uk essay on mental illness

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• v.40(3); 2015 May

“Mental illness is like any other medical illness”: a critical examination of the statement and its impact on patient care and society

The nature of mental illness has been the subject of passionate discussion throughout history. In ancient Greece Plato, 1 , 2 promoting a mentalist definition of mental illness, was the first to coin the term “mental health,” which was conceived as reason aided by temper and ruling over passion. At around the same time, Hippocrates, 3 taking a more physicalist approach, defined different mental conditions as a variety of imbalances between different kinds of “humours.” Griesinger 4 , 5 almost 2 centuries ago was the first to state that “mental illness is brain illness,” an expression that has provided a strong impetus to the more recent medical conception of mental illness. The substantial progress accomplished in genomics and brain imaging in the last few decades made biological psychiatry stronger than ever and contributed to the reification of mental disorders as illnesses of the brain. The almost exclusively biogenetic conceptual framework for understanding mental illness has acquired a hegemony that has influenced mental health practitioners while also influencing campaigns designed to improve public attitudes toward the mentally ill. As a result, the statement “mental illness is like any other illness” has become almost axiomatic and, therefore, by definition it embodies an accepted truth not in need of a proof.

This view of mental illness is presented for better acceptance of the mentally ill by the public and of treatment by those experiencing mental illness and is indeed based on accumulated, albeit limited, knowledge in the neurobiology of mental disorders. However, anything that reaches axiomatic proportions needs a serious examination. In this editorial we examine the reasons underlying this perspective, its consequences and the evidence to support or refute its continued justification. We then present a position that we believe best fits the current state of knowledge and is closest to clinical realities and public perceptions of mental illnesses.

What does the statement actually imply?

The statement that “mental illness is like any other medical illness” implies that mental illness has a biological basis just like other medical illnesses and should be treated in the public’s eye in a similar manner. The purpose of this article is not to present a philosophical or ideological argument in favour of or against a biological basis explaining mental illness, but rather to examine the clinical and public utility of presenting a dominant neurobiological model of mental illness to patients, their families and the public at large.

Illness, pathophysiology and the “self’’

To understand the justification of equating mental and medical disorders, a comparison often made between type 2 diabetes and mental disorders, especially schizophrenia, other psychoses and depression, is worth examining in some detail. Diabetes, although very complex, is understood as the result of dysfunctional glucose metabolism related to absolute or relative insufficiency of insulin signalling. This dysfunctional metabolism is the consequence of endogenous predispositions, such as hereditary diathesis, and environmental factors, including personal choices, such as poor diet and sedentary life style. Therefore, by improving glucose metabolism, either through medication, insulin replacement or changes in lifestyle, positive health outcomes can be expected. Diabetes is diagnosed by confirming high levels of fasting glucose and other related biochemical markers of glucose metabolism. Further, the cascade of its effects on other systems (e.g., cardiovascular, central nervous system) are, or could be, well explained on the basis of physiologic mechanisms. They can also be prevented/treated by better and early control of diabetes. All through this, however, the patient is aware of the nature of his or her problems, including personal choices, and diabetes generally does not affect his or her day-today thinking, behaviour or perception. Except for mental health complications due to neurologic illnesses (e.g., delirium in the context of severe metabolic complications, depression as a consequence of awareness of the life and death implication of the disorder, abnormal perceptions in the case of some neurologic conditions), it can be stated that somatic illnesses, such as diabetes do not usually alter the core self of a person substantially. More importantly, the model of attribution presented to the patient is congruent with the scientific “facts,” thereby making it easier for the person as well as society to accept the condition.

Mental disorders, on the other hand, affect the very core of one’s being through a range of experiences and phenomena of varying severity that alter the individual’s thinking, perception and consciousness about the self, others and the world. This is seen to an extreme degree with more serious mental disorders, such as psychoses and bipolar disorders, but to a lesser albeit significant degree with anxiety, mood, eating and other psychiatric disorders. Emotion, perception, thought and action are the essence of human identity and the concept of “self,” and these are the prime domains altered in mental disorders. The precise definition of what constitutes the self and whether the location of a state of self is a material reality in the brain, its form and the brain-related factors that influence it are deeply philosophical issues, 6 , 7 but not the subject of this editorial. Suffice it to say that factors involved in increasing the risk for mental disorders are endogenous (genetics is recognized as a major contributor to most mental disorders) as well as environmental, much like most medical disorders. Psychological deprivation and trauma, social defeat and isolation, poverty and poor family environment are but some of the environmental factors that have been reported to increase the risk for mental disorders. In addition to changes at the physiologic level, common to somatic and mental disorders the latter encompass changes in one’s definition of “self,” and are not situated outside the “self.” It can even be argued that in the absence of any substantiated biological marker for mental disorders (only 1 has been included in the recent DSM-5: orexin change in narcolepsy), 8 the hallmark defining features of mental disorders, at least for now, remain the changes in how the patients feel, think and act and how these changes affect their relation to themselves and to others.

As a first corollary of this definition, contrary to medical conditions where restoring dysfunctional physiologic mechanisms is the main target of therapeutic interventions, this is only 1 part of the therapeutic interventions for mental disorders. The primary focus of therapeutic interventions in mental disorders is helping the patient to feel better and interact more adaptively with his or her social and physical environments. Although there is little doubt that all medical conditions require psychological attention, mental health interventions focus primarily on achieving a positive change in feeling, self-esteem, mood, perceptions, thoughts and action — all changes in the “self” that are not primarily targeted in the treatment of medical conditions. Different models of psychological and social interventions are the main ingredients for these desired changes in the self.

A second corollary of this definition is the fact that mental health is very laden with values, not because scientific factors are lacking, but because values become of the utmost importance — more so than for medical disorders — when we deal with the self and its restoration. While somatic illnesses such as diabetes are primarily defined and shaped by biologically discernible facts, values do play a certain role but do not define the disorder. Societal and personal values are important in the treatment of most medical disorders, but acquire paramount importance in the case of mental disorders. Societal and cultural values even define variations in diagnoses over time and across geographic locations. Compulsory treatments, a particularity in the mental health field, are a strong testimony of how mental health can interfere with the self and how the personal values of the patient can clash with the societal values, thus necessitating legal, value-laden mitigation.

Neurobiology and experience of mental illness

Advances in neurosciences have surely given us much better biological mechanistic explanations of many of the uniquely human cognitive, emotional and conative functions, such as memory, thinking, perception, mood and action. This knowledge has informed us that many mental illnesses derive their vulnerability from underlying biological variations. However, we are far from being able to explain in neurobiological terms many of the behaviours and experiences that constitute the core presentations of mental disorders. Even if neurobiology one day were to provide better explanations of the workings of the brain, more elaborately explain the role of genes in increasing the risk for mental illness and the mechanisms behind complex human behaviour, one would still need to understand the experiences of patients with different forms of mental illness in psychological terms, as recently described by Kendler 9 so eloquently. By equating mental illness with any medical illness and, therefore, situating it in an organ within the human biology and not recognizing its unique nature in the way it affects the “self” cannot be justified on the basis of current state of knowledge nor may it serve our patients and society well, as we explain in the rest of this editorial.

Mental illness and the utility of explanatory models

Indeed, it is envisaged that putting mental illness on the same footing as medical illness, society will understand it better and not react negatively toward those with mental illnesses. It is hoped that as a result those with mental illness may face less social stigma — a major obstacle to people seeking and/or receiving help — and reducing stigma may help individuals regain eventual acceptance by society as productive members. Interestingly, the public’s explanatory models of mental illness do not follow this narrative and, on the contrary, the public have multiple models of explaining mental illness varying across cultures and times.

One needs to ask the pragmatic question of whether the strategy of using a biogenetic model of mental illness and equating it with medical illness has actually helped. There are 2 areas worthy of examination in this regard.

Explanatory models, stigma and society

The first is to examine the effect of the statement, “mental illness is like any other medical illness,” on social stigma toward people with mental illness. As indicated previously, implicit in the axiomatic statement is a primarily biological origin of the behaviour and suffering that characterize mental illness. Let us examine the evidence in this regard. In the last decade or 2, biogenetic attribution of all mental disorders, having acquired a hegemoneous status 10 has been used primarily to inform campaigns for reducing stigma and promoting better acceptance of mental illness and the people with mental illnesses by society. 11 , 12 Several well-conducted studies have concluded, almost uniformly, that this strategy has not only not worked, but also may have worsened public attitudes and behaviour toward those with mental illnesses. Investigations of stigma have shown that those who consider mental disorders as primarily attributable to biological forces, just like other medical disorders, while absolving the mentally ill person of responsibility for their behaviour and actions, tend to feel less optimistic about their ability to get better and function well, are less accepting of them and feel less positively toward them. 13 – 16 In a review of the literature related to the concept of mental illness being like any other illness, Read and colleagues 17 reported that biogenetic causal theories and diagnostic labelling as illness are both positively related to perceptions of dangerousness and unpredictability and to fear of and desire for social distance. The attitudes investigated in these studies are reflected in individuals’ responses to whether they would live next door to, socialize or make friends with or have a close relative get married to a person described as being mentally ill. There is also evidence to suggest that biogenetic explanatory models may have negative consequences for those with mental illness in terms of their implicit self concept and explicit attitudes, such as fear. 18 Further, campaigns to reduce stigma that encourage people to think about mental illness as simply another form of medical illness have produced results that show effects to the contrary. For example, a recent study showed that over a 10-year period of deliberate use of the biogenetic explanatory model for campaigning to reduce stigma has resulted in worsening of most, if not all, aspects of public attitudes toward individuals with mental illnesses. 19 , 20 The strength of these perhaps counterintuitive findings comes from the fact that these studies were adequately designed, well powered and, most importantly, replicated in several countries (e.g., United States, Britain, Germany) with very similar results. It is acknowledged that these relatively negative attitudes may be particularly stronger in relation to certain forms of mental illness (e.g., psychosis, manic depressive illness) and addictions.

Explanatory models of mental illness and the mentally ill person

Another domain — perhaps the most important — of examination is the individual with mental illness. In clinical practice, telling patients that their presenting mental illness is like any other medical illness may initially reassure some and assist them in accepting to take medication, especially during the distressing acute phases of a serious mental disorder. They or their families may welcome a simple explanation for encouraging them to accept treatment, which in many cases includes medication. While this strategy can achieve something very important in acute crisis-like situations, it may become problematic, if persistent over time, in getting individuals to accept other highly effective psychological and social treatments. These latter interventions are highly effective and considerably less noxious than often less effective medications for some forms of mental illness, such as mild to moderate depression, anxiety and eating disorders, and emotional dysregulation associated with several long-standing mental illnesses. Even in the most serious mental disorders, such as psychotic, bipolar and severe major depressive disorders, where medications are invariably an essential part of treatment, psychological and social therapeutic interventions are the essential bridge between pharmacological interventions during the acute crises and the need for their sustained use in the long term while at the same time achieving the essential goals of relief of internal distress, restoration of self and a return to productive social and working lives.

Furthermore, presenting mental illness as any other medical illness often implies a medical treatment (medication in most cases) as the dominant treatment strategy. Patients’ rejection of the treating clinician’s medical illness model is generally described as lack of insight and starts the cycle of nonadherence to medication, which then translates into nonadherence to treatment. In reality, if patients and families are allowed to articulate their attributional models, given credit for their “experiential knowledge” and encouraged to enter into a dialogue with the treating clinician, it is more likely there will be some consensus on acceptance of recommended treatment. This may prevent the cycle of disengagement and decline in the course that follows.

