accepted for publication in Journal of Public Mental Health, September 2018 1 Geographical variation in GP drug prescribing for Schizophrenia and similar psychosis in England. Allan J. Brimicombe & Pat Mungroo Centre for Geo-Information Studies, University of East London Abstract Visualising and analysing geographical patterns in mental illness can be a starting point for understanding and creating effective policy around inequalities and how to resolve them. This research note looks at geographical variations in GP prescribing for Schizophrenia and similar psychosis using open Presentation- level Data for England downloaded from NHS Digital. We found considerable geographical variation in both the level of prescribing per thousand population at Local Authority level and in the rate of change measured over five years. There is a statistically significant north-south divide in prescribing. We have used social marketing geodemographics to explore possible correlates with the geographical patterns. Highest positive correlations shows links to deprivation and less healthy lifestyle choices. Seeing the geographical variation is in itself informative and a potential eye-opener. In doing so, new questions can be asked of the data, practice and policy. Keywords: Schizophrenia, psychosis, prescribing, geography, England 1. Introduction Mental health has been rising up the UK political agenda with the Prime Minister announcing in January 2017 that her Government will transform the way it deals with mental health problems 1 . Investigative journalism such as BBC’s Panorama has portrayed a scene of deteriorating national funding for mental health care 2 . Visualising and analysing geographical patterns in mental illness can be a starting point for understanding and creating effective policy around inequalities and how to resolve them. For example, Rowlinson et al. (2013) have used open source prescription dispensing data to look at geographical variations in spending per person on metformin and methylphenidate. This research note looks at GP prescribing for Schizophrenia but also similar psychosis as the medications prescribed can be used for a range of diagnoses. These illnesses were chosen because of the on-going debate on their causes in relation to a genetic predisposition, environmental factors such as stress, family dynamics and changes in lifestyle, the abuse of alcohol and drugs, or a combination of these (see, for example, Kirkbride et al., 2010). We link local authority level mapping for England to a geodemographic and lifestyle classification to provide some initial insight into the patterns. We also identify a significant north-south divide. We believe that such maps of prescribing for Schizophrenia have not been produced before. 2. Methods Monthly files on GP Practice Prescribing Presentation-level Data for England were downloaded from NHS Digital 3 for the periods October to September 2010/11 and 2015/16. This resulted in two years of data, five years apart - a data set in the region of 240 million data records. The separately downloadable lists of chemical substances for each period were joined so as to include both discontinued and newly introduced substances. Those prescribed for Schizophrenia and similar psychosis were then identified (listed in Table 1) and used to extract numbers of prescriptions for them from the main data set. The separately downloadable lists of GP practices for each period were joined and georeferenced from the practice postcode to the Office of National Statistics (ONS) Local Authority code. The extracted prescriptions for each period could then be aggregated by the 326 local authorities in England. These data were matched with lifestyle classification P 2 1 https://www.gov.uk/government/news/prime-minister-unveils-plans-to-transform-mental-health-support 2 http://www.bbc.co.uk/programmes/b08f0htn 3 http://content.digital.nhs.uk/article/2021/Website-Search?q=GP+practice+prescribing&go=Go&area=both