Is more mental health awareness really what we need?
The boom in mental health awareness can be seen all around us – from branded ad campaigns (think Maybelline’s “Brave Together”) to celebrities and movies addressing mental health issues (think Prince Harry; Joker) – it’s hard to avoid content urging us to be knowledgeable of what mental health struggles are like, and to be unafraid to come forward and talk about them. However, alongside this wave of heightened awareness has been an enormous rise in rates of mental health diagnosis. Anxiety, depression, ADHD and autism rates have all risen substantially for UK youth in the last 20 years, according to one study by Cybulski et al. (2021), and many other studies report similar findings from around the world. So, in this post, Shayna Weisz asks ‘what is going on?’
While some might argue that these anti-stigma initiatives usefully encourage individuals who wouldn’t previously have opened up about their mental health to come forward, Oxford psychologists Foulkes and Andrews (2023) suggest that something different might be going on. When feelings, thoughts and behaviours are increasingly framed as mental health symptoms, they suggest, people may begin to view them as such when they never had done before. So, while you might always have been a little uncomfortable in social situations, or bad at remembering people’s names, mental health awareness might lead you to now think of these as “symptoms” of disorders like anxiety or ADHD. An analogy might be someone who’s recently suffered a heart attack, who is now acutely aware of every time their heart starts racing when they walk up the stairs.
The trouble is, encouraging individuals to pay more attention to their negative emotions and their difficulties has a downside. People who previously were unconcerned about their thoughts and behaviours now become increasingly worried that something is “wrong” with them. A normal experience that commonly passes with time, such as low mood or a fear of new things, becomes fixated on - seen as a fixed and unchangeable personality characteristic. As a result, individuals might choose to stop exposing themselves to situations they see as stressful, or partaking in activities that they find challenging, in order to avoid feeling distress - despite studies showing that these are actually the best things a person can do to improve the way they feel and overcome personal hurdles.
When more and more normal behaviours are pathologised, individuals come to see them through an increasingly medicalised lens, which can not only damage their self-concept (thinking of themselves as “broken”, as opposed to existing on the ordinary scale of human emotion and experience), but also leads them to seek treatment that puts an increased strain on resources (Beeker et al., 2021). For example, prescription rates of anti-depressants have risen dramatically around the world, wait lists for therapy are now years long in some cases (with wait time especially high for children), while the popularity of ADHD stimulant medication has been so drastic it has led to an ongoing global shortage since (FDA, 2022; Lewis & Khong, 2024).
Even more troubling is the idea that mental health trends and awareness campaigns can actually bring about symptoms that weren’t previously present. In a process that Foulkes and Andrews (2023) call Overinterpretation, individuals may first view certain thoughts or feelings as a sign of a disorder – let’s say trouble focusing, which they believe is a symptom of ADHD. As they learn more about ADHD, they discover that sufferers usually have certain other accompanying symptoms, such as trouble making decisions or multitasking. As the disorder now forms a part of their identity, they (subconsciously or otherwise) begin to exhibit these other symptoms – so they start struggling to decide or multitask as well. They come to behave more like a person with ADHD once they deeply believe that they have ADHD, having found comfort or community in the label. While the suggestion isn’t that this is done intentionally, it is to draw attention to the fact that humans are suggestible and easily influenced, especially when seeking a sense of validation for their feelings (Stein et al., 2025).
Studies support this theory, such as one finding that people with broader understandings of the concept of “trauma” were more likely to experience lasting traumatic effects from watching a disturbing video (such as nightmares; Jones & McNally, 2021), or another study where adolescents who learned all about identifying negative thought patterns as a part of a programme on Cognitive Behavioural Therapy (CBT), and reported that it resulted in them feeling low, as they were constantly encouraged to dwell on the negative (Stallard et a., 2012). Demonstrating how knowledge of a disorder can have real effects on the presentation of symptoms, research has even found that telling people (falsely) that they have elevated blood pressure leads to people reporting that they have symptoms associated with high blood pressure (such as headaches) only ten minutes later (Baumann et al., 1989).
Meanwhile, as Hollywood movies and celebrities join in the mental health dialogue and are lauded for doing so, a trend emerges that fuels the desire for individuals to follow suit by finding a fitting label for themselves so that they too can become part of this movement (Franssen, 2020). Is it plausible, then, that anti-stigma efforts may be causing an increase in mental health symptoms and diagnoses rather than reducing them? Foulkes and Andrews (2023) point out the cyclical pattern that emerges, whereby the rising prevalence of mental health rates leads to more calls more mental health awareness, and more mental health awareness leads to more people – many who wouldn’t previously have considered themselves to be suffering – to identify with mental health problems.
