There is an "overdiagnosis" of mental
health conditions, says Health Secretary Wes Streeting, where Generation Z are giving up on
work, a new study suggests, with almost four in ten considering leaving their
job and ending up on benefits, and many people already in that situation. We
all probably know quite a few people who are playing the system; people who
don’t work and probably could work, where the state is funding their lifestyle;
and we all probably know people who are too unwell to work, and rely on
justified welfare support, and are not getting anything like the support they
need. Blanket solutions are problematic here, as every situation is a case by
case.
The overdiagnosis issue is a complex matter to solve, because what we have here is a Type 1 and Type 2 error problem. A Type 1 error occurs when a diagnosis wrongly identifies someone as having a mental health disorder deeming them unfit for work, when they really could and should be working. And a Type 2 error occurs when there is a failure to identify a mental health disorder that is actually present.
By and large, the UK is a very risk-averse, interferingly cautious society, where we’d rather be awash with Type 1 errors to guard against Type 2 errors – that is, by analogy, we’d rather let off ten guilty people than see one innocent person go to jail (see my Blog post on Blackstone’s ratio). Type 1 errors are becoming ever-more predominate in many areas of society – from trans issues, to online censorship, to climate change policy, to free speech impediments, to race, equality and diversity policies - and it seems clear that we are probably predisposing ourselves to increased Type 1 errors occurring in the domain of mental health, which are highly likely to be far more numerous than Type 2 errors. Additionally, because it’s both empirically harder and riskier to fail to diagnose a mental health disorder, or accuse someone of exaggerating a disorder, or suggest that their troubles could be overcome with more personal responsibility, we’d expect Type 1 errors to dominate.
If too many people are wrongly classified as unable to work, the results will be a shrinking workforce, higher welfare costs, lower productivity, and a greater burden on taxpayers. Some are saying we’ve already reached that point, and things are destined to get far worse if this continues.
I don’t claim to have easy answers to these highly complex problems – but it’s certainly something that a nation shouldn’t be afraid of addressing, because the long-term consequences of this could be severe - not just in terms of economic stagnation and an overburdened welfare state, but also in how we perceive work, personal responsibility, and resilience. Ironically, of course, failing to address an overabundance of Type 1 errors by erring too heavily on the side of caution can itself be an example of the very same Type 1 error under examination. It's a feedback loop where the excessive risk aversion perpetuates the very problem it seeks to prevent. A Type 1 error of Type 1 errors.
Further Reading: Exploring Mental Health