What needs to be done?

In clinical practice, if we are to take seriously the multidimensional goals of providing mental health services, as articulated by those seeking and receiving help for mental illness, clinicians have to work within an attributional model that makes sense to the person receiving service, that can be supported by sound argument and evidence and that provides a framework within which those receiving service and those providing it can share a common language. Such a framework will need to include the biogenetic model of attribution of mental illness as 1 of several parallel and equally authentic social, psychological, environmental and cultural models offered by service providers and researchers (acquired knowledge) as well as those who experience mental illness (experiential knowledge). There is a need to create a common language in order to come to an understanding of the person’s experience and to promote such an understanding among the public at large. Denying the special nature of mental illness is unlikely to achieve these important goals.

Some recent developments, such as the promotion of a recovery model 21 – 23 and the early intervention movement, 24 , 25 may hold more promise in improving both the quality of care and possibly involvement of and improvement in public attitudes. The former has emerged from experiential knowledge and advocacy from service users, supported later by sound qualitative research, whereas the latter has emerged from a combination of a shift in philosophy of delivery of care on the part of service providers, parallel generation of evidence of its effectiveness 26 , 27 and greater acceptance by service users and their families, who have now joined the movement as advocates. A third emerging movement, the concept of positive mental health, 28 , 29 may prove to be effective in combating the negative image of mental illness. This movement promotes and is based on human resilience and positive aspects of the experience of mental illness. There is a burgeoning literature emerging in this field, which may balance the rather deterministic, deficit oriented and largely pessimistic miasma created by using an exclusively biogenetic model to explain mental disorders.

Conclusion and recommendations

Simply seeking an axiom of “mental illness is like any other medical illness” is at best simplifying a complex human problem and at worst doing a major disservice to patients, their families and the mental health field. Our dialogue should incorporate the general complexity of human thinking, behaviour, memories and the idea of self and consciousness, including knowledge emerging from sophisticated biogenetic and social science research while attending to the specific complexities that each of us as human beings carry as part of our life stories. That is true for those receiving and those providing services.

We therefore argue that we should continue to have a social and a professional conversation where we find a proper place for neurobiology, social, cultural and environmental forces, personal histories and the uniqueness of each individual when trying to understand, explain and treat mental disorders while avoiding a simplistic reductionism that may be perceived at best as patronizing but ultimately harmful, even though the intentions may be noble. We propose that future antistigma campaigns should give up the axiom of “mental illness is like any other medical illness” and instead present the complex and multifaceted explanations of mental illness as unique along with the positive aspects as discussed here. These campaigns need to be informed not only by the acquired knowledge of service providers and scientists but equally by the experiential knowledge from service users and their families, taking into consideration new knowledge emerging from fields of recovery, early intervention and positive mental health. For clinicians, it would be equally important to embrace explanatory models of mental illness that are based on evidence in science and to include biogenetic, social and cultural models as well as those told to them by the very people they are trying to serve.

Editors’ note: The ideas expressed in this editorial are not necessarily those of the journal. Importantly, JPN continues to focus on publishing “papers at the intersection of psychiatry and neuroscience that advance our understanding of the neural mechanisms involved in the etiology and treatment of psychiatric disorders.”

Competing interests: See jpn.ca for R. Joober. None declared by A. Malla or A. Garcia.

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• Project two

Mental health and persistent pain: an introduction

Why this topic and why it is important for all those working across mental and physical health

• by Libby Keck

In September 2018, the Q Lab and Mind embarked on a year-long collaboration to understand how care can be designed to best meet the needs of people living with both mental health problems and persistent back and neck pain.

The Q Lab focuses on specific health and care challenges and brings together organisations and individuals, to pool what is known and uncover new insights and ideas.

For some, mental health and persistent back and neck pain may sound like a niche topic. In reality, the numbers of people impacted by mental health problems and persistent back and neck pain in the UK are significant, and they are the two most common reasons for people to be on long-term sick leave or unable to work. A lot of attention has been given to these as individual needs, but more needs to be done to bring them together.

This topic – and what we’re learning as a result – is connected to the wider challenge of integrating care to meet people’s mental and physical health needs. The learning from the Q Lab and Mind’s work will provide useful insights for people interested in mental health problems and persistent back and neck pain, as well as individuals and organisations supporting people with combined physical and mental health needs and multiple long-term health conditions.

Over the coming months we will be sharing findings and resources. This essay offers a reminder of what the Q Lab is, the background and context for our work with Mind on this topic, and a flavour of what is to come.

What is the Q Improvement Lab?

The Q Lab – part of the Q initiative – provides an opportunity for individuals and organisations to collaborate and make progress on complex challenges that are affecting health and care in the UK.

The Q Lab works on a single challenge for 12 months – and in that time, convenes a group of people with experience and expertise in the topic (Lab participants). Together, we do research and sense-making, combining the best information and evidence about – and people’s experiences of – the challenge, and use this insight to support teams to develop and test ideas that have the potential to improve care. The Q Lab takes a developmental approach and aims to learn by doing, helping to build the skills and capabilities that are needed to deliver collaborative change.

The project on mental health and persistent pain is the Q Lab’s second project. The first project focussed on scaling patient-to-patient peer support and the learning and insights from this work are shared on this website. For more information on the Q Lab, take a look at What is the Q Improvement Lab? and Impact that counts essays.

Meeting the needs of people living with long-term physical and mental health problems

The Q Lab and Mind’s work aims to respond to the challenges of better meeting the needs of people living with long-term mental and physical health conditions.

Across the UK, long-term conditions are increasingly common. More than 15 million people (30% of the UK population) live with one or more long-term conditions (a condition for which there is no known cure, such as diabetes or arthritis). This will increase by another 3 million people by 2025. 1 Every week, 1 in 6 adults experiences a common mental health problem such as anxiety or depression. 2

Having either a physical or a mental health problem also makes you more likely to develop both – and this interrelationship goes both ways, with the conditions likely to interact and affect people in different ways.

Despite the interconnection of our mental and physical health (or more simply our minds and bodies), not enough people are receiving care that acknowledges and takes account of these needs at the same time.

This has a negative impact on individuals in lots of ways:

• Quality of life is worse for people with long-term conditions who also experience mental health problems. For example, people with long-term physical conditions are more likely to have lower wellbeing scores than those without. 3
• Health outcomes are also affected. Evidence shows that health screening is worse for people with mental health problems – which means fewer people benefit from interventions to improve their physical health, such as weight management, diet, nutrition and exercise advice. 4 There are also physical side effects of living with multiple conditions. For example, people with mental health problems regularly report that the physical side effects of their mental health medication have not been fully explained to them. 5
• The impact of both conditions can affect many areas of someone’s life – their sense of identity, emotional wellbeing, ability to perform and thrive at work – which can also affect relationships with families, friends and carers.
• Research tells us that despite this, people are not receiving joined-up care . For example, only 1 in 5 people with arthritis reports being asked about emotional or social issues by a rheumatology professional, even though almost half would like the opportunity. 6 The Mind Big Mental Health Survey 2017 found that less than half of the 8000+ respondents felt able to discuss a physical health issue at the same time as discussing their mental health, when attending primary care. 7

These issues impact the health and care system – increasing costs and pressures within services. It is estimated that the effect of poor mental health on people living with long-term physical conditions costs the NHS at least £8 billion a year. 8

Supporting and improving quality of life for people with mental and physical health needs is not just a priority for the NHS – it is also a public health issue. Increasingly people are living longer – but are doing so with greater health needs. In England, the economic and social burden from people living with disabilities is more significant than the impact of people dying young. 9 Increased disability drives demand for statutory services and reduces productivity and employment. It is the product of, and reinforced by, health inequalities.

Shifting the status quo

There is no easy fix for systematically supporting people’s mental and physical health needs. Whole-system change will involve adapting the way services are commissioned, designed and delivered, as well as how health care professionals are trained and supported to work together across professional and/or organisational boundaries. Despite these challenges, there is growing recognition of the need to change the status quo.

Increasingly, services are moving towards delivering care using the ‘Biopsychosocial Model’ – a model that acknowledges and recognises the combined biological, psychological and social factors that determine our health and wellbeing.

There is also a drive to increase provision of mental health services, and to support the delivery of better integrated services – through new models of care, strategic transformation partnerships, and the recent commitment in the NHS Long Term Plan that every area will be served by an integrated care system by 2021. Charity and campaigning organisations are collaborating to promote the importance of mental and physical health, for example the Equally Well UK initiative, and many organisations are developing and delivering holistic models of care, that meet people’s physical and mental health needs.

The Health Foundation, who deliver the Q Lab, have funded a wide portfolio of improvement projects that aim to provide more holistic and joined-up care for people living with long-term physical and mental health conditions, including the recent successful programme 3 Dimensions for Long-term Conditions . This programme has integrated mental, physical and social care support in long-term conditions across community and secondary services in London. Find out more at: www.health.org.uk/improvement-projects/integrating-mental-physical-and-social-care-in-long-term-conditions 

From mental and physical health to persistent back and neck pain

When Mind and the Q Lab agreed to collaborate, we knew that improving care for people with mental and physical health was the right area to focus our work. It is an important topic that’s ripe for improvement.

It also allows us to build on the great work that’s happening already. For example, we drew on Mind’s work on reducing stigma for people with mental health through Time to Change (which works to end mental health discrimination by changing the way we all think and act about mental health problems) as well as their successful programme Building Health Futures that explored ways to improve the wellbeing, resilience and confidence of people with heart disease, diabetes and arthritis who may be at risk of developing mental health problems. 10

In order to undertake rapid research and develop and test ideas and solutions in practice in just 12 months, a more defined scope was needed. Through reviewing the evidence and speaking to a range of people in this field, a more focussed topic – improving care for people living with both mental health problems and persistent back and neck pain – was identified.

As you’ll go on to read in the next essay Challenges and opportunities to improve , many of the challenges and solutions we identify are either connected, or directly speak to, the challenges of bringing together physical and mental health care provision.

What we aim to achieve

The Q Lab and Mind have worked with others to understand the problem deeply, from a range of perspectives, drawing on data, evidence and experience. Our learning is shared in this essay collection to increase people’s awareness and understanding of the topic, and importantly to increase momentum for change – by highlighting opportunities and practical insights that are useful for people working in and with health and care.

The outputs take into account the evaluation of the Q Lab – conducted by the Innovation Unit – which has provided insights on the types of resources that are most useful for people working to improve health and care, in order to act on the findings.

(If you’d like to find out more about the impact we aim to achieve, take a look at the Impact that counts essay from our first project.)

What to expect from this essay collection

This essay collection presents the findings from the Q Lab and Mind, and the organisations and individuals who have worked with us on this challenge. The learning is shared as openly as possible, as we collectively seek to identify challenges and opportunities that have potential for use in services and organisations across the health and care system.

