Something is wrong with our approach to mental health in Aotearoa New Zealand. According to Statistics New Zealandmore than a quarter of the population can be described as having poor mental wellbeing, and this proportion is increasing.
Problems are particularly prevalent among young people, with 23.6% of 15-24 year olds reporting high or very high levels of psychological distress, according to the 2021/22 survey. New Zealand Health Survey – compared to only 5.1% in the 2011/12 report.
There are many likely (and familiar) contributing factors, including COVID-19 and associated social disruption, stress from rising costs of living, and inequity and marginalization on the grassroots of identity.
Other plausible factors include existential concerns about the climate crisis, overworked and underpaid teachers, social media, and the crumbling mental health system.
But there is a less obvious factor that could be contributing to the mental health crisis, particularly among young people: the paradoxical effects of increased mental health awareness.
Define the problem
Young people are more aware of mental illness than ever, largely due to explicit efforts over the past few decades to raise awareness about mental health and mental disorders, including through social media.
But a few recent search wondered whether this increased awareness was as beneficial as it seems at first glance. While greater awareness may mean “more accurate reporting of previously under-recognized symptoms,” it may also lead “some people to interpret and report milder forms of distress as mental health problems.”
People can then seek professional help, as they have been advised to do, but this help is often not available. This in turn can lead to a very real increase in distress. And it can discourage more traditional, less clinical forms of coping, like talking with friends and family or making positive lifestyle changes.
It’s also plausible that greater awareness and acceptance of mental health issues may lead people to view these issues as an inevitable part of who they are – as simply a part of their brain chemistry.
Such a view could result in the loss of a sense of personal agency in the face of psychological challenges, creating a sense of hopelessness about the possibility of positive change.
Mental health and identity
None of this is entirely surprising. The notion of “concept creephas been used to describe “the progressive semantic expansion of concepts related to harm such as bullying, mental disorders, prejudice and trauma.”
Consider how terms like “trauma” and “bullying” have become increasingly used, but their meaning has become less specific as topics of public conversation. Anecdotally, this is what we seem to see in the public understanding of mental disorders – including the assumption that mental health issues are simply part of a person’s identity.
Learn more:
The impact of childhood and adolescent anxiety disorders on later life – new research
None of this suggests that we should stop talking about such an important topic. Instead, we need to think very critically about how we talk about mental health and mental disorders – moving from thinking in terms of mental health awareness to mental health literacy.
This means discussing what constitutes a mental health problem – and what isn’t. For example, some people clearly experience truly problematic levels of anxiety. But at the same time, anxiety is a normal and healthy human emotion. Where exactly do we draw the line?
Learn more:
Is “climate anxiety” a clinical diagnosis? Should it be?
Personal agency and hope
To answer questions like this, we first need to truly understand what we mean by the concept of “mental disorder.”
Exploring how we best think about mental disorders, why they are considered disorders, and how we might better seek to explain them, is the central subject of my new book: Embodied, integrated and enactive psychopathology: reinventing mental disorder.
The book offers a new way to approach this complex but vital subject. It recognizes that mental disorders are influenced by factors in the brain, body and environment. However, it also preserves a sense of agency and hope – seeing mental health issues as things we can have influence over.
The question of how best to view mental disorders is much more than just an academic or philosophical dilemma. This has very real implications for health policy, for what our systems of care should look like, and for how individuals understand the mental health issues they or their loved ones may face.
Ultimately, how we think about mental disorders is very important.
