Location: United Kingdom
Alexa Knight
Last Monday, while marking the welcome recruitment of 8,500 mental health workers, Secretary of State for Health Wes Streeting wrote in The Independent: “The honest truth is that we don’t fully know what is driving the rising demand for mental health services or how best to meet it”.
This isn’t quite the case. We know plenty about the major drivers of rising distress and the action needed to address them. For those of us who have spent the past decade warning about the rapidly increasing numbers of people presenting with poor mental health, it’s an odd declaration from the person in charge of supporting the nation’s health.
It's understandable that Mr Streeting would say this during the government’s ongoing review into prevalence of mental health conditions (as well as the neurodevelopmental conditions of ADHD and Autism). But the fact is that, for many years, mental and public health experts across the country have been passionately telling the UK government which social and economic factors are driving the UK’s ongoing mental health crisis.
For example, take one of the single biggest drivers of poor mental health: financial insecurity. We know that when someone is financially insecure, they become more likely to develop poor mental health. As austerity, Covid and the cost-of-living crisis put pressure on people's finances, we saw levels of poor mental health increase. It’s a correlation that is clearly a causation, backed by evidence, and one that has been obvious for more than a decade.
We also know that, to maintain good mental health, people have to have access to the things that keep them mentally healthy - like a good community. But as austerity shut down community spaces, and the loneliness crisis was driven by Covid lockdowns and a lack of true recovery from those sadly necessary measures, communities have become more fragmented than ever before. And as more and more people report feeling lonely and cut off from others, levels of poor mental health increased.
So too have social media and online worlds become more dominant in our lives, algorithmically feeding us content which is too often unmoderated and designed to keep us angry and engaged, and causing us to become even less in tune with our communities. People have been exposed to levels of hate and harmful content we had hoped were relegated to the worst parts of the 20th century. Exposure to racism and bullying both make it more likely we’ll develop poor mental health.
Taken alongside the cuts to the public health provisions designed to keep us well, such as England’s public health grant which, adjusted for inflation, is still is below the level it was at when it was cut by the previous government in 2015, there is little shock in the mental health sector that more and more people have reached a level of diagnosable and debilitating poor mental health.
So many of these factors – isolation, financial insecurity, exposure to hateful or harmful content – have been concentrated on the younger generation, who face the worst levels of poor mental health. They are more likely to be renters and in insecure work, often facing little chance of escaping either, and disappointed by a lack of policy that seriously addresses the crises their generation face.
This week’s Mental Health Awareness Week focuses on action for good mental health – for ourselves and for others. But it also refers to a need for action by the UK government. In hiring these 8500 workers, the UK government has sought to address poor mental health and focus on treatment. But their action must also focus on setting out a clear vision and plan to keep people healthy in the first place, by addressing these social drivers of poor mental health.
The prevalence review must be the end of this inaction. If we are to truly address the roots of the UK’s mental health crisis – which we will never be able to solely treat our way out of – we must begin by preventing the conditions which much of the population, particularly young people, face.
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