Recognising the scale of the mental health crisis might be the very thing that brings about its solution

31 July 2017

It would be odd to think that you could go through life without ever becoming physically unwell. Be that a nasty cold at one end of the spectrum through to life-limiting conditions at the other. 

However, when we revealed during Mental Health Awareness Week that a majority of people (nearly 2 in 3) reported that they had experienced a mental health problem in their lifetime, there was a backlash from some. Documented by Paul Gallagher in I News, professional contrarians Piers Morgan and Brendon O’Neill called for the return of the "stiff upper lip" and the Head of Lifestyle Economics at the Institute of Economic Affairs claimed there was "an epidemic of over-diagnosis". 

The statistic was secured via credible methodology through an authoritative survey conducted by NatCen Social Research, who also produce the British Social Attitudes Survey and official mental health statistics for government. 

Collating the evidence

Nevertheless, one swallow does not make a summer. In research terms it is the collation of evidence from different sources that breeds confidence in a conclusion. Which is why a recent blog in Scientific American entitled "mental illness is far more common than we know" is so important. Citing new research, it sets out "that almost everyone will develop at least one diagnosable mental disorder at some point in their lives" and that "most of these people will never receive treatment, and their relationships, job performance and life satisfaction will likely suffer".

Understandably, this makes some people feel uncomfortable. To date, the statistic of choice in mental health (in England) has been that 1 in 4 people are likely to experience a common mental health problem in any given year. In time I am confident that the fact that nearly two thirds of people will be directly affected by mental health problems across a lifetime will be cited more often than the 1 in 4 statistic. 

Subconsciously, the 1 in 4 statistic creates a kind of ‘offering’ – we can feel compassion for those affected but are able to draw a sigh of relief by imagining that this applies to other people and not us. Scary enough to prod action in some, but not scary enough to reinforce the need for widespread change. 

We all have mental health

That most of us are likely to experience a mental health problem shouldn’t be such a shock to the system. Like physical health we all have mental health, and mental health problems range in severity. From common problems like anxiety disorders, which many people can self-manage with support, to severe problems like psychosis, which require dedicated help and treatment. 

However, increasing awareness of the widespread impact of mental health problems will have implications. Regardless of whether it is one person or a million, those experiencing severe mental health problems are entitled to and deserve access to care and treatment at the point of need. Beyond this, however, there will need to be a growing focus on prevention and equipping people with the skills and knowledge to understand, protect and sustain good mental health. Where possible, prevention is better than cure.

The blog in Scientific American flags the need for greater health screening for mental health problems. This was one of our five asks to government during Mental Health Awareness Week. For example, we routinely screen men in their early 40s for high blood pressure, but we don’t ask them about their mental and emotional health. This is despite men in this age range being at greater risk of death by suicide than by heart disease. 

Another key conclusion is that we need to get better at identifying and addressing the causes of mental ill-health. One of the key reasons we are living longer, physically healthier lives is because public health pioneers located and eradicated the drivers of ill-health.

On which, the authors of the Scientific American blog, Aaron Reuben and Jonathan Schaefer, raise another important implication: that there is much we can learn from the much smaller percentage of people who go through life never experiencing a mental health problem. 

What is different about them, their environment and experiences, which enable them to escape the impact of mental ill-health? In research terms this is known as positive deviance "the observation that in any community there are people whose uncommon but successful behaviours or strategies enable them to find better solutions to a problem than their peers".

If we stop assuming that good mental health throughout a lifetime is the norm we can get a much sharper idea of why those who are fortunate with their mental health are able to stay well. Recognising the scale of the mental health crisis might be the very thing that brings about its solution.

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