Dr Tony Rao describes a recent study examining alcohol use by Members of the UK Parliament
Based on the study, ‘Alcohol consumption of UK members of parliament: cross-sectional survey’, published in the British Medical Journal.
Why was the study carried out?
Although there have been previous surveys of mental health in UK MPs, this is the first to explore risky drinking in this group. There have been similar studies from other countries, all from Europe, none of which have defined risky drinking through a standardised questionnaire.
Who carried out the study?
It was initially devised by Professor Graham Thornicroft and Dr Dan Poulter MP, who set up a wide group of academics to be involved in overseeing the paper from its conception to publication. This group also included Dr Tony Rao and Dr Ioannis Bakolis as first authors, as well as Dr Nicole Votruba and Dr Jay Das Munshi.
What did the study examine?
This study assessed risky drinking by members of parliament (MPs), as well as the relationship between risky drinking and other factors that could affect drinking.
How was the study carried out?
A survey questionnaire was sent out to all 650 MPs in the UK House of Commons. Alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Risky drinking was identified by combining categories of increasing (hazardous), higher (harmful) and probable dependent drinking for those with a total score of 8 or more. As the amount of pure alcohol in a standard drink varies across the world, a drink was defined as a unit of alcohol or 8 grams of pure alcohol. The GHQ-12, a validated health questionnaire, was used to assess mental health. Results from these questionnaires were compared with a control groups from the 2014 Adult Psychiatric Morbidity Survey (APMS); which included well-defined groups, matched by socio-economic status.
What were the main findings?
146 MPs responded to the survey, which represented less than 1 in 4 potential participants. Respondents were more likely to be female or have a higher educational qualification than the general population. Although risky drinking was more likely in MPs compared with the English population, this was not significantly different from comparable socio-economic control groups. However, it was more likely for MPs to have a drink four or more times a week, consume 10 or more drinks on a typical drinking day, consume six or more drinks in one occasion, or to feel guilty because of drinking. The odds of risky drinking were nearly three times greater for MPs who had an additional work role outside parliament compared with those who did not and just over 2 times greater for MPs with probable mental ill health compared with those with no evidence of probable mental ill health.
What were the study’s strong points and those that limited their relevance?
This was the first published study to use recognised screening tools to assess alcohol use and mental health in UK Members of Parliament. The findings are relevant in that the frequency and quantity of alcohol consumed, including episodes of heavy drinking, suggests that further exploration of the determinants and consequences of alcohol use in UK MPs is needed.
It also has implications for access to support for mental ill health and risky drinking through the Parliamentary Health and Wellbeing Service.
But the authors also urge caution in interpretation of results, as the low response rate and possibility of under-reporting represent potential selection biases. There may also not have been a large enough sample size to produce significant results. However, it may have also under-estimated the true extent of risky drinking and mental ill-health through the under-representation of men and under-reporting through awareness of stigma around drinking.
What lies ahead for future research?
Replication of this study with a larger and more representative group of MPs may produce different findings. But the study does raise important points about access to help for problems with alcohol use and with mental health problems.
Aside from that, reducing the availability of alcohol within the Palace of Westminster is a possible area for harm reduction, as the authors were aware that there are 30 bars, restaurants and hospitality suites at which alcohol is available or sold and six bars open most evenings when MPs are voting or waiting to vote.
Conclusion and policy implications
Over three quarters of the participants in this study were unaware of the Parliamentary Health and Wellbeing Service. This calls for better awareness of access to help for MPs whose alcohol use has the potential to put their health at risk. It may also call for Parliament to take stock of the how the availability of alcohol may influence drinking behaviour in its MPs.
Written by Dr Tony Rao, Consultant Old Age Psychiatrist, South London and Maudsley NHS Foundation Trust and Visiting Lecturer, Institute of Psychiatry, Psychology and
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.