Mental Health & Wellbeing

Mental health prescription data

The Gibraltar Health Authority is currently in the early stages of collecting data on mental health diagnosis’ and statistics will be updated in due course. This section of the Joint Strategic Needs Assessment discusses prescription data, which has been utilised as an indicator of disease.

One major limitation of using antidepressant and antipsychotic prescriptions as a measure for mental illness is that specific drugs do not always equate with specific illnesses. Antidepressants are sometimes used to treat conditions such as eating disorders, sleep problems, smoking cessation, Irritable Bowel Syndrome and chronic pain.

Additionally, it is important to consider how not all individuals living with mental health issues opt for pharmaceutically based treatment. Some individuals may opt for alternative psychotherapy treatments may refuse treatment, and would therefore not be captured by prescription databases.

As a result, the statistics presented on anti-depressant anti-anxiety and antipsychotic prescriptions do not directly reflect the number of people in Gibraltar living with mental health illnesses, but rather help provide a picture of mental health prevalence. Further statistics are required in order to understand true mental health illness prevalence in Gibraltar.

All of the data presented in Figures 1-10 below has been extracted from the Group Practice Medical Scheme prescription data only. As a result, it fails to capture prescription data from the Ocean Views Mental Health Facility, as well as St. Bernard’s Hospital. Additionally, this data focuses on a sample of patients between 01.08.2018 and 31.08.2023. As a result, it is important to consider that the data includes both current and past prescriptions, within this time period, unless otherwise stated.

Anti-anxiety prescription data

Figures 1-3.

Figure 1: Total number of Anti-anxiety medication prescriptions issued by year. Figure 2: Number of patients prescribed anti-anxiety medication by year. Figure 3: Patients prescribed anti-anxiety medications by age. 

Figure 1 shows the total number of anti-anxiety medications prescribed by the Group Practice Medical Scheme between 01.08.2018 and 31.08.2023. In 2019, the number of anti-anxiety prescriptions peaked at 13,193 total prescriptions. The number of anti-anxiety medication prescriptions issued has gradually declined between 2020 and 2023. In 2019, the Gibraltar Health Authority conducted an audit due to concerns over high levels of benzodiazepines prescribed in Gibraltar. New protocols were implemented in order to tackle the issue in line with UK standards.

Figure 2 shows the number of patients receiving anti-anxiety medications on prescription through the Group practice Medical Scheme peaked in 2019, at 1407 patients. This number has continued to decline up until 2022.

Figure 3 shows patients prescribed anti-anxiety medication through the Group Practice Medical Scheme by age. Numbers are low between the ages of 1-16 years. It is important to note that the majority of those prescribed medication within this age group are prescribed Midazolam (Buccolam) which can be used in the treatment of acute, convulsive seizures in children from 3 months – 18 years.

There is an increase in the number of patients prescribed anti-anxiety medication which starts in the early 20s and continues until the late 30s. There appears to be a slight plateau in the number of patients prescribed anti-anxiety medication aged between 38 years and 43 years old. After 44 years of age the number of patients prescribed anti-anxiety medication generally continues to increase until 60 years. There are some data peaks which require further analysis in order to understand service user behaviour.

Antidepressant prescription data

Figures 4-6.

Figure 4: Total number of Antidepressant medication prescriptions issued by year. Figure 5: Number of patients prescribed antidepressant medication by year. Figure 6: Patients prescribed antidepressants by age. 

Figure 4 shows the total number of antidepressant medication prescriptions issued by the Group Practice Medical Scheme by Year has gradually increased, from 6576 total prescriptions in 2018, to 19328 prescriptions in 2022.
Figure 5 shows the number of patients prescribed antidepressants has declined since from 1060 patients in 2018 to 614 patients in 2022. Figure 6 shows that the number of antidepressant  prescriptions generally increase as patients age. This increase is particularly pronounced in the early stages of our lives (12 years – 30 years). However, it is important to highlight that antidepressants may be used to treat conditions other than depression, particularly in children. From years 30-57 years there is a gradual upward trend as age increases to the number of antidepressants prescribed. This peaks at 57 years of age, which is the age with the most patients prescribed antidepressants.

Antipsychotic prescription data

Figures 7-9.

Figure 7: Total number of Antipsychotic medication prescriptions issued by year. Figure 8: Number of patients prescribed antipsychotic medication by year. Figure 9: Patients prescribed antipsychotics by age.

The total number of antipsychotic medication prescriptions peaked in 2020 (figure 7). This number has decreased gradually, however statistics for 2023 are complete only up until 31.08.2023. The number of patients receiving prescriptions for antipsychotic medications peaked in 2019 at 1170 patients. Figure 8 shows a steep incline in the number of patients receiving antipsychotic medication after the age of 17. This could be related to age of onset of which symptoms of certain psychiatric disorders usually start. For example, in most patients with schizophrenia, symptoms generally start in the mid to late 20s.

Sex differences between antidepressant, anti-anxiety and antipsychotic prescriptions

Females were prescribed more antidepressants, anti-anti-anxiety medications and antipsychotics by the Group Practice Medical Scheme between 01.08.2018 and 31.08.2023. Further analysis is required in order to establish the statistical significance of these findings.

Of those prescribed antidepressants by the Group Practice Medical Scheme, 68.7% were female, 37.22% were male, 0.02% classed unknown.

Of those prescribed anti-anxiety medications 51% were female, 49% were male. 

Of those prescribed antipsychotic medications, 61% were female and 39% were male. 

These findings support global and UK findings (Archer et al, 2022) which indicate a rise in anti-anxiety and antidepressant prescriptions amongst women. One possible explanation for increased antidepressant, anti-anxiety and antipsychotic prescription use among female could relate to the fact that women are more likely to seek help for their mental health, or are more willing to take medication for mental health issues. As a result, they are more likely than men to be prescribed medications to address mental health issues.

Mental Health Charities

There are various mental health charities supporting mental health locally, these include GibSams, Clubhouse Gibraltar and Childline Gibraltar. In recent years, service engagement with local mental health charities has increased. Clubhouse Gibraltar has seen an increase in the number of members joining the charity from 65 members in 2013 (Figure 9). In 2022 a total of 226 members were registered with Clubhouse Gibraltar.  The increase in individuals seeking access to mental health services can be attributed to various factors including the rise in social media, the COVID-19 pandemic, demographic and societal changes.

Figure 9: Number of Clubhouse Gibraltar members by year

In 2020-2021 the Childline helpline answered a total of 884 calls – higher than previous years. When considering this data, it is important to highlight how numbers can reflect the same individual calling the service more than once.

The main reasons children contacted the helpline included anxiety, mental health, family relationships, education, peer relationships, self-harm, health issues, suicide, and sexual identity (Figure 10). During this time, 21 referrals were made to Social Services regarding children who were experiencing or at risk of significant harm.

Figure 10: Reason for calls to Childline Gibraltar

There are various charities supporting mental health within the community. Contact information on mental health community resources can be found below.

Local Mental Health Charities

Useful Mental Health resources

Page last reviewed : December 2023