Mental Health in NI: Does Northern Ireland have the highest rate of people claiming disability benefits and the highest prevalence of mental ill health in the UK?

• Although there are some differences across the UK in how the social security system approaches disability, Northern Ireland clearly has the highest proportion of people claiming support.
• It is difficult to compare rates of poor mental health in different parts of the UK, for a wide variety of reasons – including different measures being used in different areas and challenges relating to the use of self-reported survey data.
• Previous research indicated that prevalence of mental ill health is 25% higher in NI compared with the UK in general, but this figure appears to be out of date.
• Some data suggests that prevalence may be higher in NI, but other figures suggest otherwise – and overall there is little clarity.
• However, analysis by the Mental Health Champion’s office indicates that levels of local mental ill health are worse than elsewhere in the UK, meaning that individual instances of poor health tend to be more severe locally.
• The Department of Health provided a similar analysis to FactCheckNI, noting “a convergence” in prevalence in recent years but making clear that the scale of local mental ill health is higher than other parts of the UK.

In a statement to the Northern Ireland Assembly on the 18th of March 2025, Alliance Party MLA Sian Mulholland said:

“Northern Ireland has the highest rate of people claiming disability benefits and the highest prevalence of mental ill health in the UK.”

There are two aspects to this claim:

1. Northern Ireland has the highest uptake of disability benefits in the UK; and
2. Northern Ireland has the highest prevalence of mental ill health in the UK.

The first claim is supported by evidence. Although there are some divergences in the disability support offered across the UK, the latest figures indicate that 18.3% of the Northern Ireland population use some form of disability support. The region with the next highest uptake is Wales (14.7%).

The second part of the claim is more complicated. It is difficult to compare rates of mental ill health between different parts of the UK, for several reasons; including the use of different measurements in different places, and the nature of the data being used (usually self-reported answers to survey questions).

Some wider measures have previously indicated that Northern Ireland has the highest rates of mental ill health in the UK – but some more recent figures suggest NI’s rates are similar to Scotland’s and perhaps not much higher than in England. Overall, it is difficult to determine the accuracy of whether the prevalence of mental ill health is higher here than elsewhere.

However, prevalence is only one part of the issue. Internal research from the Mental Health Champion’s office (a copy was provided to FactCheckNI) suggests that the scale of poor mental health here is higher, as individual instances tend to be more severe than in other parts of the UK.

The Department of Health said something similar in a statement to FactCheckNI, noting “a convergence over recent years” in prevalence of mental ill health while “Northern Ireland’s mental ill health cases tend to be more severe than other regions.”

For more details, read on.

• Source

FactCheckNI contacted Ms Mulholland about this claim. In her response, she said:

“Northern Ireland has the highest rate of people claiming disability-related benefits and the highest prevalence of mental ill health anywhere in the UK. According to Pivotal’s Economic Inactivity in Northern Ireland report (May 2024), 11.9% of the working-age population in Northern Ireland is not in work due to long-term sickness or disability—by far the highest figure across all UK regions. That equates to over 140,000 people. This figure is notably higher than the UK average of 6.9%.¹

“At the same time, the Department of Health’s Mental Health Strategy 2021–2031 confirms that mental illness in Northern Ireland is around 25% more prevalent than in England.² Other studies, including research from Ulster University and the Bamford Centre for Mental Health and Wellbeing, have long shown that the region carries a disproportionately high burden of mental health issues, much of it linked to the legacy of the Troubles.³”

The citations given by the MLA for the three references noted above are:

1. A report by Pivotal Public Policy Forum, the local think tank, called Economic Inactivity in Northern Ireland, published in 2024.
2. The Department of Health’s (DoH) Mental Health Strategy 2021–2031, published in 2021.
3. Research from Ulster University’s Bamford Centre for Mental Health and Wellbeing.

Economic inactivity and uptake of disability benefits are not the same thing – some disability supports are not means tested and can be accessed by people in work. To take a full look at the uptake of disability benefits requires further analysis (see below).

