Is mental health in the UK getting worse?
Yes, No and Don’t know!!
There are lots of statistics floating around such as more people, particularly 18-35 s reporting more stress at work and time off for sickness has increased. Google searches, on how to reduce stress in the UK, occur every few minutes. Schools and universities are reporting more young people impacted by mental health struggles. The NHS reports long wait lists for those people with mental health conditions or those waiting to be assessed and GPs report that 25% of their patients are reporting issues that impact their mental health. However, measures of mental health vary, and the definition of mental health has broadened since its original use.
Let’s look at what we mean when we talk about mental health. We all have mental and physical health, and we expect our mental health to change in relationship to what’s going on in our lives too. There are life struggles and events that leave us sad, upset, angry or feeling lost and lonely. Our emotions are up and down, and we might need support for these struggles and the very natural emotions they evoke. We might not enjoy our lives and feel unfulfilled or under pressure. We could be despairing after a family breakdown or debt for a period or devastated by bereavement and need support from a GP or others but that is not the same as a diagnosed mental health condition. Life- struggles have always existed and continue to test us but the number of NICE (evidence-based recommendations for healthcare UK) listed diagnosis disorder categories have tripled in mental health since the time it began in the 50s.
There’s a lot of talk about ADHD and Autism diagnoses on the rise and these spectrum conditions are often diagnosed through NHS mental health services, yet neurodiversity is a normal aspect of community life and not a mental health condition although adjustments particularly for specific impactful neurodivergence needs may be required and there is an increased risk of mental ill health alongside these diagnoses. ADHD may be a controversial diagnosis, but it is relatively undertreated in British children compared to those in America. The latest research shows that the life expectancy of men and women with diagnosed ADHD is reduced by approximately 6 and 8 years respectively but there may be a disproportionate impact of poverty, experience of the justice system, historic trauma and addiction which may be attributed in part to undertreatment or late diagnosis.
The societal pressures now e.g. poverty, homelessness, domestic abuse, worklessness, too much work or poor work design or toxic relationships at work, having a chronic physical health condition, being a victim of crime or a family carer increase our risk of developing a mental health condition, but many of the above will struggle and are not deemed mentally ill. We also have people living longer with the impact of chronic illness on their mental health and illnesses such as Dementia and new struggles with mental health for the lonely, frustrated and disconnected.
There are people who have a bad time with their anxious or depressive thoughts and then start to recover and resume normal life again and return to good health. For many, mental health lows return to a normal level with support or in time.
But there is also something else going on. The NHS is struggling to meet all the needs of patients with physical illness and has even less resource to meet the needs of those who could meet the threshold of mental illness and need their help more urgently. School special education need services (SEND) are struggling to process and adequately resource young peoples’ support plans. Waits for mental health services, for assessments, emergency care and intervention and for longer term conditions are growing and thresholds for specialist care are also rising meaning that those who really need care are at risk of deterioration and serious harm with long term negative consequences for recovery. Many have campaigned successfully over previous decades about the rights and wrongs of sectioning a very ill person, but we probably have more people now begging for a hospital place who can’t get one, under any terms. Some very ill people are being held in prisons or entirely inappropriate facilities. There aren’t the hospital beds for severe mental illness, and the community provision has not kept pace to support people in their communities to prevent them from getting very ill. Elderly mental health services also are under pressure.
There are also some unknown things. Has the Covid epidemic changed or just worsened the trajectory of mental health decline? More recent studies have been carried out on children and young people, which have found that the pandemic accelerated the deterioration in mental health. In 2022 one in six 7-16 year-olds and one in four 17- to 24-year-olds in England had a probable mental health condition, up from one in nine and one in ten respectively in 2017. By 2024 the Mental health report figures, showed that 23% of young people described their mental health as bad, and 1 in 7 adults concurred.
Is the awareness campaign for mental health issues creating more awareness of struggle and the support gaps but confusing the overall picture and overwhelming the mental illness services with people who are struggling?
It’s complicated. We know the needs and they are diverse. Everyone’s support needs are important, and it is time to consider new ways alongside increased financial resourcing to help people with their struggles through a variety of system-wide and preventative mechanisms from community groups, access to social activities, fitness, family support, nature and arts and to deliver the right timely mental health services to those who need them most. There’s also a risk according to journalist Georgia Banjo from the Economist who quotes a professor, that a rationed statutory service means that when you when you inflate clinical diagnoses or over -pathologize society’s distress, “You end up diverting resources away from smaller numbers of people who need them to larger numbers of people who don’t’. Fresh thinking and community resourcing, engagement with those who seek the support about what works for them in new service co-designs, digital innovation, robust and consistent measurement and impact assessment into support services; that will help boost everyone’s wellbeing.
Georgia Banjo Economist https://www.economist.com/britain/2023/12/07/britains-mental-health-crisis-is-a-tale-of-unintended-consequences