The next Lab essay in this collection – Challenges and opportunities to improve – brings together the outputs from surveys, workshops and interviews involving over 150 people. If you have lived or professional experience in mental health and persistent back and neck pain, the insights in this essay may be familiar to you and we hope it is a useful tool for you to share and build support for your work. If you are new to the topic – and want to understand more – this essay will provide an overview of the known problems and potential solutions and practical ideas that have worked elsewhere, that may be relevant for you to consider locally.

At the time of writing this essay, we have just started to work with four organisations – Health Innovation Network , Robert Jones and Agnes Hunt Orthopaedic Hospital , Powys Teaching Health Board and Keele University with Midlands Partnership NHS Foundation Trust – to build on our initial sense-making of the topic and translate that into practical actions to improve care.

Over the next six months you can also expect to see from us:

• Practical ideas and solutions to address this topic that have been shown to work elsewhere, with advice about how this could be translated to different contexts.
• Information on using design approaches to develop and test ideas in practice , curating learning from supporting four organisations to test ideas with the potential to improve care for people living with mental health problems and persistent pain.
• Ideas on developing skills for collaborative improvement – including a framework for the skills and attitudes for collaborative and creative problem solving (co-produced with Nesta ).
• Learning from delivering the Q Lab – with stories of how the Lab approach and ethos is helping to deliver impact to health and care in the UK – and what this means for others seeking to deliver change at scale, and for the evolution of the Lab in the coming year.
• Discover what the Q Lab and Mind have learned about mental health and persistent pain in Challenges and opportunities to improve
• Know someone who might be interested in this essay? Share it!
• To connect with people interested in transforming care for people with mental health and persistent back and neck pain, join the Q Lab online group .
• If you have ideas about what you’d like us to produce in the future, get in touch at [email protected]

Challenges and opportunities to improve

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• Comparison of mental...

Evidence from England’s mental health services suggest that the mental-health crisis from the Covid-pandemic was not minimal

Rapid response to:

Comparison of mental health symptoms before and during the covid-19 pandemic: evidence from a systematic review and meta-analysis of 134 cohorts

Linked editorial.

Mental health and the covid-19 pandemic

Linked Opinion

A patient’s perspective on mental health and the pandemic

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Rapid Response:

Dear Editor

A recent article published in the BMJ provided meta-analysis of mental health symptomatology in repeated-time designs 1. Findings are detailed and invaluable, and the article has gathered significant attention in global media outlets (2,3) and social media (4). However, the gathering momentum around media interpretations of Sun et al.’s findings is concerning.

Tools/scales are used for diagnoses of common mental health disorders; yet this does not represent the outcomes for all mental health. Self-harm and suicidal behaviour, the leading cause of incidents in UK mental health services (5), have no validated rating scales (6) and huge variability (7). There are notable effects of the pandemic on the mental health of layers of populations 8; such as gender and age. Evidence from the health workforce mirrors this (9).

A valid hypothesis is that state-anxiety remained stable during the pandemic (10) because the emotional burden of ‘threat’ is associated with anxiety-related personality traits such as preparedness and stoicism due to the constant battling of ‘threat’. If this is true, then it may be that greater changes in depression-scales could have been observed in individuals that were not depressed prior to the pandemic – though their scores are unlikely to have been recorded or of interest to scholars.

We should consider that the paradigm for incident-reporting in mental health settings flounders significantly behind somatic equivalents (11). Current global mental health data reflects the severity of conditions, rather than gaps or issues with care that may contribute towards incidents. In short: we don’t really know what is going on with our most unwell population – but we report incidents when patients do things which we think they probably shouldn’t.

What we do know is that there has been an exponential increase in self-harming behaviour in England since 2015. England currently records and reports all incidents and publishes these through the centralised National Reporting and Learning System (12). These data are then published in quarterly summary tables (5).

Data from 2015-2022 were downloaded, merged and then analysed in R. A steady increasing trajectory in self-harm incidents (196% by period end) was reported, whereas infection control incidents rose significantly during the pandemic (800% in Q4 2020) but then declined, ending the same period at a 119% increase. 12 times as many self-harm incidents were recorded even at the peak of infection (Q1, 2021). There is an unabating exponential rise in self-harm incidents, and this sped up during the pandemic.

These incidents are not likely to be included in Sun et al.’s study – largely because the occurrence of self-harm is not captured in most rating scales. This calls into question the best ways we can measure mental illness prevalence in populations: objective and validated tools/criteria only exist for a small selection of presentations – and the authors note heterogeneity in included studies.

The debate around whether the pandemic affected mental health seems to reflect the variance in how we measure mental health, rather than whether or not there was an effect. It seems clear that there were effects – and a significant amount of this we are likely yet to uncover. Studies like Sun et al.’s are valuable and will help us understand prevalence and populations so we can plan effective interventions alongside understand the conditions better.

Measuring mental illness is problematic – and arguably steeped in a constructionist paradigm with cultural differences between populations. Assuming that a rapid spread of lethal disease with multifactorial effects on health, economy and industry is not linked to mood and symptomatology of mental ill health is not only reductionist, but erroneous. However, this does make an interesting story that is likely to spark debate and monetise journalistic content.

References:

1. Sun Y, Wu Y, Fan S, et al. Comparison of mental health symptoms before and during the covid-19 pandemic: evidence from a systematic review and meta-analysis of 134 cohorts. BMJ 2023;380 2. BBC News. Mental-health crisis from Covid pandemic was minimal - study BBC News,: BBC; 2023 [Available from: https://www.bbc.co.uk/news/health-64890952 accessed 10/3/23 2023. 3. Business Insider. The pandemic didn't cause a mental health crisis, says a surprising new study 2023 [Available from: https://www.businessinsider.com/study-covid-pandemic-mental-health-depre... accessed 10/3/23 2023. 4. BBC World Twitter Feed. Mental-health crisis from pandemic was minimal, study suggests 2023 [Available from: https://twitter.com/BBCWorld/status/1633717516617891843 accessed 10/3/23 2023. 5. NHS England. National patient safety incident reports 2023 [Available from: https://www.england.nhs.uk/patient-safety/national-patient-safety-incide... accessed 10/3/2023 2023. 6. Chan MK, Bhatti H, Meader N, et al. Predicting suicide following self-harm: systematic review of risk factors and risk scales. The British Journal of Psychiatry 2016;209(4):277-83. 7. Harris IM, Beese S, Moore D. Predicting future self-harm or suicide in adolescents: a systematic review of risk assessment scales/tools. BMJ open 2019;9(9):e029311. 8. Kan FP, Raoofi S, Rafiei S, et al. A systematic review of the prevalence of anxiety among the general population during the COVID-19 pandemic. Journal of affective disorders 2021;293:391-98. 9. Roberts N, McAloney-Kocaman K, Lippiett K, et al. Levels of resilience, anxiety and depression in nurses working in respiratory clinical areas during the COVID pandemic. Respiratory medicine 2021;176:106219. 10. Voss C, Shorter P, Weatrowski G, et al. A comparison of anxiety levels before and during the COVID-19 pandemic. Psychological Reports 2022:00332941221093250. 11. Woodnutt S. Safe staffing in mental health services: Current evidence and next steps. International Mental Health Nursing Research Conference 2022. University of Oxford, 2022. 12. NRLS. Welcome to NRLS Reporting 2023 [Available from: https://report.nrls.nhs.uk/nrlsreporting/#:~:text=The%20National%20Repor... . accessed 11/3/23 2023.

Competing interests: No competing interests

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Mental Health and Wellbeing in Literature

With exams and deadlines looming, this can be a busy time of year. Across the Bodleian Libraries, we’ve been thinking a lot about wellbeing and how we can offer support, from alpacas (and a llama!) and therapy dogs to walks and coffee mornings . Here at the EFL, we’ve done what we do best – we’ve turned to literature!

You might have noticed a new display in the library, exploring how mental health and wellbeing has been represented in literature since the nineteenth century. If you’ve not caught the display yet, read on to find out more about it. Or if you have seen the display and want to discover more about some of the topics for yourself, read to the end for a handy list detailing the resources used in putting the display together.

Madness in nineteenth-century literature

Madness was a common and popular theme in nineteenth-century literature. The field of psychology and understandings of mental health as we know them today were starting to emerge in this period, and novelists and poets could play just as important a role as scientists and philosophers in the formation of this emerging discipline.

Although it’s now an outdated term, for Victorian authors and readers ‘madness’ encompassed a whole range of different conditions which are today recognised as mental disorders and illnesses. Those suffering from madness – who were often ( though not always ) women – might withdraw from the world, waste away, or even be hidden and locked away. Whether they were locked up for their own good, for the safety of those around them, or because their condition and behaviours were shameful, is not always clear.

Not all nineteenth-century literatures of madness approached their theme in the same way. Here, we have two different examples: Romantic madness and Gothic madness.

The Romantic view

Alfred Lord Tennyson’s poems often feature a Romantic version of madness, with women who are isolated and trapped becoming dream-like and ethereal as a result of grief and suffering. Think of Mariana waiting in her ‘lonely, moated grange’ for someone who will never return, or the Lady of Shalott who can only watch reflections of the world from her isolated tower.

The Gothic view

Charlotte  Brontë takes a much more Gothic view of madness than Tennyson did. In  Jane Eyre , Bertha – Mr Rochester’s first wife, who is kept under lock and key in the attic – embodies a far more menacing type of madness than Tennyson’s other-worldly women. She is a source of danger and horror, presenting a threat which can only be resolved through her death.

Illness in twentieth-century literature

In the twentieth century, attitudes toward mental illness in literature began to change. Gone was the madwoman in the attic and the Romantic woman sighing over lost loves – twentieth-century authors (and society) understood ‘madness’ very differently .

Part of the change was in the medium of writing about mental illness. Instead of poems or novels, there was a shift toward authors drawing on their own experiences of mental illness to inform their writing. That could sometimes be in the form of essays or memoirs, but it could also include autobiographical (or semi-autobiographical) fiction.

This shift meant twentieth-century literature about mental illness brought with it a more sympathetic approach to mental ill-health in literature. There was a recognition of the experience of the sufferer rather than just the reactions of those around them, and the causes of mental ill-health began to be explored.

Virginia Woolf struggled with mental illness, and her personal experiences of ill-health informed her writing. In  Mrs Dalloway , this is reflected in Septimus, a veteran of WWI suffering from what would now be recognised as PTSD. Unlike many of her contemporaries (including medical professionals) who considered ‘shellshock’ to be weakness or cowardice, Woolf portrays Septimus sympathetically , revealing the callousness of a society and medical profession which failed him.

Society and expectations

Like Woolf, Sylvia Plath’s struggles with mental illness fed into her writing. Many readers see echoes of Plath’s own depressive episodes and hospitalisation in  The Bell Jar . Other critics have suggested  The Bell Jar  speaks to more than Plath’s personal experiences , revealing the pressures resulting from the toxic culture of a society with contradictory and conflicting expectations of women.

Mental health in twenty-first century literature

Today, we are far more open about mental health than in years gone by. We’re still a long way from dismantling all taboos and stigma around mental health, but society as a whole is far more ready to acknowledge mental health issues – including in literature.

Mental health in literature

In modern literature, we can see the development of the twentieth-century trend of writing about – and from – one’s own experiences. In Transcendent Kingdom , Ghana-born and Alabama-raised Yaa Gyasi explores the consequences of immigration for an entire family : from the brother who succumbs to addiction and the mother struggling with depression, to the father who cannot cope and returns home, all viewed through the eyes of Gifty, a high achieving yet repressed first-generation American.

