I nearly always welcome comments on my posts, but for this one, I actively encourage participation because diverse perspectives might be particularly valuable here, and I’d value your views on the subject.
Here I’m considering the UK’s perception of mental health and how we are performing in diagnosing negative mental health. Getting the right kind of mental health diagnosis at a population level is a complex problem to solve. Are we over-diagnosing or under-diagnosing mental health problems in the UK? And how would we measure that?
Let’s start with something we can probably say with confidence. Given that, throughout most of our modern history, very little regard was given to the subject of mental health, and given that most of the mental health problems people now encounter were undiagnosed and not even conceived of in our history, it’s a fairly safe assumption that we have under-diagnosed mental health problems in the past. But what about now?
Part of the consideration of under or over-diagnosis has to be about the definitions used. For example, the World Health Organisation (WHO) defines mental health as “A state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” Under that definition, I’d expect most people to claim sub-optimal mental health, especially during many difficult periods of their life, because those criteria are big asks.
Moreover, because of the numerous ways the UK has made a big mess of its own society, there are lots of impediments (some of them self-created) to an individual realising their abilities, coping with the normal stresses of life, working productively, and contributing positively to their community, that may not be proximally attributable to poor mental health. Perhaps we are under-diagnosing negative mental health in some cases and over-diagnosing it in others. Perhaps we are not focusing enough on the causes of positive mental health or doing enough to encourage these things. I don’t know.
And the places in which we are over-diagnosing negative mental health are bound to be extremely costly for UK society as a whole. There are likely to be many areas in life in which the cause of sub-optimal well-being is more directly attributable to things like not seeking the truth, failing to take proper responsibility for thoughts and actions, having too few close connections, an absence of positive people in life, life choices that negatively affect sleep, exercise, and diet, inadequate emotional awareness, and things of that nature. These are likely to increase anxiety, and may even lead to a diagnosis of depression, which in some cases might not be justifiably clinical.
A successful diagnosis can give an individual access to medication, support and other resources they might not otherwise have had. A faulty diagnosis may deepen the problems further, create a stigma, and distract attention from more viable correctives. And there are obvious costs with false negatives (not diagnosing a mental health issue when it’s there) and obvious costs with false positives (diagnosing a mental health issue when there is a better explanation).
At some point in the future, I hope to address the complex landscape of mental health with a video series on my YouTube channel. But for now, I’d love to hear your perspectives in the comments section.