The latest DoH mental health strategy states:

“Northern Ireland has the highest prevalence of mental health problems in the UK, with a 25% higher overall prevalence of mental health problems than England.”

That comment clearly supports the second aspect of the claim. However, as will be laid out below, there are doubts about whether this particular statistic still applies.

Ms Mulholland’s response also mentioned a 2021 study from the Office for Statistics Regulation – Review of mental health statistics in Northern Ireland – which states that:

“Northern Ireland is reported to have the highest prevalence of mental health problems in the UK. Academic studies and research articles have reported that Northern Ireland has the highest prevalence of mental illness in the UK, with psychiatric morbidity in Northern Ireland 25% higher than in the UK.” 

This report is from 2021 and it is worth noting that some of its cited sources are from years before that. The academic study linked to above is from 2011 while the research article (also in bold) is from 2018. It is further useful to note that one of the authors for both these papers is Professor Siobhan O’Neill, the current NI Mental Health Champion (more on that later).

The report goes into some detail about the poor standard of official data regarding mental health in Northern Ireland, which it says is not good enough to provide full and proper analysis. It states:

“Statistics serve the public good when they enable a range of statistics users to answer key important questions on a particular topic. Mental health statistics in Northern Ireland are currently not fully serving this vision …

“Statistics users are turning to other data to answer the questions that they have. We heard through our user conversations, that academic research is the primary source of mental health information in Northern Ireland. For example, the new 10 year Mental Health Strategy by the Department of Health (NI) is primarily based on academic research due to limited official data.”

This clearly points to a lack of robust data on levels of mental ill health. However, that does not mean there is no data. But first, let’s look at the numbers for disability support.

• Disability and social security in the UK

In the UK, there are five different types of disability benefit that individuals can claim, depending on their age, level of need, and where they live:

• Disability Living Allowance (DLA) is now only available to children under 16, although some adults – including some in NI – remain on DLA if they started claiming it before the introduction of PIP and have not yet been reassessed. Children under 16 across the UK may still claim DLA, except in Scotland, where new child disability claims are made through Child Disability Payment (CDP).

• Personal Independence Payment (PIP) is the main disability benefit for people aged between 16 and the State Pension age in England, Wales, and Northern Ireland. It is gradually being replaced in Scotland by Adult Disability Payment (ADP, see below), which provides similar support. PIP covers additional daily living or mobility costs resulting from a long-term health condition or disability. If awarded before reaching pension age, PIP can continue beyond that age as long as the claimant remains eligible. It should be noted that PIP is unrelated to employment status, meaning it can be accessed by people in work (and so is not directly related to economic inactivity, in reference to some analysis above).

• Attendance Allowance (AA) is available for people over State Pension age who have care needs due to illness or disability. It does not cover mobility needs and cannot be claimed at the same time as PIP or DLA. In Scotland, Attendance Allowance will eventually be replaced by Pension Age Disability Payment, which is expected to launch in 2025.

Scotland now operates its own system of disability benefits under Social Security Scotland. Adult Disability Payment (ADP) has replaced PIP for new claimants aged 16 to pension age, and Child Disability Payment (CDP) has replaced DLA for children under 16. These new benefits are similar in structure to their UK-wide counterparts but are managed separately.

Although the structure of disability benefits is broadly consistent across the UK, the system is becoming increasingly distinct in Scotland due to devolution. The general rule across all nations is that individuals can only receive one form of disability benefit at a time, depending on their age and circumstances.

• Comparisons

Data on the number of people receiving benefits is available from the following sources:

• Stat-Xplore (registration required) – this holds PIP, DLA and Attendance Allowance data for England, Wales and (partial data for) Scotland
• Social Security Scotland – this holds Adult Disability Payments and Child Disability Payments for Scotland
• Department for Communities – this holds data for PIP, DLA and Attendance data for Northern Ireland

Taking the most recent data available as at the time of writing (April 2025), the % of the population receiving each type of disability benefit is broken down in the table below – with the total percentage of the population receiving a benefit in the final column:

​​Figure 1 – sources: as listed above.