Carmen Maria Machado similarly writes from her own experiences. In the Dream House is Machado’s response to the abuse she herself suffered, an attempt to help others suffering abuse in same-sex relationships know that they are not alone . Through her innovative and experimental form and style, Machado catapults the reader into the fragmented and disorienting mental state that she experienced.

Mental health through literature

As well as representing mental health issues, literature can also be a way of supporting mental health, through what has been termed ‘bibliotherapy’. While studies can be inconclusive in terms of the concrete psychological benefits of bibliotherapy (have a look at the list below for some examples), the two writers here show through their memoirs how literature unequivocally helped them to deal with illness.

Yiyun Li writes about her struggles with depression and mental health, reflecting in Dear Friend … on the importance of literature in the wake of her hospitalisation following suicide attempts. She describes reading as her means of survival , offering both recovery and discovery. Similarly, in Metamorphosis  Robert Douglas-Fairhurst has written about how turning to literature helped him after he was diagnosed with MS. In literature, he found characters who shared his suffering , through whom he could understand and make sense of his illness.

Hopefully you’ve found this whistle-stop tour of mental health in literature interesting. As promised, to end this post, here are some of the sources and resources used in creating this display, which you may like to use as a starting point to find out more about some of the topics covered .     

Sources and Resources

Featured in the display (in order of appearance).

Alfred Lord Tennyson, Selected Poems (London, 2007).

Charlotte Brontë, Jane Eyre (Oxford, 1969). First published 1847.

Peter Melville Logan, Nerves & Narratives: A Cultural History of Hysteria in 19th-Century British Prose (Berkeley, 1997). Also available as an open access e-book .

Virginia Woolf, Mrs Dalloway (London, 2011). First published 1925.

Sylvia Plath, The Bell Jar (London, 1966). First published 1963.

Elizabeth J. Donaldson (ed.), Literatures of Madness: Disability Studies and Mental Health (London, 2018).

Ali Smith, Summer (2020).

Emma Smith, Portable Magic: A History of Books and their Readers (2022).

Yaa Gyasi, Transcendent Kingdom (2020).

Carmen Maria Machado, In the Dream House (2020).

Yiyun Li, Dear Friend, From My Life I Write to You in Your Life (2018).

Robert Douglas-Fairhurst, Metamorphosis (2023).

Nineteenth Century

General background.

Chaney, Sarah, “A Hideous Torture on Himself”: Madness and Self-Mutilation in Victorian Literature’ , in The Journal of Medical Humanities , 32:4 (2011), pp.279-289.

Pedlar, Valerie, The Most Dreadful Visitation: Male Madness in Victorian Fiction (Liverpool, 2006). Also available as an e-book .

Rylance, Rick, Victorian Psychology and British Culture 1850-1880 (Oxford, 2000).

Shemilt, Jane, ‘Tracing the portrayal of mental disorders in literature over time, through five books’ , on CrimeReads (3 May 2022). Accessed 11 May 2023.

Romantic madness

Demoor, Marysa, ‘“His way is thro’ chaos and the bottomless and pathless”: The gender of madness in Alfred Tennyson’s poetry’ , in Neophilologus , 86:2 (2002), pp.325-335.

Whitehead, James, Madness and the Romantic Poet: A Critical History (Oxford, 2017).

Gothic madness

Horner, Avril and Sue Zlosnik (eds.), Women and the Gothic: An Edinburgh Companion (Edinburgh, 2016). Also available as an e-book .

Sinha, Sunanda, ‘Gendering Madness and Doubling Disability in Jane Eyre’ , in The Grove , 28 (2021), pp.111-126.

Twentieth Century

General background.

Taylor, Steven J. and Alice Brumby (eds.), Healthy Minds in the Twentieth Century: In and Beyond the Asylum (Cham, 2020). [Open access]

Viusenco, Anca-Luisa, ‘The madness narrative, between the literary, the therapeutic and the political’ , in Romanian Journal of English Studies , 10:1 (2013), pp.309-323.

Virginia Woolf

Gordon, Lyndall, ‘Woolf [née Stephen], (Adeline) Virginia’ , in ODNB (23 September 2004). Accessed 12 May 2023.

Lohnes, Kate, ‘Mrs. Dalloway: novel by Woolf’ , in Encyclopedia Britannica (27 July 2018). Accessed 12 May 2023.

Yu, Eileen Xiaoxi, ‘Indifference over Sympathy: Transcendental Communication in Virginia Woolf’s On Being Ill and Mrs Dalloway’ , in Virginia Woolf Miscellany , 89/90 (2016), pp.57-59.

Sylvia Plath

Churchwell, Sarah, ‘An introduction to The Bell Jar’, from British Library Discovering Literature: 20th & 21st Century (25 May 2016). Accessed 2 May 2023.

Hunt, Daniel and Ronald Carter, ‘ Seeing through The Bell Jar : Investigating linguistic patterns of psychological disorder ’, in Journal of Medical Humanities , 33 (2012), pp.27-39.

Marcarian, Hannah and Paul O. Wilkinson, ‘Sylvia Plath’s bell jar of depression: Descent and recovery’ , in The British Journal of Psychiatry, 210:1 (2017), p.15.

Twenty-first century

Arbuthnot, Leaf, “It felt like a piece of bad news I should pass on to someone else” – Robert Douglas-Fairhurst on his MS diagnosis’ , in The Spectator (25 February 2023). Accessed 16 May 2023.

Conrad, Peter, ‘Portable Magic: A History of Books and Their Readers review – a spine-tingling adventure’ , in The Observer (15 May 2022). Accessed 15 May 2023.

Lea, Richard, ‘Calloused, not callous: Healing the scars of displacement’ , in TLS (21 March 2021). Accessed 15 May 2023.

Mbue, Imbolo, ‘Yiyun Li’s brave look at depression and the consoling power of literature’ , from The Washington Post (16 February 2017). Accessed 3 May 2023.

Morrison, Blake, ‘Metamorphosis by Robert Douglas-Fairhurst review – books as therapy’ , in The Guardian (17 February 2023). Accessed 16 May 2023.

Sagers, Flora, ‘Time on our hands in Ali Smith’s Summer ’, in Moveable Type , 13 (2021), pp.102-105. [Open access]

Thomas-Corr, Johanna, ‘In the Dream House by Carmen Maria Machado – review’ , in The Observer (5 January 2020). Accessed 15 May 2023.

Books as Bibliotherapy

Carney, J. et al., ‘Five studies evaluating the impact on mental health and mood of recalling, reading, and discussing fiction’ , in PLoS  ONE , 17:4(2022)

Feigel, Lara, ‘Inside story: the first pandemic novels have arrived, but are we ready for them?’ , in The Guardian (27 November 2021). Accessed 15 May 2023.

Troscianko, Emily T., ‘Fiction-reading for good or ill: eating disorders, interpretation and the case for creative bibliotherapy research’ , in Medical Humanities , 44:3 (2018), pp.201-211.

Wigand, Moritz E. et al., ‘Migration, Identity, and Threatened Mental Health: Examples from Contemporary Fiction’ , in Transcultural Psychiatry , 56:5 (2019), pp.1076-1093.

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Mental Health Essay Topics with Outline & Examples

Published by Ellie Cross at April 5th, 2022 , Revised On January 3, 2024

Mental health studies are a discipline that looks into various mental illnesses to see how they affect people, their causes, and what we can do about them. On the other hand, selecting the right topic for an argumentative essay is crucial to addressing a specific mental health issue. In other words, mental health essay topics have equal importance as the idea of mental health itself. 

Students who have a real passion for any particular area of mental health should spend considerable time searching and finding the right topic for their essays. 

This article presents many good mental health essay topics for your argumentative essay that you can use right away. These unique ideas will make it easier for students to address unique mental health issues through their arguments. 

Mental Health Essay Topics to Write About

Everyone is affected by a mental illness at some stage in their lives. So how do you explain what other people in the world are going through without feeling their pain, emotions and anxiety? The success of your argumentative essay largely depends on the quality and uniqueness of the topic. Here are some exciting and intriguing mental health essay topics you can consider:

• The relationship between obesity and mental health
• The relationship between teenagers and self-harm
• How does a returning soldier deal with his mental health problems?
• The causes of post-traumatic stress disorder in soldiers and its treatment
• What does anorexia nervosa mean?
• It is recognising and addressing indicators of a loved one’s mental health.
• What do you think about people who have “dark” thoughts?
• What does ADHD mean, and what factors may play a role in its development?
• An analysis of gender with most of the mental health problems
• The possible treatment options for obsessive-compulsive disorder
• The most common mental disorders in geriatric people
• The treatments that are used most frequently in depressed patients
• Identifying the main influences on brain screening
• The impact of depression on overall mental wellbeing
• Differences between anxiety disorders and key protective factors for mental health
• Do video games have an impact on a person’s mental health?
• How does music affect mental health?
• How do graphic images affect mental health?
• The effects of obsessive-compulsive disorder on human activity
• How to identify mental illness
• What makes you feel anxious?
• How can stress cause depression?
• What are anxieties, and why do people fear everyday objects?
• Examine the mental health of Holocaust survivors.
• Postpartum depression is a real problem. 
• What are the benefits of a cognitive health crisis? 
• How does poverty affect mental health? 
• The importance of improving psychological and emotional health 
• Common mental health problems of women and men
• What role do school programs play in addressing mental health?

Grave Mental Health Essay Topics

You may also write about some more serious mental health topics. However, acing a mental health essay on a grave mental health issue will require you to relate your content to people’s real-life experiences and start accumulating arguments to support your claims. Here are some interesting but super specific mental health essay topics. 

• Identify and discuss the role of physiotherapy in maintaining mental health.
• Sigmund Freud’s contributions to mental health
• What role does parenting stress play in depression?
• The influence of nightmares on depression
• The contribution of insomnia to depression
• Is it possible to keep the brain healthy to protect its health?
• Is it possible to forget painful memories?
• What educational credentials are required to practice psychiatry?
• What role do horror films play in anxiety?
• Why do people watch scary films?
• Discuss the relationship between mental health and therapy
• What measures are taken to treat mental health problems in the UK?
• Why are so many artists mentally ill?
• Do you think that living in the limelight causes mental illness?
• Discuss COVID-19 and mental health.
• How can you tell if someone is suffering from anxiety?
• An unintended consequence of online learning
• The impact of divorce on children’s mental health
• Why dropping out can harm a student’s mental health
• There is a link between physical violence and mental illness. Discuss

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Topics on Mental Illness Argumentative Essay

• Writing about a mental illness in your essay will require you to have an in-depth understanding of the illness you will investigate. If you pursue one of those in-depth mental health topics, you can surely impress your professor. TV shows that can benefit people with mental illnesses
• In the LGBTQ community, mental illness is common.
• Why are the people of the black community facing more mental illness?
• How can child abuse lead to mental illness?
• How is substance abuse related to mental illness?
• What are coping mechanisms most prevalent in mental illness?
• What is the impact of trauma on mental health?
• School-based programs to support students with mental health problems will be considered.
• What is the most common mental illness faced by raped victims? Discuss each of them.
• How lack of confidence can affect mental health
• Discuss the most recent developments in the field of clinical depression
• Anxiety caused by sexual assault in the metaverse
• How does anxiety affect the ability to cope with your daily life activities?
• Does women’s mental health matter in the nation?
• What are the most common mental illnesses faced by children?
• How can mental health be promoted at colleges and universities?
• How did music come to be associated with mental health?
• Mental health and its connection with peer groups
• How images of homeless people can affect a person’s mental health
• How can people on low incomes receive mental health care?
• The value of forgiveness for mental health
• Name and explain why one of the countries in the world has the highest rate of mental illness.
• The role of society in mental health problems
• Can a change of environment improve mental wellbeing?
• How can love help people who have a mental illness, and how can it not?

