The Shetland Islands: the effects of social and ecological change on mental health.

The authors review the literature concerning the mental health and social effects of industrialization, urbanization and the transition from a rural to an industrial society. They point out the need for prospective and longitudinal studies. To illustrate a working model of the type of research needed, the authors describe a long-term study now underway in the Shetland Islands. This research investigates the effects that rapid social and ecological change (from the North Sea oil developments) will have on the islanders. To test the hypothesis that the changes, associated with the construction of Europe's largest oil port in these previously isolated rural islands, will have a deleterious effect on the Shetlanders' health and way of life, a prospective study has been initiated that contains two sub-studies. The General Survey involves monitoring reported data on ecological, epidemiological and sociological change and is intended to provide an overview of the general impact of the oil developments. The Individual Survey involves interviewing two populations (total N = 533) and is designed to examine individuals' reactions to change and variables associated with those reactions. The target population live in a conservation region where they are not likely to be directly affected by the oil developments. Baseline findings are presented from the General Survey concerning psychiatric morbidity, crime, divorce and suicide and from the Individual Survey that focus on the prevalence of medical and psychiatric symptoms and illnesses.