New Thinking

The challenge

  • The financial burden of poor mental health in the UK has been conservatively estimated at £300 billion per year: much of it due to losses in productivity.[1]
  • In a global survey of 64 countries, the UK is ranked equal bottom for mental well-being, with 35% of the population found to be “distressed” or “struggling”.[2]
  • 20% of the UK population have taken a psychiatric drug in any one year.[3]
  • about one in five children and young people have a probable mental health problem, according to the NHS.[4]
  • UK ranks last in a survey of life satisfaction in 15 year-olds; girls and those experiencing disadvantage are particularly affected.[5]

Flourish believes that mental health policy in the UK needs a radical rethink.  It needs to be reframed as a societal problem, not a medical problem.  Increasingly, the evidence supports the idea that the root causes of persistent psychological distress arise from relatioships in the social environment, rather than there being a biological problem such as a “chemical imbalance in the brain”. 

However, reconfiguring mental health in societal terms is not straightforward.  Firstly, we must recognise that society is complex with many factors at work.  Secondly, each person’s path to persistent psychological distress is unique.  That means that one-size fits all solutions are not well suited to cater for such complexity.  But first we must surely grasp this complexity, rather than rely upon quick fixes.

The analysis

So how do people come to experience persistent psychological distress?  Counsellors and psychotherapists are well-placed to know, since therapy typically reveals much of each client’s unique personal story.  Childhood adversity is an almost ubiquitous background factor which creates vulnerabilities which shape later life.  This includes how they will respond to a life challenge such as a loss or a social hurt.  Life challenges that are often discussed in the media include social media, exam pressures, poverty, the loss of a job and many others.  But there are other more subtle forces in our culture which cause suffering.

 

For example, if a person sees that they have a mental health problem then the prevalent medical model leads them to look inside their head and deal with it – perhaps see a GP and get a medicine: those who suffer commonly believe there is “something seriously wrong with me”.  There is little in our culture that might encourage a belief that mental suffering happens to people with a well-functioning brain, and that the causes of their distress lie outside the brain.  As clinical psychologists often put it: “we should not ask ‘what’s wrong with you?’, but rather ‘what happened to you?’”

 

Talking therapies can create a space from which outward-looking conclusions emerge; here are just two. Firstly, typically the client better understands the circumstances and impact of their past adversity and concludes that they are normal after all.  Secondly, they can identify changes they may want to make in life, such as finding or creating more nurturing relationships, having more contact with nature or making changes in the worlds of education or work.

 

A second factor in our culture is the belief, often subconsciously-held, that by and large, people get what they deserve.  This is often known as the “fair world fallacy”.[6]  This can be deeply damaging to who are struggling with their mental health and also face, as is often the case, the challenges of poverty and other disadvantage.  Self-blame, low self-esteem and despair result, perpetuating a vicious cycle from which it is difficult to escape.

 

We believe that the multiple factors and pathways to persistent psychology suffering need to be better identified and articulated to society, so that appropriate preventative and remedial approaches can be adopted.  That would require us to look outside of the medical realm and draw upon a range of different disciplines that speak more generally to the human condition in our complex world.

 

For more information, please see under RESOURCES for our briefing note: Charting a New Course for Mental Health and Well-Being in the UK.

 

REFERENCES:

[1] https://www.centreformentalhealth.org.uk/publications/the-economic-and-social-costs-of-mental-ill-health/#:~:text=This%20analysis%20finds%20that%20the,due%20to%20mental%20ill%20health.

[2] In contrast the figure for Italy is 17%.  See: https://sapienlabs.org/wp-content/uploads/2024/03/4th-Annual-Mental-State-of-the-World-Report.pdf  

[3] For England data, see: https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2023-wave-4-follow-up#:~:text=Key%20Facts,20%20to%2025%20year%20olds.

[4] https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2023-wave-4-follow-up#:~:text=Key%20Facts,20%20to%2025%20year%20olds.

[5] https://www.childrenssociety.org.uk/sites/default/files/2024-08/Good%20Childhood%20Report-Summary-Report.pdf?_gl=1*1yjip4b*_up*MQ..&gclid=CjwKCAjwuMC2BhA7EiwAmJKRrHXE11aArugn1JnTExev-Xl2YtddVZ2RVQrH-32tqbUZWCpc4yxebxoCZxwQAvD_BwE

[6] Furnham, A. (2003).  Belief in a just world: research progress over the past decade.  Personality and Individual Differences, 34, 795-817.

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