Factors associated with non-referral among people with (A) mental health needs and (B) social needs: risk ratios and 95% CIs (objective 4)
| (A) People with mental health needs | |||
| % with mental health needs who had no new or active referral (n/n) | Unadjusted RR (95% CI) | Adjusted RR (95% CI) | |
| Total | 29.9 (6503/21 719) | ||
| Gender (N=21 719) | |||
| Men | 31.8 (3046/9578) | 1.12 (1.07 to 1.16) | 1.14 (1.09 to 1.18) |
| Women | 28.5 (3457/12 141) | 1 | 1 |
| Age group (N=21 719)* | |||
| 15–19 | 40.6 (1272/3137) | 1.86 (1.51 to 2.28) | 1.81 (1.47 to 2.23) |
| 20–24 | 33.9 (1342/3954) | 1.55 (1.26 to 1.91) | 1.53 (1.25 to 1.89) |
| 25–34 | 29.3 (1632/5579) | 1.39 (1.09 to 1.65) | 1.30 (1.06 to 1.60) |
| 35–44 | 27.0 (1236/4686) | 1.24 (1.00 to 1.52) | 1.17 (0.95 to 1.44) |
| 45–64 | 22.5 (948/4140) | 1.05 (0.85 to 1.29) | 0.98 (0.80 to 1.21) |
| 65 | 21.9 (73/334) | 1 | 1 |
| Ethnic group (N=21 230)* | |||
| White | 29.0 (5452/18 816) | 1 | 1 |
| Black | 41.3 (239/579) | 1.42 (1.29 to 1.57) | 1.42 (1.29 to 1.57) |
| Indian/Pakistani/Bangladeshi | 38.7 (368/951) | 1.34 (1.23 to 1.45) | 1.32 (1.21 to 1.43) |
| Mixed race | 28.0 (128/458) | 0.96 (0.83 to 1.12) | 0.98 (0.85 to 1.14) |
| Chinese | 61.8 (34/55) | 2.13 (1.73 to 2.63) | 2.09 (1.68 to 2.59) |
| Other | 33.4 (124/371) | 1.15 (1.00 to 1.33) | 1.18 (1.02 to 1.36) |
| Employment status (N=20 419)* | |||
| In work or study | 37.2 (2935/7897) | 1 | 1 |
| Unemployed | 26.2 (2467/9421) | 0.70 (0.67 to 0.74) | 0.71 (0.68 to 0.74) |
| Registered sick | 19.9 (355/1786) | 0.53 (0.49 to 0.59) | 0.51 (0.46 to 0.56) |
| Retired | 23.2 (113/488) | 0.62 (0.53 to 0.73) | 0.62 (0.53 –to 0.73) |
| Looking after the home or family/other | 34.3 (284/827) | 0.92 (0.84 to 1.02) | 0.89 (0.81 to 0.99) |
| Area level deprivation (IMD quintile) (N=20 783)* | |||
| 1 (least deprived) | 29.5 (1260/4270) | 1 | 1 |
| 2 | 27.9 (1169/4189) | 0.95 (0.88 to 1.01) | 0.97 (0.91 to 1.04) |
| 3 | 28.5 (1165/4088) | 0.97 (0.90 to 1.03) | 0.97 (0.91 to 1.04) |
| 4 | 29.6 (1225/4137) | 1.00 (0.94 to 1.07) | 1.01 (0.95 to 1.08) |
| 5 (most deprived) | 32.5 (1334/4099) | 1.10 (1.03 to 1.18) | 1.09 (1.03 to 1.17) |
| Primary psychiatric diagnosis (N=21 719) | |||
| None recorded | 38.5 (3784/9819) | 1 | 1 |
| Mood disorder | 15.6 (584/3737) | 0.41 (0.37 to 0.44) | 0.43 (0.40 to 0.47) |
| Psychotic disorder | 3.8 (19/505) | 0.10 (0.06 to 0.15) | 0.11 (0.07 to 0.18) |
| Anxiety or trauma-related disorder | 34.4 (348/1012) | 0.89 (0.82 to 0.98) | 0.87 (0.80 to 0.94) |
| Eating disorder | 11.5 (19/165) | 0.30 (0.20 to 0.46) | 0.33 (0.21 to 0.50) |
| Alcohol misuse | 30.8 (735/2390) | 0.80 (0.75 to 0.85) | 0.82 (0.77 to 0.87) |
| Alcohol disorder | 27.2 (279/1026) | 0.71 (0.64 to 0.78) | 0.73 (0.66 to 0.80) |
| Substance misuse/disorder | 32.1 (349/1086) | 0.83 (0.76 to 0.91) | 0.98 (0.89 to 1.07) |
| Multisubstance use | 29.7 (240/809) | 0.77 (0.69 to 0.85) | 0.89 (0.79 to 0.99) |
| Personality disorder | 11.4 (110/963) | 0.30 (0.25 to 0.35) | 0.34 (0.29 to 0.41) |
| Learning difficulties or autism | 17.4 (36/207) | 0.45 (0.34 to 0.61) | 0.56 (0.41 to 0.75) |
| (B) People with social needs | |||
| % with social needs who had no referral to social or VCSE services (n/n) | Unadjusted RR (95% CI) | Adjusted RR (95% CI) | |
| Total | 79.6 (9469/11 892) | ||