As is clear from the table, Northern Ireland is the region with the highest uptake of disability benefits in the UK (including both the highest current uptakes of PIP and DLA). Therefore, the first part of this claim is supported by evidence and is accurate.

• Mental health

What about mental ill health? Are rates higher here than in other parts of the UK?

Prevalence data for mental ill health in Northern Ireland is provided by the Northern Ireland Health Survey, which uses the results of a survey called the GHQ-12 (General Health Questionnaire-12) to estimate prevalence.

The GHQ-12 consists of 12 questions covering symptoms such as anxiety, depression, and social dysfunction, rated on a four-point scale. Answers are self-reported, and a score of four or more typically indicates a level of distress that may warrant further assessment. While not a diagnostic tool, the GHQ-12 is regularly used in UK health surveys to estimate the prevalence of probable mental ill health.

In the most recent Northern Ireland Health Survey at the time of writing (2023/24), 19% of respondents (3,410 individuals aged 16 or over) had a GHQ-12 score of four or greater, which could indicate a mental health concern.

The most recent data for England is from 2022 (the Health Survey for England 2022) and indicated that 19% of adults had a GHQ-12 score of four or greater; GHQ-12 data has not been included more recently. The most recent data for Scotland (the Scottish Health Survey 2023) indicated that 21% of adults had a score of four or greater.

However, while GHQ-12 scores are available for other parts of the UK, the primary measurement for rates of mental ill health in England, Scotland and Wales is the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), which is not used in Northern Ireland.

• Comparisons

When comparing GHQ-12 figures between Northern Ireland and other places in the UK, it is important to note that the figures were taken from different time periods. In 2020-21, at the height of the COVID-19 pandemic, the percentage of adults in Northern Ireland reporting a GHQ-12 score of four or greater was 27%, compared with 19% in 2019/20 and 21% in 2021/22.

The ONS publishes quarterly personal well-being estimates for the various UK regions, and measures life satisfaction, feelings of worthwhile, reported happiness, depression and anxiety. However, Northern Ireland has the best (or joint best) scores on all of these metrics.

• Drawing conclusions

There are clear challenges when trying to draw comparisons between rates of mental ill health in Northern Ireland and in other parts of the UK.

In October 2023, NI’s Mental Health Champion published, Mental Health in Northern Ireland Fundamental Facts 2023, which looked at the local mental health picture in some detail.

Notes accompanying the press release announcing this report state that local data “is difficult to draw comparisons with other UK regions due to differences in how mental health is measured across the regions”. The report includes a brief section on comparing local mental health statistics with UK-wide data, which states:

“It is currently difficult to compare prevalence rates across the UK nations because different measures are used in each jurisdiction. For example, the NI Health Survey uses the GHQ-12 as a measure of prevalence among the adult population, whereas England, Wales and Scotland use the Warwick-Edinburgh Mental Well-being Scale. Health Survey England does collect data using the GHQ-12 measure, but this has yet to be published for the 2021/22 year.”

Furthermore, even comparisons between different parts of the UK using only WEMWBS has obstacles to proper comparisons, for example with different population demographics. NHS England noted previously that:

“Cross-cultural validation of the WEMWBS within the UK has been limited. Differences between ethnic groups may be influenced by social, cultural or economic differences between groups rather than reflecting true variations in wellbeing.”

Further issues arise even when considering some of the ancillary data we cited above. Northern Ireland has a significantly higher percentage of the population taking antidepressant medication compared with England, but scores better on surveys designed to measure mental ill-health. This could be seen as somewhat contradictory.

• What about those sources?

The figures above don’t sit neatly with the Department of Health’s statement that Northern Ireland has the “highest prevalence of mental health problems in the UK, with a 25% higher overall prevalence of mental health problems than England” or the similar claims made by the Office for Statistics Regulation.