So what can be done? Perhaps instead of increasing people’s focus on turning inwards and scrutinising themselves for signs of abnormality, we should encourage a turn outwards, towards a consideration of the external forces that lead to mental distress, and how they can be reduced. Time after time, studies conclude that the biggest drivers of mental disorder are social factors, such as poverty, discrimination, violence and abuse (e.g. Lund et al., 2018; McManus et al., 2016). Therefore, it makes more sense to be raising awareness of these issues, and to direct government spending towards reducing these injustices in society, as opposed to funnelling more money into ever-increasing mental health awareness efforts that fail to address the root problem. For example, evidence shows that directing government spending towards issues like housing stability, financial security, and social support lead to measurable improvements for mental health (e.g. Baxter et al., 2019; Lund et al., 2018; Stuckler er al., 2021), and thus experts such as Lund et al. (2018) are urging that more attention is focused in these, and related, areas. Otherwise - as the World Health Organisation (2008) pointedly stated in their report on the social determinants of mental health - we end up “treat[ing] people only to send them back to the conditions that made them sick in the first place”.
Ultimately, maybe we don’t need more mental health awareness, more diagnoses, or more medication. Instead, I argue that we should demand solutions that focus on the growing hardships and inequalities many people face, and more practical action to be taken to address the increasing unmanageability and hostility of the world around us. Instead of constantly being asked to figure out what’s wrong with us, we should be asking: what’s wrong with society? Perhaps that is the question we need to be asking in order to guide policy decisions that will tangibly improve whole population mental health.
Shayna Weisz is a College of Social Sciences scholarship PhD student at the University of Birmingham, whose research explores the reproduction of neoliberal and post-feminist ideologies within women’s mental health discourse on social media.
References
Baumann, L. J., Cameron, L. D., Zimmerman, R. S., & Leventhal, H. (1989). Illness representations and matching labels with symptoms. Health Psychology, 8(4), 449.
Baxter, A. J., Tweed, E. J., Katikireddi, S. V., & Thomson, H. (2019). Effects of housing improvement interventions on health and socio-economic outcomes: A systematic review. BMC Public Health, 19, 1168. https://doi.org/10.1186/s12889-019-7856-0
Beeker, T., Bhugra, D., Te Meerman, S., Thoma, S., Heinze, M., & Von Peter, S. (2021). Psychiatrization of society: a conceptual framework and call for transdisciplinary research. Frontiers in Psychiatry, 12, 645556.
Cybulski, L., Ashcroft, D. M., Carr, M. J., Garg, S., Chew-Graham, C. A., Kapur, N., & Webb, R. T. (2021). Temporal trends in annual incidence rates for psychiatric disorders and self-harm among children and adolescents in the UK, 2003–2018. BMC psychiatry, 21(1), 229.
Foulkes, L., & Andrews, J. L. (2023). Are mental health awareness efforts contributing to the rise in reported mental health problems? A call to test the prevalence inflation hypothesis. New Ideas in Psychology, 69, 101010.
Franssen, G. (2020). The celebritization of self-care: The celebrity health narrative of Demi Lovato and the sickscape of mental illness. European Journal of Cultural Studies, 23(1), 89-111.
Jones, P. J., and McNally, R. J. (2021). Does Broadening One's Concept of Trauma Undermine Resilience. Psychol. Trauma Theor. Res. Pract. Pol. doi:10.1037/tra0001063
Lewis, A., & Khong, T. K. (2024). ADHD medication shortages: more than just a supply issue. Drug and Therapeutics Bulletin, 62(2), 18-18.
Lund, C., Brooke-Sumner, C., Baingana, F., et al. (2018). Social determinants of mental disorders and the Sustainable Development Goals: A systematic review of reviews. Psychological Medicine, 48(11), 1–14. https://doi.org/10.1017/S0033291717002220
McManus, S., Scott, S., & Sosenko, F. (2016). Joining the dots: The combined burden of violence, abuse and poverty in the lives of women (Executive summary). Agenda – Alliance for Women & Girls at Risk.
Stallard, P., Sayal, K., Phillips, R., Taylor, J. A., Spears, M., Anderson, R., Araya, R., Lewis, G., Millings, A., & Montgomery, A. A. (2012). Classroom based cognitive behavioural therapy in reducing symptoms of depression in high risk adolescents: pragmatic cluster randomised controlled trial. BMJ, 345.
World Health Organisation. (2008). WHO Commission on the social determinants of health. Final report. http://apps.who.int/iris/bitstream/ 10665/43943/1/9789241563703_eng.pdf
Stein, M. V., Faerman, A., Thompson, T., Kirsch, I., Lynn, S. J., & Terhune, D. B. (2025). Revisiting the domain of suggestion: A meta-analysis of suggestibility across different contexts. Personality and Individual Differences, 241, 113181.
Stuckler, D., Reeves, A., Karanikolos, M., & McKee, M. (2021). Austerity and health: The impact in the UK and Europe. Social Science & Medicine, 113019. https://doi.org/10.1016/j.socscimed.2021.113019