Soc PsychiatryPsychiatr Epidemiol (1995) 30:1-4 9 Springer-Verlag 1995 R. Jenkins - H. Meltzer The National Survey of Psychiatric Morbidity in Great Britain The formulation and implementation of an effective mental health policy, at either national or subnational level, that will meet the mental health needs of the po- pulation requires a sound framework of mental health information. Such a framework must include informa- tion, first on incidence, prevalence, severity and dura- tion of illness; secondly, on the inputs of staff, beds, clin- ics and training; thirdly, on the processes of accessing and obtaining treatment, consultation with primary care services, diagnosis and treatment in primary care, referral to secondary care, hospital admissions and man- agement in the community including, in Britain, the Care Programme Approach and Supervision Registers; fourthly, on the patient health outcomes in terms of morbidity and mortality. Hitherto, in England, the Department of Health has had information on the incidence and prevalence of spe- cific mental disorders in the general population from relatively small-scale research studies in single geo- graphical areas, but these can be difficult to generalise to the whole population. It has also had detailed infor- mation on the use of hospital inpatient beds broken down by diagnosis, age and sex, but it has not had infor- mation on outpatient attendances by diagnosis; nor has it had national information on how far needs for health and social care are being met appropriately. This last would entail combining a study of prevalence of mental illness and accompanying social disability with a study of service use (Department of Health 1993 b). Therefore, planning and conceptional development for the survey was started 5 years ago by the Depart- ment of Health for England, in conjunction with the Of- fice of Population Censuses and Surveys, to supply some of the information the Department needs on mental health. During this period, England published a pio- neering health strategy "The Health of the Nation" R. Jenkins (f~) - H. Meltzer Mental Health, Elderly and Disability Health Care (Medical) Division, Department of Health, Room 307 Wellington House, 133-155 Waterloo Road, London SE1 8UG, UK (Department of Health 1992) which, for the first time, set targets for real health outcomes (Jenkins 1990), rath- er than simply for service processes either as ends in themselves or as proxies for outcomes. In this strategy document, mental illness was identified as one of the five key areas for priority action, and it sets targets for improving the health and social functioning of people with mental illness and for reducing mortality from sui- cide. The strategy for achieving these targets has three aspects - first, to improve information and understand- ing about mental illness, secondly to develop local com- prehensive services, and thirdly to develop good prac- tice in assessment, diagnosis and management of men- tal illness (Department of Health 1994; Jenkins 1994). A national survey of psychiatric morbidity was there- fore an external component fo the Health of the Nation Mental Illness key area action plan to improve informa- tion on mental illness, and in 1992 the Department of Health for England, in conjunction with the Scottish Of- fice and the Welsh Office, commissioned OPCS to carry out a survey of psychiatric morbidity as defined by ICD- 10 (WHO 1993), combining household and institution- alised populations to represent the whole population: the nature and extent of associated social disability; the nature and extent of comorbidity; use of services; and recent precipitating factors of illness and their associa- tion with different lifestyles. The survey is being co-ordinated by a Department of Health steering group chaired by Rachel Jenkins and carried out by an OPCS team led by Howard Meltzer. The steering group contains representation from the Department of Health, OPCS and expert epidemiolo- gists. It meets regularly to review and reach consensus on methodological issues such as sampling, instru- ments, data analysis, preparation and dissemination of reports, and coordinates the overall programme and timetables. The steering group for the survey arose out of an ear- lier working group also chaired by Rachel Jenkins, which reviewed the mental health information needs of the Department of Health, reviewed the adequacy of