Of course, this statement comes from its mental health strategy, published in 2021 – approaching half a decade ago – and situations change over time. The question is whether this is still correct now.

FactCheckNI highlighted GHQ-12 scoring figures to both the Department of Health and the Mental Health Champion, asking both how those figures compare with the claim that NI has worse rates of mental ill health – specifically, 25% worse – than elsewhere in the UK.

The Mental Health Champion’s office said that their understanding was that the 25% figure came from this Departmental Framework from 2014 which was then quoted in the 2016 Mental Health Foundation’s Fundamental Facts of Mental Health in NI.

They added that these documents were used to help prepare for the Mental Health Strategy 2021-31 which is why the figure appeared in the document.

“The figure that NI has a 25% higher overall prevalence of mental health problems than England, is no longer considered to be accurate and is not a statistic that our office would use.

“However our office would argue that from the evidence-base attached, that while the prevalence of mental ill health in NI is the same to other regions in recent times, we can claim that NI’s mental ill health cases tend to be more severe than other regions as shown by the disability rates and increases in PTSD and complex PTSD levels, which are higher than the most recent England figures.”

The evidence base mentioned in the quotation above is a piece of internal analysis carried out by the Mental Health Champion’s office that indicates, as per the rest of the quotation, that NI’s levels of poor mental health are the worst in the UK based on their scale. This research was shared with FactCheckNI and permission was provided for us to publish it in full.

The Department of Health’s statement in response to our query said:

“The 25% figure stated was based on a collation of data and originates in research initiated around the time of the Bamford review in the early 2000s.

“The figure appeared in the Department’s Making Life Better framework, published in 2014, and was quoted in the 2016 Mental Health Foundation’s Fundamental Facts of Mental Health in NI. These documents were used to inform some of the background work which would become the Mental Health Strategy 2021-2031, which is why the figure is used in the Strategy.

“It should be noted however that this figure is not included in the most recent Mental Health Foundation’s Fundamental Facts of Mental Health in NI which was published in 2023.

“The Department recognises that there has been a convergence over recent years in relation to available data on mental health needs in UK regions.

“However, while the prevalence of mental ill health in Northern Ireland has been more similar to other regions in recent times, Northern Ireland’s mental ill health cases tend to be more severe than other regions as shown by the disability rates and increases in PTSD and complex PTSD levels, which are higher than the most recent England figures. The legacy of the Troubles, deprivation levels and societal inequalities will all have consequences for mental well-being.”

The Mental Health Champion’s office also stated that research from the Northern Ireland Audit Office (NIAO) indicates that NI sees less spent per capita on mental health services than other UK regions, and supplied us with this table:

Figure 2 – source: NIAO

Ultimately, comparing mental ill health prevalence amongst various parts of the UK is complicated by inconsistent data and other difficulties.

It may (or may not) be the case that the claim that Northern Ireland has the highest prevalence of mental ill health in the UK – but this is not clearly supported by data. For this reason, we find the second aspect of this claim to be unsubstantiated.

However, based on the research provided to us by the Mental Health Champion’s Office – and a similar statement of fact made by DoH – it is crucial to note that there is evidence to support that the levels of mental ill health in NI are worse than in other parts of the UK.

• More information

For anyone who is interested in local mental health, the Mental Health Champion’s 2023 report – mentioned above, and which was jointly prepared by the Mental Health Foundation – is a great starting point for more information.

It not only looks at prevalence, but also outlines risk factors for poor mental health and delves into the experiences of different demographics within NI.

The way mental health data is collected and analysed – both in Northern Ireland and other parts of the UK – means that comparisons can be difficult. Some of these issues are tough to work around (any data relying on self-reporting comes with some caveats) but that doesn’t mean better – and accessible –  data is not possible.
As always, if you have any further information that supports or challenges our conclusions, please get in touch.