One in four of us have a mental health disorder. Ruby says it (and Stephen Fry too), so then it must be true. But has one in four people I pass in the street really got a diagnosable mental health problem? If this sounds like rather a lot, then it is: 15 243 750 people from the last estimate of the UK population.
I emailed the Time to Change Campaign to ask them where they got their numbers from and, seemingly unable to provide any hard evidence themselves, they pointed me toward the webpages of Mind, the Royal College of Psychiatrists and the Institute of Psychiatry. Pause for a minute to consider that a campaign that is happily promulgating ‘one in four’ via television advertisements and on London-wide posters is unable to produce simple evidence for it to an interested party on request. Of the three websites, that of Mind is the most helpful and points towards two surveys, the references of which are below. Both of them use population surveys to come their conclusions.
But before I get to that, think about this; in his book Blink: the power of thinking without thinking the eloquent Malcolm Gladwell essentially posits the following thesis: if you are faced with something and your first reaction is ‘that’s bollocks’ (my phraseology) then this inner voice should not be ignored; it well might be correct. I put it to you that ‘one in four’ statistic is just such instinctual bollocks and it is only because it is told to us by ‘experts’ and written all over our world that it is accepted as fact.
Because anyone like me who’s in the business of identifying mental health disorders knows one thing. Sometimes it’s very difficult to do and untangling symptoms of reasonable distress from those of functional mental illness is more often than not utterly impossible. I’ve written before about people whose ‘career’ as psychiatric patients involves being given a number of different classifications on which any two psychiatrists often disagree. What hope then for surveys whose aim is to tease out these same symptoms with scant regard to the whole person whose reasons meanings and circumstance will be complex and opaque? Thus ‘one in four’ is a vast overestimate reached in part as life is hard and distress but not ‘mental illness’ is widespread.
Sadly the more something is repeated, the more it is accepted as fact. And this is true doubly if it is coming from the mouth of a celebrity. But soberingly: even if these numbers are not real, they may be real in their consequences and in a world where 25% of the population is mentally ill, we get what we deserve. In the UK 2.5 million working age people are claiming disability benefits, and only 20% of people claiming these benefits will return to work within the next five years. This amounts to massive waste of potential and one which doctors are expected to police, despite often not even having received ten seconds tuition on the matter whilst at medical school or since.
Yes there is a significant number of people in the population with serious problems in their mental health, and yes, Time for Change’s aim to reduce mental health stigma is laudable. But their ‘one in four’ slogan is an untruth sold to them by foolish psychiatrists. Time for change indeed…
ONS 2000, Psychiatric morbidity among adults living in private households in Great Britain,
States that the number of people with a mental health disorder in the UK at any one time is 1 in 6 people. This number represents those with ‘significant’ mental health problems.
Goldberg, D. & Huxley Common mental disorders a bio-social model which uses a wider definition of mental illness and correspondingly provides us with a ‘one in four’