How to stop mental health overmedication

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FOR THE PLACE with a reputation for buttoned-up stock, Britain is very open about mental health. The British are more likely than people in any other rich country to think that mental illness is a disease like any other. Only the Swedes accept the idea that a history of mental health problems should not disqualify someone from public office. The importance of good mental health is a cause strongly advocated by everyone from the Princess of Wales to opposition leader Sir Keir Starmer; employers preaching the gospel of the gospel. The British were once encouraged to hide their feelings; now they are asked to seek support.

Much of the rich world has been struggling with rising rates of self-reported mental health problems, particularly since the covid-19 pandemic. But the numbers in Britain are alarming. Around 4.5m Britons were in contact with mental health services in 2021-22, an increase of almost 1m in five years. In the last ten years no other European country has seen a greater increase in the use of antidepressants. National Health Service (SNS) study found that in 2023 one in five people aged 8 to 16 in England had a similar mental disorder, up from one in eight in 2017. to one in four. The number of unemployed people with mental health conditions has increased by a third between 2019 and 2023.

It’s good that people don’t feel they have to bottle things up and the suffering with mental illness is real. Awareness of mental health has reduced the stigma of some conditions and revealed that the needs of many Britons are not being met. But awareness has also caused damage.

For their good intentions, campaigns aimed at raising awareness lead some people to give normal responses to the problems of life with mental health problems. Special treatment creates incentives for people to seek diagnosis and treat problems unnecessarily. The need to treat people with milder conditions competes with care for those with the most severe conditions.

Start with the idea that mental health has become a catchy term. The large proportion of people who say they have a disorder is a red flag. About 57% of university students say they suffer from a mental health issue; more than three quarters of parents with school-aged children sought help or advice about their child’s mental health in 2021-22. In surveys Britons report more grief and stress as mental illnesses, redefining how illness is understood. Most conditions do not yet have objective biomarkers, so self-reported symptoms are heavily weighted in official statistics and research processes.

People have incentives to label mild forms of distress as a disorder. In 2022 more than a quarter of 16 and 18-year-olds in British schools were given extra time in official exams due to health conditions. Evidence of a mental health problem can unlock benefit payments. A certificate does not have to come from a SNS doctor: there are plenty of private clinics ready to provide. Companies may prefer to emphasize disorder rather than deal with the consequences of recognizing that working conditions are poor (the World Health Organization suggests that good management is the most better protect mental health in the workplace). The highest rates of diagnosed depression are among England’s poorest, but the government may prefer prescribing antidepressants to trying to solve it get on poverty.

Treatment with mild distress may not benefit patients. One study of mindfulness courses in 84 British schools found that conventional teaching was just as good for mental health. But the greatest harm from overdiagnosis is on those who need help the most.

The SNS, in theory, able to triage patients according to need. In practice, a service that has long been understaffed and poorly organized is struggling to cope with increasing demand. The number of young people contacting mental health services has increased by more than three and a half times the number of staff in child and adolescent psychiatry. A 22% increase in the overall mental health workforce in the five years to 2021-22 could not have equated to a 44% increase in referrals per patient. At least 1.8m people are waiting for mental health treatment.

Increased demand is bringing workers into private practice. Clinicians burned out from dealing with the worst SNS cases can earn up to £1,000 ($1,265) per session doing assessments of attention deficit hyperactivity disorder. The SNS which has only 6% more consultant psychologists than a decade ago, compared to 86% more consultants in emergency medicine. The police pick up some of the pieces – officers in England spend around 1m hours a year with mental health patients in accident and emergency departments – but that’s not treatment. Even as awareness of mental health conditions rises, outcomes for people with serious mental illnesses, such as bipolar disorder and schizophrenia, are worsening; they die 15-20 years earlier than the rest of the population, a gap that was widening before covid-19 and was exacerbated by it.

A number of changes are needed to rethink Britain’s approach to mental health. More money should be spent on research so that individuals are treated appropriately; mental illness takes up 9% of England’s health budget but 6% of medical research funding. More attention should also be paid to the social causes of mental illness. Earlier this year the government scrapped an ambitious plan to look at the underlying context of mental illness, from poverty to isolation; that plan should be revived. More time and effort should be devoted to those who need help the most; reforming the Mental Health Act, a penal law that still criminalises the mentally ill, would be a start.

Causes and effects

Above all, Britain must avoid mass medicine in mild forms of distress. Bringing people into a health care system that is too long has the expected effect. All suffering should be taken seriously, but judgment is not always in someone’s best interest; one recent piece of research found that volunteers were happier when they learned to suppress negative thoughts. Britain has become more compassionate about mental health. He needs to be more thoughtful, too.

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