Good Essay Topics on Mental Health

• The role of extremists in the deterioration of mental health care in their holy places
• What happens when parents ignore their children, and how does it affect their mental health?
• The difference between religious counselling and professional counselling
• What does it mean to be anti-social, and how can you change or support someone who is?
• Recognise and explain the role of chronic stress and anxiety disorders in long-term loneliness. Discuss the impact of remote working on mental health and how to manage it.
• Talk about ways to deal with unhappy feelings to avoid slipping into chronic mental health problems.
• How can you tell if a person’s mental health is okay?
• How can you empower a handicapped person to pursue their goals without becoming depressed because of physical limitations?
• How can the general public best respond to someone suffering from a mental illness?

Cause-Effect Essay Topics on Mental Health

• What role does physical health play in maintaining mental health?
• The effects of post-traumatic stress disorder are severe. Explain why?
• Does emotional stress affect the immune system?
• How can break-ups help or hurt your mental health?
• How does early retirement affect or worsen mental health?
• What can a child do if they are diagnosed with schizophrenia, and how can they be helped?
• What are some of the potentially harmful behaviours that can exacerbate mental illness?

Argumentative Essay Topics on Mental Health

• People who are mentally ill are not religious. Argue on this perception
• Religion has both negative and positive influences on an individual’s mental health
• Anxiety is influenced by discrimination
• Depression can also be caused by self-awareness
• There are five reasons why mental illness is so prevalent
• Depression is a common problem among young people and is never taken seriously
• Suicide is a result of ignoring mental illness at its early stages. Argue

So now, when you have an opportunity to dazzle your teachers by working on these unique mental health essay topics, you must also know about the basic structure of a mental health essay. We have created a brief outline for you guys to understand the structure before delving into the topics. 

Outline of the Essay

It would be best to write down what you want to cover in your essay after conducting your research on a topic. Do not forget to find and review different academic sources when writing a mental health essay. 

Mental Health Essay Introduction

Your essay must have a hook that attracts the reader. Next, you need to establish a thesis statement to show you understand the significance of the topic you are exploring. You can also use your introduction to tell a story or share an experience.

Use proverbs, statistics, or anything that you feel is relevant to your topic in an introduction. Before concluding your introduction, give background information about your essay so that the reader knows what it is about.

The body is divided into paragraphs that support your thesis with evidence and arguments. In general, the body should consist of five paragraphs . However, each sentence must contain a topic sentence linked to independent thought on the topic of mental health. You can also write each sentence with a definite purpose, convincing arguments, supporting details, and examples.

The conclusion sums up the content that you have presented in your essay. You can include a statement of your thesis at the end of your conclusion, and you can even ask a rhetorical question about the future of mental health. However, it would help if you did not make any new arguments in conclusion.

Important Tips when Writing Mental Health Essay

• Present sufficient knowledge of the actual topic
• Know the difference between mental health/illness and emotions
• A generalisation of the term “Mentally Ill” should be avoided
• Use neutral terms, be precise in your arguments/claims
• Emphasis on the treatment and positive vibes through your content
• Get professional assistance if you struggle with your medical or nursing essay.

Frequently Asked Questions

How to write an excellent essay on mental health.

To write an excellent essay on mental health, research the topic thoroughly, provide personal insights, use a clear structure, support your arguments with evidence, and offer practical solutions. Prioritize empathy and awareness throughout.

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Mental Health Essay

Introduction

Mental health, often overshadowed by its physical counterpart, is an intricate and essential aspect of human existence. It envelops our emotions, psychological state, and social well-being, shaping our thoughts, behaviors, and interactions. With the complexities of modern life—constant connectivity, societal pressures, personal expectations, and the frenzied pace of technological advancements—mental well-being has become increasingly paramount. Historically, conversations around this topic have been hushed, shrouded in stigma and misunderstanding. However, as the curtains of misconception slowly lift, we find ourselves in an era where discussions about mental health are not only welcomed but are also seen as vital. Recognizing and addressing the nuances of our mental state is not merely about managing disorders; it's about understanding the essence of who we are, how we process the world around us, and how we navigate the myriad challenges thrown our way. This essay aims to delve deep into the realm of mental health, shedding light on its importance, the potential consequences of neglect, and the spectrum of mental disorders that many face in silence.

Importance of Mental Health

Mental health plays a pivotal role in determining how individuals think, feel, and act. It influences our decision-making processes, stress management techniques, interpersonal relationships, and even our physical health. A well-tuned mental state boosts productivity, creativity, and the intrinsic sense of self-worth, laying the groundwork for a fulfilling life.

Negative Impact of Mental Health

Neglecting mental health, on the other hand, can lead to severe consequences. Reduced productivity, strained relationships, substance abuse, physical health issues like heart diseases, and even reduced life expectancy are just some of the repercussions of poor mental health. It not only affects the individual in question but also has a ripple effect on their community, workplace, and family.

Mental Disorders: Types and Prevalence

Mental disorders are varied and can range from anxiety and mood disorders like depression and bipolar disorder to more severe conditions such as schizophrenia.

• Depression: Characterized by persistent sadness, lack of interest in activities, and fatigue.
• Anxiety Disorders: Encompass conditions like generalized anxiety disorder, panic attacks, and specific phobias.
• Schizophrenia: A complex disorder affecting a person's ability to think, feel, and behave clearly.

The prevalence of these disorders has been on the rise, underscoring the need for comprehensive mental health initiatives and awareness campaigns.

Understanding Mental Health and Its Importance

Mental health is not merely the absence of disorders but encompasses emotional, psychological, and social well-being. Recognizing the signs of deteriorating mental health, like prolonged sadness, extreme mood fluctuations, or social withdrawal, is crucial. Understanding stems from awareness and education. Societal stigmas surrounding mental health have often deterred individuals from seeking help. Breaking these barriers, fostering open conversations, and ensuring access to mental health care are imperative steps.

Conclusion: Mental Health

Mental health, undeniably, is as significant as physical health, if not more. In an era where the stressors are myriad, from societal pressures to personal challenges, mental resilience and well-being are essential. Investing time and resources into mental health initiatives, and more importantly, nurturing a society that understands, respects, and prioritizes mental health is the need of the hour.

• World Leaders: Several influential personalities, from celebrities to sports stars, have openly discussed their mental health challenges, shedding light on the universality of these issues and the importance of addressing them.
• Workplaces: Progressive organizations are now incorporating mental health programs, recognizing the tangible benefits of a mentally healthy workforce, from increased productivity to enhanced creativity.
• Educational Institutions: Schools and colleges, witnessing the effects of stress and other mental health issues on students, are increasingly integrating counseling services and mental health education in their curriculum.

In weaving through the intricate tapestry of mental health, it becomes evident that it's an area that requires collective attention, understanding, and action.

  Short Essay about Mental Health

Mental health, an integral facet of human well-being, shapes our emotions, decisions, and daily interactions. Just as one would care for a sprained ankle or a fever, our minds too require attention and nurture. In today's bustling world, mental well-being is often put on the back burner, overshadowed by the immediate demands of life. Yet, its impact is pervasive, influencing our productivity, relationships, and overall quality of life.

Sadly, mental health issues have long been stigmatized, seen as a sign of weakness or dismissed as mere mood swings. However, they are as real and significant as any physical ailment. From anxiety to depression, these disorders have touched countless lives, often in silence due to societal taboos.

But change is on the horizon. As awareness grows, conversations are shifting from hushed whispers to open discussions, fostering understanding and support. Institutions, workplaces, and communities are increasingly acknowledging the importance of mental health, implementing programs, and offering resources.

In conclusion, mental health is not a peripheral concern but a central one, crucial to our holistic well-being. It's high time we prioritize it, eliminating stigma and fostering an environment where everyone feels supported in their mental health journey.

Frequently Asked Questions

• What is the primary focus of a mental health essay?

Answer: The primary focus of a mental health essay is to delve into the intricacies of mental well-being, its significance in our daily lives, the various challenges people face, and the broader societal implications. It aims to shed light on both the psychological and emotional aspects of mental health, often emphasizing the importance of understanding, empathy, and proactive care.

• How can writing an essay on mental health help raise awareness about its importance?

Answer: Writing an essay on mental health can effectively articulate the nuances and complexities of the topic, making it more accessible to a wider audience. By presenting facts, personal anecdotes, and research, the essay can demystify misconceptions, highlight the prevalence of mental health issues, and underscore the need for destigmatizing discussions around it. An impactful essay can ignite conversations, inspire action, and contribute to a more informed and empathetic society.

• What are some common topics covered in a mental health essay?

Answer: Common topics in a mental health essay might include the definition and importance of mental health, the connection between mental and physical well-being, various mental disorders and their symptoms, societal stigmas and misconceptions, the impact of modern life on mental health, and the significance of therapy and counseling. It may also delve into personal experiences, case studies, and the broader societal implications of neglecting mental health.

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Mental Health in the UK

Introduction.

Mental health is an area of service that is not as well known or understood by people, but it is essential to people who are living with mental health issues. It is a service that can help restore or maintain the health of individuals or their families who experience mental health problems. The term ‘mental health’ refers to mental health problems, which are a collection of symptoms, including but not limited to, depression, anxiety, bipolar disorder, psychosis, mania, autism, schizophrenia, paranoia, and dementia. Mental health is an inherent constituent of the human condition, and the ability to cope with mental distress is an essential part of life (Makwana, 2019)

Mental health includes mental illness and the ability to cope with everyday life. Mental illness consists of all mental conditions that can cause distress and is commonly referred to as a mental disorder. Mental health has been linked to the menace of suicide in individuals with mental illness. A recent study found that 12% of persons with a mental illness have attempted suicide. Mental health is also linked to addiction and an increased likelihood of suicide (Banerjee, Kosagisharaf, and Rao, 2021). Additionally, mental health interventions are often not as effective as they could be due to the high stigma associated with mental health issues.

Mental health in the UK is increasing, but still very much a work in progress. A survey shows that mental health concerns are rising in children and young people, but they are not just a war on the young. In the UK, mental health problems are still significant even though the government has introduced large amounts of money towards addressing them. However, the introduction of the Mental Health Act 2005 has significantly affected how mental health is addressed. Mental Health Act 2005 has increased the roles of the NHS in dealing with mental health issues and has made it easier for the public to access mental health services (Wessely, Lloyd-Evans, and Johnson, 2019). In the UK, mental health is a very diverse illness that is not only affected by personal factors such as genetics, mental health history, and the individual, but also by social factors.

