How to stop overmedicating your mental health

The importance of good mental health is a cause strongly championed by everyone from the Princess of Wales to Opposition Leader Sir Keir Starmer; employers preach the welfare gospel. Britons used to be encouraged to hide their feelings; now they are asked to seek support.

Much of the rich world has struggled with rising rates of self-reported mental health problems, particularly since the Covid-19 pandemic. But the figures in Britain are surprising. Around 4.5 million Britons were in contact with mental health services in 2021-2022, an increase of almost 1 million in five years. In the last decade no other European country has seen a greater increase in the use of antidepressants.

A National Health Service (NHS) survey in 2023 found that one in five 8- to 16-year-olds in England had a possible mental disorder, up from one in eight in 2017. In 17- to 19-year-olds the figure was increased from one in ten to one in four. The number of people out of work with mental health problems has increased by a third between 2019 and 2023.

It’s good that people don’t feel like they have to shut things down, and suffering from 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 taken its toll.

For all their good intentions, campaigns aimed at raising awareness are leading some people to confuse normal responses to life’s difficulties with mental health disorders. Special treatment creates incentives for people to seek diagnoses and treat problems unnecessarily. The need to treat people with milder conditions competes with caring for those with more severe conditions.

Start with the idea that mental health has become a buzzword. The large percentage of people who say they have a disorder is a red flag. Around 57% of university students claim to suffer from a mental health problem; over three-quarters of parents with school-age children sought help or advice for their child’s mental health in 2021-2022.

In surveys, Britons are increasingly describing grief and stress as mental illness, redefining how illness is understood. Most conditions do not yet have objective biomarkers, so self-reported symptoms weigh heavily in official statistics and diagnostic processes.

People have incentives to label mild forms of anxiety 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 because of a health condition. Evidence of a mental health problem can unlock welfare payments. The certification does not have to come from an NHS doctor: many private clinics are willing to provide it.

Firms may prefer to label stress a disorder rather than deal with the consequences of accepting poor working conditions (the World Health Organization suggests that good management is the best way to protect mental health in the workplace). The highest rates of diagnosed depression occur in England’s poorest people, but the government would probably rather prescribe anti-depressants than try to solve poverty.

Mild discomfort medicine may not benefit patients. A study of mindfulness courses in 84 British schools found that normal teaching was just as good for mental health. But the great harm from overdiagnosis is to those who need help the most.

The NHS is, in theory, able to triage patients as needed. In practice, a long-understaffed and poorly organized service is struggling with growing demand. The number of young people in contact with mental health services has expanded to more than three and a half times the workforce in child and adolescent psychiatry. A 22% increase in the overall mental health workforce in the five years 2021-2022 could never have achieved a 44% increase in referrals for all patients. At least 1.8 million people are waiting for mental health treatment.

Increased demand is pushing staff into private practice. Clinicians burnt out from dealing with the NHS’s most severe cases can earn up to £1,000 ($1,265) a session carrying out attention deficit hyperactivity disorder assessments. The NHS has just 6% more consultant psychiatrists than a decade ago, compared with 86% more consultants in emergency medicine.

The police take some of the pieces – officers in England spend around 1 million hours a year with mental health patients in accident and emergency departments – but this is not treatment. Even as awareness of mental health conditions increases, 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 worsened by it.

Rethinking Britain’s approach to mental health requires some changes. More money needs to go into research so that individuals can be treated properly; mental disorders absorb 9% of England’s health budget but 6% of medical research funding. The social causes of mental illness also need more attention. Earlier this year the government dropped an ambitious plan to look at the underlying context for mental disorders, from poverty to isolation; that plan must be revived. More time and effort should be devoted to those who need help the most; reforming the Mental Health Act, an outdated law that leaves the mentally ill feeling like criminals, would be a start.

Causes and effects

Above all, Britain should avoid mass-medicating mild forms of anxiety. Putting people in an overstretched health care system has predictable effects. All suffering should be taken seriously, but a diagnosis is not always in one’s best interest; a recent study found that volunteers were happier when they learned to suppress negative thoughts. Britain has become more compassionate about mental health. She also needs to become more thoughtful.