The most depressed neighbourhoods in England are all in the north and the Midlands, with almost a quarter of patients at some GP surgeries seeking help for the condition, research by the Guardian shows.

Yet it is in these areas where psychiatrists are most scarce, with more than twice as many practitioners in London as in Yorkshire per head of population. Proportionately, more specialist psychiatric research and treatment is also undertaken in the capital.

Analysis by the House of Commons library, of statistics from GP surgeries across England, shows a stark London-versus-everywhere-else divide when it comes to mental health in England.

Of the 15 neighbourhoods with the lowest prevalence of depression, 12 were in London, with the other three being the Isles of Scilly and two affluent pockets of Kent. The lowest rate was around London zoo, in Westminster, London, where a three-bed flat can cost £3.5m and just 3.1% of NHS patients were depressed.

Facebook Twitter Pinterest Areas around London zoo, in Regent’s Park, have among the lowest levels of depression in England. Photograph: Richard Isaac/Rex/Shutterstock

Conversely, of the 15 neighbourhoods with the highest prevalence of depression, 12 out of 15 were in the poorest pockets of the north-west of England. The other three were in Sutton Hill, in Telford & Wrekin; Kidderminster Town, in Wyre Forest, Worcestershire; and Dinnington South, in Rotherham, South Yorkshire.

The highest rate was in Brinnington, a suburb of Stockport, in Greater Manchester, where 23.6% of patients were depressed. The real rate is likely to be even higher: one local GP told the Guardian that 61% of the patients he had seen in the previous six weeks were depressed or had previously suffered from the condition.

All of the areas where depression is rife are disproportionately poor and have above-average levels of people living alone, in poor physical health, unemployed and/or on benefits: all well-established risk factors for mental health disorders, according to the Adult Psychiatric Morbidity Survey.

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In Bidston, in Birkenhead, Merseyside, which has the second highest prevalence of depression in England (20.2%), more than half of children live in poverty. Neighbourhoods where there are a lot of smokers are also known to be more troubled by depression. In Brinnington, 30% of the population smoke, twice the England average. In Bidston, 26.7% of pregnant women smoke.

Wendy Burn, the president of the Royal College of Psychiatrists, urged the government to put more money into the most deprived parts of England. “They should be putting more money into tackling social deprivation rather than specifically putting more money into treating depression [for] housing and employment and all those things,” she said.

Areas where more people receive jobseeker’s allowance are also more likely to have high rates of depression, the Adult Psychiatric Morbidity Survey showed. In the Brinnington and Central ward of Stockport, 9.9% of the population claim that benefit, compared with the English average of 3.3%.

Recent benefit changes, particularly the replacement of the disability living allowance (DLA) with personal independence payments (PIP) have exacerbated mental health problems, said Burn: “If you have mental health problems you are more likely to lose your benefits than physical health problems.”

Researchers from York University found benefit claimants who had a psychiatric condition were 2.4 times more likely than those with diabetes, back pain or epilepsy to lose their entitlement when transferring from DLA to PIP.

Despite the overrepresentation of depressed people outside London, there are proportionally more psychiatrists in the capital than anywhere else in England. London (north, central and east) has the most psychiatrists per 100,000 population (27.7), closely followed by the rest of the capital.

The figures, based on the September 2018 workforce stats from NHS Digital and the latest ONS population data for all clinical commissioning groups, showed there were just 15.2 psychiatrists per 100,000 population in the north-west, 12.7 in Yorkshire and Humber, 15.4 in the West Midlands and 15 in the east Midlands. Bottom of the table was Wessex, with 12.5.

Wendy Burn

Burn says the recruitment problems emerge early on because student psychiatrists overwhelmingly want to live in London, partly for lifestyle reasons and partly because there are more specialist training opportunities. “Twenty-five percent of the trainee psychiatrists are in London – there’s a big skew with that,” said Burn, who practises psychiatry in Leeds. “When we recruit our young psychiatrists there is always competition for London.”

London has more psychiatric specialist centres, said Burn, for example, the Institute of Psychiatry, Europe’s largest centre for research and postgraduate education in psychiatry, psychology, basic and clinical neuroscience.

“There is a long tradition of specialist health services being based in London, not just mental health,” said Burn. “Think of Great Ormond Street, which treats really tricky child cases from people all over the country who have been referred in. It’s both good and bad. You probably get better care somewhere that is very specialised but you might have to come many miles away from home.”

Paradoxically, mental health spending per head in 2018-19 (including dementia and learning disabilities) shows that spend per head in the north of England for this current financial year is planned to be £208, compared to £153 in the south-east.

The figures, based on the latest ONS population data for all local commissioners (and the planned spending drawn from the NHS England dashboard), also found a planned spend of £177 in the south-west, £182 in the Midlands and east, and £187 in London. That could be because more Londoners go private for mental health treatment. Research has suggested Londoners are more reluctant than people in other regions to seek help for depression from their GP, said Burn.

Highest estimated neighbourhood prevalence of depression

1. Brinnington, Stockport, Greater Manchester: 23.6%

2. Bidston Hill, Wirral, Merseyside: 20.2%

3. Partington, Trafford, Greater Manchester: 19.4%

4. Fleetwood North East, Wyre, Lancashire: 19.3%

5. Sutton Hill, Telford & Wrekin: 18.9%

6. Middleton Wood Side, Rochdale, Greater Manchester: 18.6%

7. Tranmere, Wirral, Merseyside: 18.5%

8. Fleetwood North West, Wyre, Lancashire: 18.4%

9. Kidderminster Town, Wyre Forest, Worcestershire: 18.3%

10. Dinnington South, Rotherham, South Yorkshire: 18.2%

11. Milnrow East & Newhey, Rochdale, Greater Manchester: 18.1%

12. Woodchurch, Wirral, Merseyside: 18%

13. Birkenhead Central, Wirral, Merseyside: 17.9%

14. Belah, Carlisle, Cumbria 17.8%

15. Milnrow West & Kingsway, Rochdale, Greater Manchester: 17.8%

Lowest estimated neighbourhood prevalence of depression

1. Townshend & Zoo, Westminster, London: 3.1%

2. Isles of Scilly: 3.2%

3. Southall Green, Ealing, London: 3.5%

4. Hainault East, Redbridge, London: 3.6%

5. Hainault West, Redbridge, London: 3.6%

6. Knightsbridge, Belgravia, Westminster, London: 3.6%

7. Mullion & St Keverne, Cornwall: 3.17%

8. Wimbledon Common, Merton, London: 3.7%

9. Wembley West, Brent, London: 3.8%

10. St John’s Wood, Westminster, London: 3.8%

11. Istead Rise & Meopham, Gravesham, Kent: 3.8%

12. Joydens Wood, Dartford, Kent: 3.8%

13. Alperton East, Brent, London: 3.9%

14. Ilford North West, Redbridge, London: 3.9%

15. Queensbury East, Harrow, London: 3.9%

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