THE PURPOSE

Mental health services (MHS) have seen a dramatic transformation over the past few decades, moving from inpatient care to outpatient treatment in the community. An international standard comparison of mental health care systems is necessary for developing an appropriate balance and utilization of resources. Both the United Kingdom and France will be compared in this research. Not only is there a disparity in the number of mental health professionals, but there is also a disparity in the need for mental health services. To aid legislation and promote equal access to care across both European nations, it is critical to conduct systematic comparisons of MHS. Additionally, the comparative study will take place in light of the ongoing efforts of public health programs in both countries to promote healthy mental well-being and avert mental health problems.

A SUMMARY OF THE FACTS

An individual’s emotional, mental, and social comfort all go under the umbrella term “mental health.” Because good mental health helps an individual deal with the usual pressures of life and operate efficiently, it is necessary. Mental illness is the foremost source of disability in the United Kingdom. Out of four individuals, one has a mental disorder in any given year. Poor mental health can be caused by various social, economic, biological, and psychological causes (Zhai and Du, 2020). The stigma linked with mental sickness is thought to be the most significant obstacle to persons seeking treatment and care. People’s views on mental health have shifted recently, though. Mental health services were primarily underfunded for a long time; since 2000, there has been a gradual decrease in the number of psychiatric beds available in the UK (Barbui, Papola, and Saraceno, 2018).

Anxiety, sadness, and psychiatric disorders are the most frequent forms of mental illness in the United Kingdom. Antidepressant usage in the United Kingdom has nearly quadrupled between 2007 and 2017 (United Kingdom: antidepressant pharmaceutical consumption 2017 | Statista, 2022). In addition, those with significant depression have a higher chance of taking their own life. Suicide rates among males in the United Kingdom were higher than among women in 2019. Self-injury is another prevalent habit associated with suicide, and the younger generation is more likely to engage in self-inflicted wounds.

Mentally ill individuals may pose a risk to both themselves and others. People who pose a danger to themselves or others can be held and treated under the Mental Health Act, even if they object. Patients’ rights and access to care are protected under the Mental Health Act 1938 in England and Wales and the Mental Health Order 1986 in Northern Ireland (Harrop et al., 2021; Campbell et al., 2018). On admission to a hospital in England in 2020/21, 35.3 thousand people were detained under the Mental Health Act.

French citizens were more aware of their mental health during the coronavirus outbreak. There was a steep increase in the incidence of depression and insomnia when the government placed the country under lockdown. Antidepressants and anxiolytics prescriptions soared. France’s number of psychotropic medication prescriptions increased significantly between March 2020 and April 2021. Social distancing techniques impeded access to mental health services. Teleconsultations replaced face-to-face meetings with mental health professionals in a flash. More than 77,500 mental health teleconsultations were recorded in France in the first four months of 2020, compared to fewer than 1,000 in the year’s first month.

Public psychiatric care in France is anchored by psychological Medical Centers (CMPs). These local outpatient care facilities result from a protracted process that began in the 1960s. There was an uneven distribution of CMPs per 100,000 people in France in 2018. By 2020, the number of psychologists in France outnumbered psychiatric doctors by a wide margin. CMPs must cover extra-hospital care and needs for the mental sector. These facilities provide a wide range of medical and social psychology services to patients at no cost.

According to the number of patients treated for psychiatric maladies, mood and neurotic disorders, such as depression and generalized anxiety disorder, were France’s most frequent form of mental disease in 2019. Addiction disorders were the second most frequent mental disease among men that year. Psychiatric hospitalization is currently reserved for life-threatening situations. The number of mental care beds in France has significantly dropped during the past several years. A poll done in 2021 found that the French populace had a favourable view of outpatient psychiatric care. Patients with acute mental problems in French psychiatric facilities are subjected to seclusion and constraint measures at the discretion of healthcare practitioners.

Current Status

Every one of us has a mental state at any given time. A good mental state is a precondition for success in life. To be able to think, feel, and act in a way that makes us happy and capable of dealing with life’s issues does not imply that we have a mental health disorder. That doesn’t mean we must live a constant worry, though. What do you think? Let’s put it to the test. The Mental Health Foundation hired Nat Cen in March 2017 to survey its panel members in the United Kingdom, and the results were released in April 2017. The researchers sought more information about mental health issues, how people cope with stress, and how people can cope with stress. Eighty-two percent of the interviews were conducted over the phone, while 18 percent were conducted online with more than 2,000 individuals.

It can be challenging to identify the symptoms of many mental health conditions. Psychological disorders are diagnosed and treated using two widely used diagnostic methods in America: This question has a wide range of possible answers depending on how it is framed. Adult Psychiatric Morbidity Survey found that one in six persons had recently shown indicators of a shared mental condition, and one in eight people had recently sought treatment for their mental health (Dagleish et al., 2020). Mental illness was reported to afflict 25 percent of people who participated in the Health Survey for England in the same year. In comparison, 18 percent of those surveyed stated that they had never been diagnosed. According to a 2017 survey, 66% of Britons have had some mental illness problems, with 26% claiming panic attacks and 42% reporting depression.

After 2000, mental health problems increased, while suicide declined. Suicidal thoughts rose from 3.8% in 2000 to 5.4% in 2014. According to a study of 3,500 adults by the Office for National Statistics, this year’s coronavirus epidemic has boosted depression to 19.2%. UK Council for Psychotherapy: Income cuts and fines are “toxic” to mental health.

Some areas have seen an increase in many individuals seeking mental health care, while others have seen a decrease. 40% of mental health trusts have had their budgets slashed by the government. Mental health organization Sane’s Marjorie Wallace said, “Cuts to services across the country continue, and people seeking care are still being failed.” After being referred for a diagnosis in 2018, many autistic children in England had to wait an average of 137 days, far longer than the target time of 91 days. At the end of 2019, the Voluntary Organizations Disability Group counted 2,250 people with special needs living in long-term NHS housing. Four hundred sixty-three people had been there for more than five years, and 355 had been there for more than ten years. It appeared impossible for these people to receive high-quality care in the community. Between 2011 and 2021, the number of NHS mental health inpatient beds decreased by 25 percent (Davis et al., 2020). The number of consultant-led mental health beds is expected to fall from 23,447 in 2011 to 17,610 by 2021. Children needing counseling for mental health issues will have to wait a very long by 2021. Most waited fewer than four weeks, 29 percent waited between four and 12 weeks, and 20 percent waited longer than 12 weeks. Some youngsters with mental health concerns were taken to A&E as they waited for A&E because of a crisis. Several children were moved to adult wards due to a lack of room in the children’s ward.

Key Considerations

Mental health affects a person’s capacity to handle obstacles and perform well. People in the United Kingdom are probably more disabled by mental ailment than any other cause. When it comes to mental health issues, one in every four people will experience them at some point. Various social, economic, biological, and psychological factors might significantly contribute to mental health issues. There is a widespread belief among the general public that seeking treatment for mental health disorders would result in social stigma. Thoughts on mental health have recently altered, according to recent polls. Before 2000, mental health beds in the UK steadily declined. Around 24,5 000 mental beds were available in the previous year.

Regarding psychiatric staffing in the United Kingdom, the number has amplified from about 8.2 thousand in 2000 to approximately 12.7 thousand in 2020. According to our analysis, poor mental health costs the economy significantly (Stansfeld et al., 2011). It can enhance the community’s general health while lowering mental health treatment costs by emphasizing prevention. Every UK government pays attention to the data and commits to investing in cost-efficient prevention programs that have been shown helpful. Evidence-based preventative interventions and policies are sometimes overlooked because they are too expensive. The treatment of mental health issues is not an option due to the rising costs for people’s health and our economy. It is estimated that investing in community-wide measures to prevent and treat mental health problems will boost our economy by hundreds of billions of dollars annually.

As evidenced by research undertaken in the United Kingdom and worldwide, mental health deterrence and treatment plans positively impact public health and the economy. We can accomplish this goal by addressing issues like postpartum depression, bullying, and social isolation in the elderly. Many well-documented initiatives have been made to promote good parenting, easy access to psychiatric and psychosocial treatment for those with specific needs, and creating and maintaining welcoming workplaces for everyone. A growing body of research demonstrates that parenting programs offer a considerable return on the money spent. Long-term savings of up to £15.80 can be predicted for every £1 invested in the program. It was shown that for every pound spent on mental health care, £5 might be saved.

Everyone in the NHS receives free treatment at the point of delivery, primarily funded by government taxes. Even if there are certain exceptions for the elderly, pregnant women, persons on welfare, and others, the standard price for all drugs is around $11. Because of excessive wait times and a lack of government funding, the National Health Service (NHS) is a frequent focus of British discontent. However, the general public holds it in high esteem and considers it superior to the US system, which relies on medical insurance. Companies restrict their access to care based on their ability to pay. According to a 2017 study conducted by the Daily Telegraph, many people are willing to pay a higher tax rate in exchange for additional funding for the NHS. Children, adults, and the elderly are eligible for accessible mental health care under the NHS. As part of a more extensive healthcare system, doctors and other medical experts are involved.

Psychologists in the community assess patients’ situations and recommend the best course of action. If you have serious mental health difficulties, you may benefit from seeing a psychologist, a psychiatric professional, or a mix of the two. Choosing one’s first mental health professional should be supported by the government. If a patient is dissatisfied with the practitioner’s diagnosis, a second opinion can be obtained, but it is not required by law. Patients who require a psychiatric hospital bed must join a waiting list for some of the services available. General government money is used to pay for health care services rather than a separate NHS levy. It is because of this that both of these concerns have arisen. As a result, it risks losing benefits due to budget cuts. Because of a decrease in government funding, mental health institutions have experienced overcrowding and extended wait periods due to fewer beds. Government policies and organizations like Time for Change (which is not technically an organization but is run by one) have helped shift public perceptions of mental illness in the United Kingdom.

Consequently, an educated guess is made about how mental health disorders affect the economy. Investing in effective preventative interventions has a solid economic argument, especially when the general public’s mental health is at stake. Health and social care providers and the government must work together more consistently and effectively to improve outcomes. Cost estimates as high as $1,179.9 billion are likely to be overstated because of the scarcity of information in many key areas (Plaistow et al., 2014). Due to overcrowding or lack of interest, many people who could benefit from treatment do not receive it. There will be a lot of health care costs because of this Costs to the criminal justice and housing systems include mental health-related expenditures, addiction-related expenditures, and expenses linked with self-harm and suicide. According to the most recent patient satisfaction data, people are less satisfied with community mental health services than they were in the past. The UK Household Longitudinal Study (UKHLS) analyzed data between April 2020 and May 2021 and discovered that more people than previously assumed were suffering from mental distress. First wave: Roughly a quarter of the population had considerably raised pain and recovered. At the same time, about a fifth of the population had persistently elevated anguish, and a quarter had slightly elevated distress and recovered, with more significant increases occurring in the second wave. New research shows that some people’s mental health may be affected by pandemic waves. Younger persons, women, those who live alone, those without a job or money, and those with COVID-19 symptoms were the most likely to experience long-term stress.