| Gender (N=11 892)* | |||
| Men | 82.3 (4439/5397) | 1.06 (1.04 to 1.08) | 1.06 (1.04 to 1.08) |
| Women | 77.4 (5030/6495) | 1 | 1 |
| Age group (N=11 892)† | |||
| 15–19 | 70.7 (1301/1841) | 0.92 (0.83 to 1.02) | 0.94 (0.85 to 1.05) |
| 20–24 | 77.1 (1763/2287) | 1.00 (0.90 to 1.11) | 1.03 (0.93 to 1.14) |
| 25–34 | 81.9 (2536/3095) | 1.06 (0.96 to 1.17) | 1.09 (0.99 to 1.21) |
| 35–44 | 82.6 (2065/2500) | 1.07 (0.97 to 1.18) | 1.10 (0.99 to 1.21) |
| 45–64 | 83.5 (1716/2055) | 1.08 (0.98 to 1.20) | 1.11 (1.00 to 1.21) |
| 65 | 77.2 (88/114) | 1 | 1 |
| Ethnic group (N=11 608)* | |||
| White | 79.7 (8140/10 213) | 1 | 1 |
| Black | 76.5 (273/357) | 0.96 (0.91 to 1.02) | 0.96 (0.91 to 1.02) |
| Indian/Pakistani/Bangladeshi | 79.3 (399/503) | 1.00 (0.95 to 1.04) | 1.00 (0.96 to 1.05) |
| Mixed race | 83.6 (224/268) | 1.05 (0.99 to 1.11) | - |
| Chinese | 78.1 (25/32) | 0.98 (0.82 to 1.18) | - |
| Other | 83.0 (195/235) | 1.04 (0.98 to 1.10) | - |
| Employment status (N=11 204)* | |||
| In work or study | 79.2 (3409/4305) | 1 | 1 |
| Unemployed | 82.0 (4515/5508) | 1.04 (1.01 to 1.06) | 1.03 (1.01 to 1.05) |
| Registered sick | 68.1 (572/840) | 0.86 (0.82 to 0.90) | 0.87 (0.83 to 0.91) |
| Retired | 79.5 (132/166) | 1.00 (0.93 to 1.09) | 0.99 (0.92 to 1.08) |
| Looking after the home or family/other | 70.1 (270/385) | 0.89 (0.83 to 0.95) | 0.88 (0.83 to 0.95) |
| Area level deprivation (IMD quintile) (N=11 205)* | |||
| 1 (least deprived) | 81.8 (1839/2249) | 1 | 1 |
| 2 | 79.0 (1788/2264) | 0.97 (0.94 to 0.99) | 0.99 (0.96 to 1.02) |
| 3 | 79.8 (1816/2277) | 0.98 (0.95 to 1.00) | 1.01 (0.98 to 1.03) |
| 4 | 79.5 (1721/2166) | 0.97 (0.94 to 1.00) | 0.99 (0.97 to 1.02) |
| 5 (most deprived) | 77.5 (1742/2249) | 0.95 (0.92 to 0.98) | 0.98 (0.95 to 1.01) |
| Primary psychiatric diagnosis (N=11 892)‡ | |||
| None recorded | 76.9 (4135/5375) | 1 | 1 |
| Mood disorder | 79.8 (1617/2026) | 1.04 (1.01 to 1.07) | 1.03 (1.00 (1.06) |
| Psychotic disorder | 85.9 (165/192) | 1.12 (1.05 to 1.19) | 1.11 (1.04 to 1.17) |
| Anxiety or trauma-related disorder | 66.6 (380/571) | 0.87 (0.81 to 0.92) | 0.86 (0.81 to 0.91) |
| Eating disorder | 79.5 (66/83) | 1.03 (0.93 to 1.15) | 1.04 (1.06 to 1.12) |
| Alcohol misuse | 83.9 (1077/1284) | 1.09 (1.06 to 1.12) | 1.09 (1.06 to 1.12) |
| Alcohol disorder | 83.3 (454/545) | 1.08 (1.04 to 1.13) | 1.07 (1.03 to 1.12) |
| Substance misuse/disorder | 87.6 (595/679) | 1.14 (1.10 to 1.18) | 1.13 (1.09 to 1.17) |
| Multisubstance use | 87.9 (442/503) | 1.14 (1.10 to 1.18) | 1.14 (1.10 to 1.18) |
| Personality disorder | 84.3 (428/508) | 1.10 (1.05 to 1.14) | 1.08 (1.04 to 1.13) |
| Learning difficulties or autism | 87.3 (110/126) | 1.13 (1.06 to 1.21) | 1.12 (1.05 to 1.20) |
Adjusted RRs adjusted for year of presentation, hour of presentation, hospital attended, role of assessor (doctor or nurse) and method of harm.
– denotes cell counts too low to estimate adjusted RR.
*Not adjusted for hour or year of presentation due to model non-convergence.
†Not adjusted for year of presentation or hospital attended due to model non-convergence.
‡Not adjusted for hour of presentation, hospital attended or method of harm due to model non-convergence.
IMD, Index of Multiple Deprivation; RR, risk ratio; VCSE, voluntary, community and social enterprise.