Mental Health Campaigns and the Rise of Mental Health Problems

In recent years, mental health has gained increased attention and recognition as an important aspect of overall well-being. Efforts to raise awareness about mental health issues have grown significantly, with campaigns, initiatives, and discussions aimed at reducing stigma and promoting help-seeking behaviours. But is there a relationship between mental health awareness efforts and the reported prevalence of mental health problems? By examining the potential factors at play and considering empirical evidence, we can gain a deeper understanding of this complex issue.

Reduction in Stigma

Mental health awareness efforts have contributed to a more open and public dialogue surrounding mental health issues. This has helped to break down long-standing stigmas, encouraging individuals to share their experiences and seek support. Mental health awareness campaigns have led to increased availability of information and resources. This has empowered individuals to better understand mental health, recognize symptoms, and seek appropriate help when needed.

Efforts to raise mental health awareness have been successful in reducing the stigma associated with mental health conditions. This has created an environment where individuals feel more comfortable disclosing their struggles and seeking help, leading to increased reporting. Increased awareness initiatives have improved mental health literacy, enabling individuals to recognize and label their mental health symptoms. This enhanced understanding may contribute to a higher reporting rate as people become more aware of their mental health concerns. Several societal factors, such as increased stress levels, changing social dynamics, and evolving cultural norms, may also contribute to the rise in reported mental health problems. While mental health awareness efforts can facilitate identification and reporting, these broader contextual factors should be considered.

Promotion and Recognition

Extensive resources have been poured into raising public awareness about mental health problems. One positive outcome of mental health awareness efforts has undeniably brought about positive changes by reducing stigma, promoting help-seeking behaviours, and connecting individuals with necessary support services. These initiatives have provided platforms for education, empathy, and community-building.

While mental health awareness campaigns are essential, it is crucial to acknowledge potential unintended consequences. While the goals have been admirable, there is an increasing realization, that they may be creating an escalation in the reporting of ‘mental health problems’ especially in younger age categories. In an interesting paper by Foulkes and Andrews, (2023), on the prevalence inflation hypothesis, they argue that mental health awareness efforts are leading to more accurate reporting of previously under-recognized symptoms, which they say is one beneficial outcome, but secondly, they propose that awareness efforts are leading some individuals to interpret and report milder forms of distress as mental health problems and that this may lead to some individuals experiencing a genuine increase in symptoms because labelling distress as a mental health problem can sometimes affect an individual's self-concept and behaviour in a way that is ultimately self-fulfilling.

Mixed Findings

Empirical studies examining the relationship between mental health awareness efforts and the reported prevalence of mental health problems have yielded mixed results. Some studies suggest a positive association, while others find no significant correlation or even a decrease in reported mental health issues. The complexity of measuring mental health, variations in survey methodologies, and potential reporting biases must be considered when interpreting research findings. These factors can influence the reported prevalence rates and make it challenging to establish a direct causal relationship between awareness efforts and increased reporting. Some concerns include the possibility of overmedicalization, self-diagnosis without professional input, and the potential for individuals to identify as having mental health issues based on popular trends or misinterpretations.

Mental health awareness efforts play a critical role in reducing stigma and promoting help-seeking behaviours. While they have contributed to an increase in reported mental health problems, this rise may be attributed to multiple factors, including reduced stigma and improved mental health literacy. Empirical evidence suggests a complex relationship, emphasizing the need for nuanced approaches that balance the benefits of awareness with potential concerns. Continued research, monitoring, and targeted interventions are necessary to ensure that mental health awareness efforts effectively support those in need while minimizing unintended consequences.

So Many Mental Health Campaigns

Campaigns may be actively contributing to the so-called ‘psychologising’ of everyday suffering and distress. Campaigns promoting self-disclosure may seem admirable, but it has been recognised that stigma and shame remain significant barriers to people seeking professional help, especially in the workplace. One potential social consequence is that there may also be a social dividend to self-disclosure and it may provide secondary gains to those talking about it. Often seen as an explanation as to why mental health problems are often glamorised or even romanticised, particularly on social media (e.g. quotes about depression on aesthetically-appealing backgrounds are widely shared) Foulkes and Andrews (2023). The question is do these campaigns lead to an excessive tendency to interpret negative psychological experiences as mental health problems?

Labels and Experiences

One interesting theory on how humans use categories is proposed by philsopher Ian Hacking involves what he calls the "looping effects". He explores the dynamic relationship between social categories and individual behaviour. He examines how the classification of individuals into certain categories can influence their self-perception and subsequent behaviour, leading to a feedback loop that reinforces and reshapes the very categories themselves.

Psychiatry Essential Reads

Rachel Aviv’s Search for the Meaning of Mental Illness

What's Wrong With the Self in Schizophrenia?

Hacking's theory of looping effects challenges the traditional view of categories as static and objective, instead emphasizing their active role in shaping the social and psychological realities they represent. According to Hacking, categories such as mental disorders, personality types, or social identities are not fixed entities but rather socially constructed phenomena. They are products of historical, cultural, and scientific processes that involve the interaction between experts, institutions, and individuals. Hacking argues and I believe rightly so, that once a category is created and applied to individuals, it can have significant effects on their behaviour and experiences, leading to a transformation in the very nature of the category itself.

Inventor and the Invention

One key concept in Hacking's theory is "interactive kinds." Interactive kinds are categories that have the power to affect the individuals classified within them. For example, the classification of individuals as "autistic" has led to a transformation in the understanding and experience of autism. This classification has influenced not only the way autism is perceived but also the behaviour, self-perception, and lived experiences of individuals diagnosed with autism. The very act of categorization creates new possibilities for self-understanding and shapes the individual's subsequent actions.

Hacking identifies two primary looping effects: "human kinds" and "dynamic nominalism." Human kinds refer to categories that shape individuals' experiences and self-identification, influencing the development of new ways of being. For instance, the categorization of individuals as having "multiple personality disorder" led to the emergence of new psychological phenomena, with individuals adopting and embodying multiple identities as a result of the diagnostic label. Dynamic nominalism, on the other hand, describes the process through which categories change over time due to their impact on individuals' behaviour. As individuals conform to or resist the expectations associated with a category, the category itself evolves. The process of categorization has real-world consequences, influencing individual behaviour, institutional practices, and social dynamics. By recognizing the looping effects, Hacking urges us to critically examine and understand the power dynamics inherent in the creation and application of categories, encouraging a more nuanced and reflexive approach to the ways we classify and understand ourselves and others.

Over-interpretation of experience can lead to over-pathologising of common everyday distress. As Hacking reminds us, we can trigger a self-fulfilling prophecy effect, where the prophecy of the event leads to the event of the prophecy. Believing our distress to be a sign of some pathological issue may well bring about a greater anxiety or depressive response. We need to better understand how mental health campaigns can seek to reduce these negative effects, with an eye on better outcomes and treatment availability for all, regardless of age, gender, race or social background.