Over 26,000 people in the UK were polled as part of one of the most significant ongoing research, and nearly half of those surveyed (over 18) reported talking to friends or family members to help maintain their mental health throughout the epidemic (such as mindfulness and meditation). Apart from medication, 19 percent of respondents said they sought support from mental health professionals, 8 percent from their primary care physician, and an additional 8 percent through helplines or online programs to enhance their mental health. People over the age of 65 sought less support than those under 25. Subgroups within the community could prefer different approaches to mental health care. People over 65 and those with less education were more likely to take medication for mental health issues and less likely to contact a mental health professional or use an internet forum for help. Drug use was also more common among the poor, the study found. Minority groups were less likely to take medication but more likely to use a hotline or online forum. Regarding caring for one’s mental health, women outnumbered men. Adults who lived alone were also more likely than those who lived with others to seek medical advice, practice self-care and open up about their mental health to others.

Mental health includes our thoughts, feelings, and behaviors. These decisions almost always result from an individual’s grief at losing a loved one. Chronic stress can have significant health impacts on the body and mind, including anxiety and depression. The information in this article is aimed to assist people in managing work-related stress in general. Preexisting health conditions may be exacerbated, and new symptoms may arise due to work-related stress. Employers are legally obligated to assist their employees with health problems, regardless of whether work creates or exacerbates them. It is vital to look into the prevalence of mental health difficulties at work to gauge the level of the risk to employees. As soon as a threat is discovered, it is imperative to take steps to reduce or eliminate it as much as feasible. Some recruits may have preexisting physical or mental health issues, while others may develop them due to factors unrelated to their jobs. Additional legal duties, such as those imposed by equal rights legislation, may force their employers into making the necessary adjustments.

Workplace stress and mental health issues are frequently linked, and their symptoms can be very similar. A preexisting mental health problem can be exacerbated and harder to manage if work-related stress is involved. An existing mental health issue can become so intertwined with work-related stress that it is difficult to separate them. Anxiety and depression can occur even if there is no external stressor present. Their main differences are their causes and how they are treated. Many factors might cause stress in a person’s personal and professional lives. Grief, breakup, postnatal depression, health conditions, or a family problem history are everyday life events that might trigger mental health difficulties. However, these kinds of issues can arise in people for a variety of different reasons. You can prevent folks from becoming stressed out by removing or reducing the stressors in their lives.

It will be easier for those needing mental health services such as shelters and safe havens to find them in their neighborhoods, and the Mental Health Act will be updated to give patients more control over their treatment. Mental health services in the NHS will benefit from a $150 million investment over three years, allowing those in need to receive care outside of the ER while enhancing patient safety in mental health facilities. A seven-million-pound investment in specialized mental health ambulances will be made across the country to minimize the number of persons who require ambulance transport and prevent the employment of police cars for this purpose. Emergency services can be relieved of some responsibility to improve response times and outcomes for those in need (McIntosh et al., 2014).

Volunteer-run “crisis houses” will allow persons needing mental health care to obtain it closer to home rather than in a hospital due to this investment. It is critical to boost local capacity to prevent preventable hospitalizations and unnecessary out-of-area hospitalizations. Patient outcomes should improve as specialists can treat patients in crisis at the appropriate location and time, decreasing the likelihood of readmissions. A significant benefit of the Mental Health Act is eliminating discrimination against persons with mental illness. Because of this disparity, people of color, Asians, and other ethnic minorities are more prospective to detainment under the Mental Health Act. Due to the legislation, more than ten times as many black persons as whites are subjected to a community treatment order.

NHS England is collaborating with mental health trusts to develop a framework to help them better serve patients from ethnic minorities. The legislation will handle people with learning disabilities and autism differently due to the amendments. Section 3 of the statute states that detaining people with learning disabilities or autism for treatment is banned. Only those with mental illnesses, such as autism or learning impairments, might be treated in a psychiatric facility. Mentally ill people will benefit from vicissitudes in the criminal justice organization. A 28-day time limit has been put in place to guarantee that defendants with serious mental illness receive the necessary treatment at the correct time.

• Social Media

The general public has a wide diversity of opinions on mental health issues. A better approach to measure the degree of the gap has not been available until now. People who have mental illness can now talk openly about their problems. It is crucial to seek safe spaces for the unsayable by talking about one’s experiences with those who “get it,” rather than a hostile or apathetic group of relatives and friends. Due to this shared living environment, people who weren’t active in the discourse on mental health are now participating. A growing number of people’s perspectives on mental health are turning away from their own experiences and toward ideas and methods that everyone can agree on. As a result, new views on mental health have evolved among the general public. For the Journal of Social and Political Psychology, Diana Rose penned an article on mental health service users’ expanding forms of activism. It is now possible for people to engage in a variety of “hidden activisms” by joining groups and sharing their stories on social media. Social media has made it possible for people who have never met each other before to express their opinions and feelings on a wide variety of topics and events. New ideas and attitudes have developed through social media in the same way that mental health blogs in 2004 brought me new insights, fresh knowledge, and opinions.

Those with mental health issues can use social media to break free of conventional thinking and institutional practices that bind them. Liberation and dread go hand in hand when you decide to break free as a group. This community is now publicly discussing their perspectives on mental health. Thoughts and theories are surfacing in ways that point to exciting new possibilities. Regardless of whether they use social media, everyone is affected by this moment of immense upheaval, and you can see it in their actions. The relationship between mental health and social media has gotten much attention, but not much attention has been paid to how social media affects mental health more broadly. As social media has risen in popularity, information and power gatekeepers have responded by assessing its value from a distance (Gorczynski et al., 2017). No one can deny that social media and mental health are unrepresentative since they encourage both bad and good behavior, an arms race regarding public outbursts, and the display of talent. It’s a prevalent misperception that criticism of mental health and social media is inherently useless or only accountable to the people who made the criticism. This is erroneous and needs to be corrected. There are exceptions to every rule. Debates about mental health on social media often assume that they must respond to a larger context to be valid (Baker, 2020). People with mental health issues can express themselves freely and openly on sites like Facebook and Twitter, which provide a safe and open environment in which to do so. Mental illness sufferers’ perspectives on the subject are likely to differ from those held by institutions that have dominated prior discussions. A person’s self-esteem and ability to articulate their needs to the rest of society improves every time they can discover some common ground.

Some mental health issues may be linked to certain personality traits, eating habits, and coping strategies. Researchers have recently examined some of these behaviors. In several researches, psychological discomfort is related to eating habits, exercise, alcohol consumption, and sleep quality. For many people, “thinking positively” goes hand in hand with their involvement in the arts and other activities (Catalao et al., 2020). There is still a stigma attached to mental health care in the UK, which most Americans are unaware of. In the United States, seeing a psychologist is seen as usual, but in the UK, it’s seen as an admission of shame, and therefore therapy sessions are likely to be kept a secret. A sad individual is encouraged to “get on with it,” “sort it out,” and not “make a fuss” because of Britain’s prevailing cultural norms. Those seeking treatment are afraid to tell their coworkers for fear of losing their jobs. Furthermore, admitting that your job made you sad or anxious might be interpreted as an admission that you lacked the required qualifications.

Banerjee, D., Kosagisharaf, J.R. and Rao, T.S., 2021. ‘The dual pandemic of suicide and COVID-19: A biopsychosocial narrative of risks and prevention.  Psychiatry Research ,  295 , p.113577.

Barbui, C., Papola, D. and Saraceno, B., 2018. Forty years without mental hospitals in Italy.  International journal of mental health systems ,  12 (1), pp.1-9.

Campbell, J., Brophy, L., Davidson, G., and O’Brien, A.M., 2018. Legal capacity and the mental health social worker role: An international comparison.  Journal of Social Work Practice ,  32 (2), pp.139-152.

Harrop, C., Read, J., Geekie, J., and Renton, J., 2021. How accurate are ECT patient information leaflets provided by mental health services in England and the Royal College of Psychiatrists? An independent audit.  Ethical Human Psychology and Psychiatry .

Makwana, N., 2019. Disaster and its impact on mental health: A narrative review.  Journal of family medicine and primary care ,  8 (10), p.3090.

O’Connor, R., 2021.  When It Is Darkest: Why People Die by Suicide and What We Can Do to Prevent It . Random House.

Statista. 2022.  Psychiatrists employment in the UK 2000-2020 | Statista . [online] Available at: <https://www.statista.com/statistics/462704/psychiatrists-employment-in-the-united-kingdom-uk/> [Accessed 5 July 2022].

Statista. 2022.  United Kingdom: antidepressant pharmaceutical consumption 2017 | Statista . [online] Available at: <https://www.statista.com/statistics/1020751/antidepressants-pharmaceutical-consumption-in-the-uk/> [Accessed 5 July 2022].

Wessely, S., Lloyd-Evans, B. and Johnson, S., 2019. Reviewing the Mental Health Act: delivering evidence-informed policy.  Lancet Psychiatry ,  6 (2), pp.90-91.

World Health Organization. Department of Mental Health, Substance Abuse, World Health Organization, World Health Organization. Department of Mental Health, Substance Abuse. Mental Health, World Health Organization. Mental Health Evidence and Research Team, 2005.  Mental health atlas 2005 . World Health Organization.

Zhai, Y. and Du, X., 2020. Addressing collegiate mental health amid COVID-19 pandemic.  Psychiatry Research ,  288 , p.113003.

Dalgleish, T., Black, M., Johnston, D. and Bevan, A., 2020. Transdiagnostic approaches to mental health problems: Current status and future directions. Journal of consulting and clinical psychology, 88(3), p.179.

Davis, K.A., Coleman, J.R., Adams, M., Allen, N., Breen, G., Cullen, B., Dickens, C., Fox, E., Graham, N., Holliday, J., and Howard, L.M., 2020. Mental health in UK Biobank–development, implementation and results from an online questionnaire completed by 157 366 participants: a reanalysis.  BJPsych Open ,  6 (2).

Stansfeld, S.A., Rasul, F.R., Head, J. and Singleton, N., 2011. Occupation and mental health in a national UK survey. Social psychiatry and psychiatric epidemiology, 46(2), pp.101-110.

Plaistow, J., Masson, K., Koch, D., Wilson, J., Stark, R.M., Jones, P.B. and Lennox, B.R., 2014. Young people’s views of UK mental health services. Early intervention in psychiatry, 8(1), pp.12-23.

McIntosh, A.M., Stewart, R., John, A., Smith, D.J., Davis, K., Sudlow, C., Corvin, A., Nicodemus, K.K., Kingdon, D., Hassan, L., and Hotopf, M., 2016. Data science for mental health: a UK perspective on a global challenge. The Lancet Psychiatry, 3(10), pp.993-998.

Gorczynski, P., Sims-Schouten, W., Hill, D. and Wilson, J.C., 2017. Examining mental health literacy, help-seeking behaviours, and mental health outcomes in UK university students. The Journal of Mental Health Training, Education and Practice.

Baker, C., 2020. Mental health statistics for England: prevalence, services, and funding.

Catalao, R., Mann, S., Wilson, C. and Howard, L.M., 2020. Preconception care in mental health services: planning for a better future. The British Journal of Psychiatry, 216(4), pp.180-181.

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Review of gender services has major implications for mental health services

Cass report calls for move away from mainly medical treatment as part of dramatic shift in approach to gender dysphoria

• Thousands of children unsure of gender identity ‘let down by NHS’
• Key findings of the NHS gender identity review

A long-awaited review by consultant paediatrician Hilary Cass into the NHS’s gender services for children calls for a dramatic shift in the type of treatment offered to children and young people with gender dysphoria.

