compared to the previous survey years, the prevalence of all three types of disorders increased significantly, both at the national and the regional levels. All three disorders have a lower prevalence in the Flemish Region than in Brussels and the Walloon Region.

  • Depressive disorders
  • Anxiety disorders
  • Sleeping problems

Prevalence of depressive disorders in Belgium and its regions, 2001-2013
Source: Own calculations based on Health Interview Survey, Sciensano, 2001-2013 [2]

Prevalence of anxiety disorders in Belgium and its regions, 2001-2013
Source: Own calculations based on Health Interview Survey, Sciensano, 2001-2013 [2]

Prevalence of severe sleeping problems in Belgium and its regions, 2001-2013
Source: Own calculations based on Health Interview Survey, Sciensano, 2001-2013 [2]

All three psychological disorders are more common among women than among men. Depressive and anxiety disorders are common among all age groups. An important point of concern are the recent trends among young women aged 15-24 years, with steep increases in the prevalence of depressive disorders (from 7% in 2008 to 21% in 2013) and anxiety disorders (from 5% in 2008 to 15% in 2013).

  • Depressive disorders
  • Anxiety disorders
  • Sleeping problems

Prevalence of depressive disorders by age and sex, Belgium, 2013
Source:  Health Interview Survey, Sciensano, 2013 [2]

Prevalence of anxiety disorders by age and sex, Belgium, 2013
Source:  Health Interview Survey, Sciensano, 2013 [2]

Prevalence of severe sleeping problems by age and sex, Belgium, 2013
Source:  Health Interview Survey, Sciensano, 2013 [2]

Psychological disorders are less common in the group with the highest level of education than in the groups with lower educational levels.

Prevalence of psychological disorders by educational level, Belgium, 2013
Source: Own calculations based on Health Interview Survey, Sciensano, 2013 [2]

4. Suicidal ideation and attempts

More people in the Belgian population aged 15 and older report that they have had suicidal thoughts (in their lifetime or recently). In contrast, the percentage of people who have actually tried to commit suicide (in their lifetime or recently) has not evolved. In 2013, 5% of the population said that they had seriously thought about committing suicide in the past 12 months and 0.4% reported having actually attempted suicide in this time period. 4% of the Belgian population aged 15 and older reported at least one suicide attempt during their lifetime.

In the Flemish Region, the figures are more favorable than in the other two regions of the country for suicide (thoughts and attempts) ever in life, but these regional differences are not observed for recent suicidal thoughts and attempts (<12 months).

  • Suicidal thoughts
  • Suicide attempts

Prevalence of suicidal thoughts during the past 12 months in Belgium and its regions, 2008-2013
Source: Own calculations based on Health Interview Survey, Sciensano, 2008-2013 [2]

Lifetime prevalence of suicide attempts in Belgium and its regions, 2004-2013
Source: Own calculations based on Health Interview Survey, Sciensano, 2004-2013 [2]

Recent suicidal thoughts and attempts are as common in men as in women. On the other hand, more women than men report that they have tried to put an end to their lives at least once in their lives.

The indicators of suicidal thoughts and attempts (lifetime or recent) do not show a clear age pattern. Although suicidal thought and attempts are less reported by the elderly (75+), this is in contradiction with the effective suicide figures, which are high among the oldest people, especially so for men.

  • Suicidal thoughts
  • Suicide attempts

Prevalence of suicidal thoughts during the past 12 months by age and sex, Belgium, 2013
Source: Health Interview Survey, Sciensano, 2013 [2]

Lifetime prevalence of suicide attempts by age and sex, Belgium, 2013
Source: Health Interview Survey, Sciensano, 2013 [2]

Suicidal thoughts (in lifetime or recently) are not related to the level of education, but the transition to the act would be: fewer people from high education households have attempted to commit suicide, both in their lifetime and in the past 12 months.

Prevalence of recent suicidal ideation and lifetime suicidal attempts by educational level, Belgium, 2013
Source: Own calculations based on Health Interview Survey, Sciensano, 2013 [2]

5. Consumption of psychotropic medicines

In 2013, 16% of the population reported using one of the following medicines in the two weeks preceding the survey (sometimes in combination): sleeping pills or tranquillizers (13%) and antidepressants (8%).

The use of psychotropic medicines is higher in the Walloon Region (19%) than in Brussels (13%) and the Flemish Region (16%). This difference is mainly explained by the higher use of antidepressants in the Walloon Region (9.5% versus 6.9% and 6.7% in Brussels and the Flemish Region, respectively).

During the period 1997-2013, the use of sleeping pills or tranquillizers has remained constant among the residents of the Flemish Region, and has even declined in the Brussels and Walloon Region. The use of antidepressants, on the other hand, shows a rising trend over time in the three regions of the country. For Belgium as a whole, applying these figures on a standardized population in terms of age and sex, the use of antidepressants almost doubled over the 15-year time period (from 4.2% in 1997 to 7.7% in 2013).

  • Sleeping pills or tranquillizers
  • Antidepressants

Consumption of sleeping pills or tranquillizers in Belgium and its regions, 1997-2013
Source: Own calculations based on Health Interview Survey, Sciensano, 1997-2013 [2]

Consumption of antidepressants in Belgium and its regions, 1997-2013
Source: Own calculations based on Health Interview Survey, Sciensano, 1997-2013 [2]

Proportionally, women use psychotropic medicines more often than men (20% versus 12%, respectively). The gender difference is particularly evident for the use of sleeping pills or tranquillizers (16% versus 10%), but also for the use of antidepressants (9.5% versus 5.6%).

The use of psychotropic medicines was also much more frequent after the age of 45, especially in the most elderly age group. This increase with age was more pronounced for women than for men.

  • Sleeping pills or tranquillizers
  • Antidepressants

Consumption of sleeping pills or tranquillizers by age and sex, Belgium, 2013
Source: Health Interview Survey, Sciensano, 2013 [2]

Consumption of antidepressants by age and sex, Belgium, 2013
Source: Health Interview Survey, Sciensano, 2013 [2]

The use of psychotropic medicines, whatever they are, is more common in households with the lowest level of education.

Consumption of psychotropic medicines by educational level, Belgium, 2013
Source: Own calculations based on Health Interview Survey, Sciensano, 2013 [2]

6. Read more

View the metadata for this indicator

HISIA: Interactive Analysis of the Belgian Health Interview Survey

Definitions

Symptom Checklist-90-Revised
The "Symptom Checklist-90-Revised" (SCL-90-R) was used to gauge psychological disorders. It examines the current symptomatology of the person (in the past week). From a technical point of view, the subscales of SCL-90-R correspond to different disorders derived from a factor structure. It is an instrument that has acceptable psychometric criteria and is commonly used in general population studies. The subscales included in the 2013 Health Interview Survey are limited to those of depressive disorders, anxiety disorders, and sleep problems.

References

  1. https://www.canada.ca/en/public-health/services/health-promotion/mental-health/mental-health-promotion.html
  2. Health Interview Survey, Sciensano, 1997-2013. https://his.wiv-isp.be/