For a country known for its staunch asceticism, Britain is surprisingly open about mental health. Britons are more likely than people in any other wealthy country to think of mental illness like any other illness. Only Swedes are more accepting of the idea that a history of mental health problems should not disqualify people from public office. The importance of good mental health is a cause vigorously championed by everyone from the Princess of Wales to opposition leader Sir Keir Starmer. Employers preach the gospel of happiness. British people were once encouraged to hide their emotions. Now they are being urged to seek help.
For a country known for its staunch asceticism, Britain is surprisingly open about mental health. Britons are more likely than people in any other wealthy country to think of mental illness like any other illness. Only Swedes are more accepting of the idea that a history of mental health problems should not disqualify people from public office. The importance of good mental health is a cause vigorously championed by everyone from the Princess of Wales to opposition leader Sir Keir Starmer. Employers preach the gospel of happiness. British people were once encouraged to hide their emotions. Now they are being urged to seek help.
Many of the world’s wealthy people are suffering from an increase in self-reported mental health problems, especially since the coronavirus pandemic. But the UK figures are startling. Around 4.5 million people in the UK used mental health services in 2021-2022, an increase of almost 1 million over five years. No other European country has seen such an increase in the use of antidepressants over the past decade. A 2023 National Health Service (NHS) survey found that one in five children aged eight to 16 in England may have a suspected mental disorder, up from one in eight in 2017. For 17- to 19-year-olds, this number increased from 1 in 10 to 1 in 4. The number of people unemployed with mental health problems increased by a third between 2019 and 2023.
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Many of the world’s wealthy people are suffering from an increase in self-reported mental health problems, especially since the coronavirus pandemic. But the UK figures are startling. Around 4.5 million people in the UK used mental health services in 2021-2022, an increase of almost 1 million over five years. No other European country has seen such an increase in the use of antidepressants over the past decade. A 2023 National Health Service (NHS) survey found that one in five children aged eight to 16 in England may have a suspected mental disorder, up from one in eight in 2017. For 17- to 19-year-olds, this number increased from 1 in 10 to 1 in 4. The number of people unemployed with mental health problems increased by a third between 2019 and 2023.
It’s good that people don’t feel like they have to hoard things, but the suffering from mental illness is real. Increasing awareness of mental health has reduced the stigma around some conditions and highlighted the unmet needs of many Brits. But awareness has also caused damage.
Despite good intentions, campaigns aimed at raising awareness can lead some people to confuse normal reactions to life’s challenges with mental health disorders. Specialized treatments create incentives for people to seek diagnosis or treat problems unnecessarily. The need to treat people with milder symptoms competes with care for those with the most severe symptoms.
Let’s start with the idea that mental health has become an umbrella term. The high percentage of people who say they have a disability is a red flag. Approximately 57% of college students claim to have a mental health problem. In 2021-22, more than three-quarters of parents of school-aged children sought help or advice about their child’s mental health. Research shows that more Brits describe sadness and stress as mental illnesses, redefining the way we understand illness. Official statistics and diagnostic processes are dominated by self-reported symptoms, as objective biomarkers do not yet exist for most conditions.
People have an incentive to classify mild suffering as a disability. In 2022, more than a quarter of 16- and 18-year-olds attending schools in England will be given extra time to sit official exams because of their health conditions. If there is evidence of mental health issues, your welfare payments may be removed. Certification does not need to come from an NHS doctor. Many private clinics are ready to offer certification. Companies may prefer to classify stress as a disorder rather than deal with the consequences of perceived poor working conditions (the World Health Organization has management is the best way). England’s poorest people are most likely to be diagnosed with depression, but the government would probably prefer to prescribe antidepressants rather than solve poverty.
Medicalizing mild pain may not be of benefit to patients. One study of mindfulness courses in 84 schools in the UK found that regular education was just as good for mental health. But the greatest harm from overdiagnosis falls on those who need help most.
The NHS could, in theory, triage patients as needed. Indeed, services that have long been understaffed and poorly organized are struggling to cope with the surge in demand. The number of young people involved with mental health services has increased by more than 3.5 times that of the child and adolescent psychiatry workforce. The 22% increase in the overall mental health workforce over the five-year period from 2021 to 2022 is not matched by the 44% increase in total patient referrals. At least 1.8 million people are waiting for mental health treatment.
Increased demand has forced staff into private practice. Clinicians burnt out dealing with the most serious NHS cases can earn as much as £1,000 ($1,265) for a session assessing attention deficit hyperactivity disorder. Consultant psychiatrists in the NHS have increased by just 6% compared to 10 years ago, while consultants in emergency medicine have increased by 86%. Although the police collect some information, British police officers spend around 1 million hours a year in accident and emergency departments working with mental health patients, not treating them. Despite increasing awareness of mental health conditions, symptoms are worsening for people with severe mental illnesses such as bipolar disorder and schizophrenia. They are dying 15 to 20 years earlier than the rest of the population, a gap that had been widening before COVID-19 and has been exacerbated by COVID-19.
Rethinking the UK’s approach to mental health requires some changes. More money should be spent on research to ensure that individuals are treated appropriately. Mental disorders absorb 9% of the UK’s health budget, but 6% of medical research funding. The social causes of mental illness also deserve more attention. Earlier this year, the government shelved ambitious plans to investigate the underlying conditions of mental disorders ranging from poverty to isolation. That plan should be revived. More time and effort should be spent on those who need help most. The first step would be to reform the Mental Health Act, an outdated law that treats the mentally ill like criminals.
cause and effect
Above all, Britain needs to avoid the mass medicalization of mild suffering. Crowding people into an overstretched health care system is having predictable effects. All suffering should be taken seriously, but a diagnosis is not always in someone’s best interest. A recent study found that volunteers who learned how to suppress negative thoughts became happier. Britain has become more considerate of mental health. It also needs to be more thoughtful.
