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Is it possible, I want to ask, that we are actually starting to become a bit too concerned with mental health? As though, if we could only impress upon enough schoolchildren, students, employees, mothers, anyone past retirement age and so on, the importance of identifying and discussing the problems they might have in their mental health, and on top of that allocate the resources necessary for treating them, this would become a much healthier and happier country?

I raise this question as a psychotherapist working both in private practice and the prison service. Much of my day is spent thinking about the ways in which people suffer and what difference if any the “talking cure” of therapy can make to them. It isn’t often, though, that I find myself talking with someone about their mental health, nor even that I understand in such terms what they might be suffering from in the first place. This is because I feel that these two words have been tagged together, often with the third word “problems” added, and used so excessively and indiscriminately as to have become virtually meaningless.

This becomes obvious the moment you consider how many people are said to have a mental health problem. For a long time, the figure you saw on posters in GP surgeries or referred to in awareness campaigns was one in four. But recently I’ve noticed this statistic sliding around. Sometimes the proportion is even higher (one in three), while at other times it’s much lower (one in six). Obviously these are broad-brush figures intended to make a point rather than proper epidemiological estimates. But with the UK population presently around 66 million, this means that up to 11 million people may or may not have a mental health problem depending which of these ratios is being used. Isn’t that rather a lot of people to be so unclear about?

The underlying issue here, of course, is that for all the attention it has received over the last few years, there is very little agreement about what “mental health” means. This is true to some extent of health as a whole, which often ends up being defined negatively, i.e. as absence of illness. So it is perhaps unsurprising that the “about mental health” section on the website of Time to Change offers no definitions or descriptions of this at all. Yet the dozen or so “mental health problems” it then goes into, ranging from common, everyday experiences like anxiety to extremely rare conditions such as schizophrenia, strike me as a curiously selective list that has an alarmist ring to it while still failing to clarify what a problem of this sort actually is.

Confusion and rhetoric, I believe, permeate much of the advocacy there is around mental health and this is why less good will come of it than is hoped for. Too often there is a sense of wanting to have it both ways: persuading people that mental health is really nothing to be afraid of, that we all have our ups and downs and can find life a bit overwhelming sometimes, while also signalling that these are specialist medical matters — or are at least connected to them — that only a doctor or perhaps “mental health professional” will be able to diagnose and treat.
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