Exclusive:'Shocking' antidepressant figures revealed as Scotland accused of 'getting it wrong' on mental health

Scotland has been accused of “getting it wrong” in tackling the mental health crisis as “shocking” figures have revealed the number of antidepressants prescribed has soared by more than 200,000 in the past year.

Figures published by Public Health Scotland show there were 8,275,583 antidepressants issued in 2023/24 - an increase of 222,801 on the previous year.

A leading mental health charity says there is an over-reliance on antidepressants in Scotland. | Getty Images

It is also an increase of 758,891 on the 7,516,692 antidepressants prescribed in 2020/21 when the Covid pandemic and two nationwide lockdowns hit Scotland.

The figures have sparked calls for Scottish ministers to “take stock” of the use of the drugs, with demands for a cultural shift away from pills towards other forms of treatment for mental health problems.

Nick Ward, chief executive of Change Mental Health, described the figures as “shocking”, but said they reflected the “significant increase” in people seeking support for their mental health.

He said: “A lot of people go to the GP and the easiest thing for the GP to do is prescribe antidepressants, and it is really sad. Lots of the people who are prescribed antidepressants will be working-class people, because it is cheaper, easier and they can’t advocate for themselves.

“Someone who has a mental illness needs really complex support like therapy and counselling in the community, but GPs don’t always prescribe that - they just give people pills and hope it gets better.

Nick Ward, chief executive of Change Mental Health | Change Mental Health

“It is an indictment that we are not getting it right in this country.”

Mr Ward added: “We absolutely as a society have an over-reliance on antidepressants. They can be transformative in allowing people to function, but it is not treating the cause and that cause will come back if it is not treated.

“It is a very short-sighted way to address a significant underlying problem.”

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In its 2007 election manifesto, the SNP pledged to “reduce over-prescribing of antidepressants”. And once the party was elected to power in Holyrood that year, ministers said they wanted to cut antidepressant prescriptions by 10 per cent.

Three years later, the SNP once again pledged to cut prescriptions of these drugs after their use increased by 7 per cent.

Scottish Conservative MSP Edward Mountain said: “Years after the SNP pledged to stop the rise in antidepressants, the figures continue to surge.

Edward Mountain MSP. | Andrew Cowan.

“We now have an extremely serious situation where huge numbers of Scots are being medicated for depression and anxiety. Of course, this treatment absolutely has a part to play, but we really need to get to a place where other remedies are offered.

“Many have complained that people are simply parked on medication because there’s an absence of alternatives. We urgently need ministers to take stock of this situation and come up with some solutions.”

Paul Sweeney, Scottish Labour's mental health spokesperson, said the increase was “another reminder of the scale of need for mental health support”.

He said: "While antidepressants will always have a place in tackling mental health struggles, they should not be a substitute for lack of resources elsewhere. The reality is that under this SNP Government, the thousands stuck on psychological therapy waiting lists may feel they have no choice about the kind of treatment they receive."

Alex Cumming, executive director of operations for Scottish Action for Mental Health (SAMH), said: "Medication has its place, but it has to be part of a broader consideration of what’s right for the person. Depression can take many forms and be more or less severe, so a range of treatments should always be considered. Depression is often linked to significant life events, and problems in life can rarely be solved overnight.

"Antidepressants should therefore be just one piece of the puzzle in most cases, with other treatment options such as talking therapies and social prescribing to community resources such as peer support groups, conversation cafes and physical activity programmes all capable of making a significant contribution to better mental health."

Figures published earlier this month from the 2022 census showed 617,100 Scots reported having a mental health condition– a rise from 4.4 per cent to 11.3 per cent of the population.

The jump was driven by a dramatic, six-fold increase among those aged 16 to 24, prompting critics to raise concerns over a growing mental health crisis.

The concern over the level of antidepressant prescriptions comes as the Scottish Government faces added pressure to review its free prescriptions policy amid more expected spending cuts to be unveiled in December’s Scottish Budget.

Caroline Lamb, director-general for health and social care and chief executive of NHS Scotland, said in August that “universal benefits” needed to be reviewed as Government departments looked to dramatically cut spending.

The Government said it was working hard to improve access to mental health support, and claimed taking antidepressants should not be stigmatised.

Mental Wellbeing Minister Maree Todd said: “It is important not to stigmatise the use of antidepressants or other mental health medication.

Mental Wellbeing Minister Maree Todd. | Fraser Bremner.

“People feel more able to come forward and talk about their mental health, which is a welcome sign that stigma is decreasing - the latest data shows. We are improving care and support for people living with depression, including appropriate access to support and treatments when they need them.

“All medicines are prescribed based on the clinical need of the patient. Decisions about the appropriateness of antidepressants are made by clinicians in discussion with the individual about what matters to them, and with reference to their medical history.

“The Scottish Government recommends that all medications, including antidepressants, be reviewed regularly to ensure that they remain the best option for the individual.”

A statement from Public Health Scotland said there were a significant number of antidepressants used for reasons other than their original licensed indication, including amitriptyline, which could be prescribed to treat pain.

“As the reason for prescribing is not available from the Prescribing Information System (PIS), it is not appropriate to assume that the use of a particular drug/drug class definitely represents use only in the original licensed indication,” the statement said.