The report proposes that instead of being offered mainly medical treatment, young people referred to NHS gender services should “receive a holistic assessment of their needs to inform an individualised care plan”, meaning that questions of gender identity should be treated alongside other possible mental health concerns.

It found that a medical pathway, such as puberty blockers, would not necessarily be the best option for children with gender dysphoria, and should not be provided “without also addressing wider mental health and/or psychosocially challenging problems”. The review suggests this “should include screening for neurodevelopmental conditions, including autism spectrum disorder, and a mental health assessment”.

The idea of a holistic assessment has so far been welcomed by medical experts, such as Dr Lade Smith, the president of the Royal College of Psychiatrists, who said: “Children who are gender questioning also commonly experience mental illness. It is extremely important that every child who is gender questioning has timely access to services that are holistic and respond to their individual needs.”

But the proposals will have major implications for wider children’s mental health services, which are already overstretched.

The waiting lists for gender-affirming care on the NHS are incredibly long. As of August 2022, there were 26,234 adults waiting for a first appointment with an adult gender dysphoria clinic, of whom 23,561 had been waiting more than 18 weeks. The number of children on the waiting list was approximately 7,600, of whom about 6,100 had been waiting more than 18 weeks.

In October, a coroner concluded that long waiting lists and barriers that prevent transgender people accessing gender-affirming care in the UK contributed to a decline in the mental health of Alice Litman, a young trans woman who killed herself in 2022.

The Cass report acknowledges that long waiting lists are a barrier to the NHS’s ability to provide effective gender-affirming care. It states: “It is only when they have been on very long waiting lists, and sidelined from usual care in local services, that they are forced to do their own research and may come to a single medical answer to their problems.”

However, general mental health services for young people are no better.

More than a quarter of a million (270,300) children and young people in England are still waiting for mental health support after being referred to children and young people’s mental health services in 2022-23, according to the children’s commissioner.

Between July and September of last year, children and young people who had an appointment for suspected autism had waited on average nine months (295 days) after their initial referral. This is despite the National Institute for Health and Care Excellence recommending that people with suspected autism should be diagnosed within three months of a referral.

Cass’s report said long waiting lists for gender services were in part due to an “unprecedented” increase in demand in recent years, which created “an unsustainable service model”. “Prior to 2009, Gids (the gender identity development service) did not attract significant attention. At that time, the service saw fewer than 50 children a year, with even fewer receiving medical treatment,” the report states.

Since the closure of the Gids clinic at the Tavistock and Portman NHS foundation trust in London in 2023, NHS England pledged to open eight regional clinics delivering a “different model of care”. The report has welcomed this, saying the regional centres “should allow care and risk to be actively managed … reducing waiting times for specialist care”. But since only one of these regional centres has opened, waiting lists will remain high for the foreseeable future.

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UCL and Islington Council collaborate to empower young people with better mental health support

Empower Islington, a project co-led by UCL and Islington Council, has helped young Islington residents co-create more effective and sustained mental health support.

12 April 2024

The pandemic may be a few years behind us, but the effects of it are still being felt, particularly on young people living with existing inequalities. 

“With 52% of Islington residents identifying as being from black, Asian minority and ethnic backgrounds, many local young people were disproportionately affected by the pandemic in terms of poverty, health disparity, racism and health access. 

“Because of this, we could see many young people were in clear need of employment, education, and mental health support,” explains Dr Keri Wong Associate Professor of Developmental Psychology at the IOE, UCL’s Faculty of Education and Society.

Dr Wong and her team have been listening to what young residents wanted in terms of support, and co-creating tailored workshops to meet their needs. The five sessions they’ve developed with templates freely accessible online (OSF), have covered everything from university life and improving sleep, to rethinking body image. Other sessions focused on social media use, and using storytelling and art to improve mental health, all topics chosen to address the areas young people wanted help with most.

The project builds on a previous collaboration, the CopeWell Study, run with the Jamal Edwards Delve charity in West London.

This knowledge exchange project has been supported by the UKRI Higher Education Innovation Funding (HEIF), managed by the Knowledge Exchange Funding team in UCL Innovation & Enterprise.

The Business and Innovation Partnerships team also helped with the partnership process, including the funding application and introducing the team to relevant contacts in the Council. 

Over 30 young people have now benefitted from the training, and the Council are looking to offer it as a regular part of their support through their Youth Progression Team.

Siobhan Scantlebury, Head of Youth Progression at Islington Council, said: “This is an exciting collaboration with UCL that's helping us to shape our employment, education and training services for young people based on their needs and aspirations. Working with an expert in this area like UCL, and amplifying the voices of young people locally, will mean we can better respond to what our young residents need with clearer insights and more targeted support.”

This project is just one example of how UCL and the London Borough of Islington are working in partnership to shape a more equitable future for the borough. The two organisations signed a Memorandum of Understanding in November 2023 to underline their shared commitment to working more closely together.

Dr Wong adds: “Completing the CopeWell and Empower Islington projects helped me put my research into practice, to see what was working in the community, what were the gaps in the system, and what more needs to be done. 

“These experiences have pushed me to thinking more deeply about the importance of connecting my research, and others, to policy. I want to make sure the communities I hear from, particularly the voices of minority ethnic groups and those living with existing inequalities, are also heard in policy spaces. 

“I’m now working as an ESRC Policy Fellow in the Home Office to see how best to translate research into policy and practice and to get policymakers into academic spaces to join in on our discussions.”

Read more about Dr Keri Wong’s experience of co-creating mental health support with young people .

Watch Dr Wong share the study’s findings on Independent Sage .

Watch a video about the Empower Islington Project

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Find out more about:

• Empower Islington
• UCL's partnership with London Borough of Islington Council
• Academic profile: Dr Keri Wong
• Businesses: develop a partnership with UCL
• UCL staff: partner with external organisations
• Innovation funding for UCL staff
• Centre for Education and Criminal Justice

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Anxious Parents Are the Ones Who Need Help

By Mathilde Ross

Dr. Ross is a senior staff psychiatrist at Boston University Health Services.

This month, across the country, a new cohort of students is being accepted into colleges. And if recent trends continue, the start of the school year will kick off another record-breaking season for anxiety on campus.

I’m talking about the parents. The kids are mostly fine.

Let me explain. Most emotions, even unpleasant ones, are normal. But the word is out about increasing rates of mental health problems on campus, and that’s got parents worrying. Fair enough. The statistics are startling — in 2022, nearly 14 percent of 18-to-25-year-olds reported having serious thoughts about suicide.

But parents are allowing their anxiety to take over, and it’s not helping anyone, least of all their children. If a child calls home too much, there must be a crisis! And if a child calls too little, there must be a crisis! Either way, the panicked parent picks up the phone and calls the college counseling center to talk to someone like me.

I am a psychiatrist who has worked at a major university’s mental health clinic for 16 years. Much of next year’s freshman class was born the year before I started working here. Technically, my job is to keep my door open and help students through crises, big and small. But I have also developed a comprehensive approach to the assessment and treatment of anxious parents.

The typical call from a parent begins like this: “I think my son/daughter is suffering from anxiety.” My typical reply is: “Anxiety in this setting is usually normal, because major life transitions like living away from home for the first time are commonly associated with elevated anxiety.” Parents used to be satisfied with this kind of answer, thanked me, hung up, called their children and encouraged them to think long-term: “This too shall pass.” And most everyone carried on.

But these days this kind of thinking just convinces parents that I don’t know what I’m talking about. In the circular logic of mental health awareness, a clinician’s reassurance that situational anxiety is most likely normal and time-limited leads a parent to believe that the clinician may be missing a serious mental health condition.

Today’s parents are suffering from anxiety about anxiety, which is actually much more serious than anxiety. It’s self-fulfilling and not easily soothed by logic or evidence, such as the knowledge that most everyone adjusts to college just fine.

Anxiety about anxiety has gotten so bad that some parents actually worry if their student isn’t anxious. This puts a lot of pressure on unanxious students — it creates anxiety about anxiety about anxiety. (This happens all the time. Well-meaning parents tell their kid to make an appointment with our office to make sure their adjustment to college is going OK.) If the student says she’s fine, the parents worry that she isn’t being forthright. This is the conundrum of anxiety about anxiety — there’s really no easy way to combat it.

But I do have some advice for parents. The first thing I’d like to say, and I mean it in the kindest possible way, is: Get a grip.

As for your kids, I would like to help you with some age-appropriate remedies. If your child calls during the first weeks of college feeling anxious, consider saying any of the following: You’ll get through this; this is normal; we’ll laugh about this phone call at Thanksgiving. Or, say anything that was helpful to you the last time you started something new. Alternatively, you could say nothing. Just listening really helps. It’s the entire basis of my profession.

If the anxiety is connected to academic performance — for instance, if your child is having difficulty following the professor and thinks everyone in class is smarter — consider saying, “Do the reading.” Several times a semester, a student I’ve counseled tells me he or she discovered the secret to college: Show up for class prepared! This is often whispered rather sheepishly, even though my office is private.

Anxiety about oral presentations is also quite common. You know what I tell students? “Rehearse your speech.” Parents, you can say things like this, too. Practice it: “Son, you wouldn’t believe how helpful practice is.”

I can prepare you for advanced topics, too. Let’s say your child is exhausted and having trouble waking up for class; he thinks he has a medical problem or maybe a sleep disorder. Consider telling him to go to bed earlier. Common sense is still allowed.

What if a roommate is too loud or too quiet, too messy or too neat? Advise your kid to talk to the roommate, to take the conversation to the problem’s source.

If your child is worrying about something more serious, like failing out of college: This is quite common in the first few weeks on campus. Truth be told, failing all of one’s classes and being expelled as a result, all within the first semester, is essentially impossible and is particularly rare among those students who are worrying about it. The administrative process simply doesn’t happen that fast. Besides, you haven’t paid enough tuition yet.

I’m making my job sound easy, and it’s not. I’m making kids sound simple, and they’re not. They are my life’s work. Some kids walk through my door in serious pain. But most don’t. Most just need a responsible adult to show them the way. And most of what I do can be handled by any adult who has been through a thing or two, which is to say, any parent.

I worry that the current obsession with mental health awareness is disempowering parents from helping their adult children handle ordinary things. People are increasingly fearful that any normal emotion is a sign of something serious. But if you send your adult children to a mental health professional at the first sign of distress, you deprive yourself of the opportunity to strengthen your relationship with them. This is the beginning of their adult relationship with you. Show them the way.

The transition to college is full of excitement and its cousin, anxiety. I enjoy shepherding young people through this rite of passage. Parents should try enjoying it, too.

Mathilde Ross is a senior staff psychiatrist at Boston University Health Services.

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Mental Health Services Monthly Statistics, Performance February 2024

This publication provides the most timely statistics available relating to NHS funded secondary mental health, learning disabilities and autism services in England. This information will be of use to people needing access to information quickly for operational decision making and other purposes. These statistics are derived from submissions made using version 4.1 of the Mental Health Services Dataset (MHSDS).

https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-services-monthly-statistics/performance-february-2024

This publication provides the most timely picture available of people using NHS funded secondary mental health, learning disabilities and autism services in England. These are experimental statistics which are undergoing development and evaluation.

This information will be of use to people needing access to information quickly for operational decision making and other purposes. More detailed information on the quality and completeness of these statistics is made available later in our Mental Health Bulletin: Annual Report publication series.

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