A Crisis in Mental Health: Why Our Approach Needs to Change

Here is the bottom line up front: demand on health services is growing year on year. In the world of Mental Health, I speak with many professionals with years of experience, and the general view is that demand is vastly greater than it was in the past. It’s increasing, and there’s no clear solution in sight.

When looking at statistics within primary mental health (services accessible through GPs), even finding reliable data is challenging. COVID skewed the numbers by including vaccine appointments in consultation figures. But year on year, consultations have been increasing by about 10% since 2000 (Kontopantelis et al., 2021). Meanwhile, GP provision has stagnated since around 2015 (BMA, 2024). To put it in perspective, over the 12-month period up to October 2023, there were 358 million GP appointments. It’s off the charts.

When I look at these numbers, I can’t help but feel disheartened. Working in mental health in both the NHS and the third sector, I try to keep my head down and do my bit. But every now and then, I lift my head and feel like we’re losing the war.

The report I’m referring to, Briefing: Improving Children and Young People’s Mental Health Services, produced by the Health Foundation (Grimm et al., 2022), presents some truly concerning data. Even though the report focuses on improvements, it offers little beyond recommending more data collection for targeted interventions. It highlights troubling trends: an increase in mental health prescriptions for children and young people, rising mental health problems outpacing service provision, probable mental health diagnoses for 25% of 17- to 22-year-old girls, higher referral rates in deprived areas, and significant gaps in data.

Our young people are truly struggling, and we need to pay attention to what’s happening. A young person under prolonged stress—for any reason—is far more likely to face mental or physical health challenges as they grow up. A child who endures hardship or deprivation during their formative years is at much higher risk for health challenges later in life. A teenager who copes with stress or illness in maladaptive ways won’t suddenly develop effective coping strategies in adulthood. Our prison population, homeless numbers, addiction rates, and chronic health conditions are dominated by people who faced significant adversity in their youth. There isn’t a psychological intervention that can neatly address and resolve years of childhood trauma and sympathetic nervous system activation.

I am grateful for reports like these, which highlight the serious concerns staring us in the face. But here’s what bothers me most: I have yet to see or hear of any changes that truly offer hope. None. No person, policy, large organization, or politician seems to have a strategy that fills me with optimism. I’d be happy to be proven wrong, and I sincerely hope I am.

In Wales, we do have the Mental Health and Wellbeing Strategy (Welsh Government, 2024), a 91-page draft consultation document that I recently reviewed. It sounds promising: government oversight, training, awareness campaigns, prioritization, outcome monitoring, and more. Truly, it sounds comprehensive, and I try to remain optimistic. But my hope waivers because, as the cynic in me notes, this strategy is just one in a long line of policies that have overseen continually worsening health and well-being. What’s different this time? The only thing that seems different is that, arguably, times are tougher for a lot of people compared to a decade ago.

Sadly, any reserve of optimism I have is further drained when I examine these reports through the lens of a men’s health advocate. If you’re someone who works with men, you might come away feeling deeply underwhelmed. Many significant health inequalities disproportionately affect men and boys. For example: higher rates of suicide, drug and alcohol abuse, stigma, homelessness, workplace injuries and fatalities, criminal justice issues, chronic health conditions, obesity, poor access to healthcare, and premature death. And this is just the tip of the iceberg.

I’m struggling to see a cohesive solution. I’m not saying the answer doesn’t exist—I just haven’t seen it yet.

What now?

Please forgive my doom and gloom—I don’t have a succinct solution. But I do know where attention is needed, and it lies in the hands of people and leaders in our communities. There is no shortage of amazing individuals running impactful projects and initiatives who want nothing more than to see more people walking through their doors. The average person struggling with multiple stressors and loneliness isn’t going to see their life improve because of a government framework or an awareness campaign from a big charity. In fact, in my career, I’ve never heard a mental health client cite an awareness campaign as having helped them in any tangible way.

The real change-makers are those who connect with people on a human level, who talk to them, and help them find a sense of belonging in a community. These are the people who can connect the dots to help relieve the real and present stressors in someone’s life. They help others build purpose and routine—whether that’s at a gym, a sports club, a men’s shed, a walking group, or any group with a shared goal.

It’s these real-life, personal connections to a community that will take some of the pressure off health services. This bit of “wiggle room” could allow health professionals to focus more on individuals’ specific needs.

A Call for Action

Here’s my ask to anyone who wants to help relieve the burden of poor well-being and mental health in our communities. Sometimes, the best thing you can do is to guide someone toward a mental health service or connect them with urgent support. This might mean calling 999, dialing 111 and pressing 2, arranging an urgent GP appointment, or reaching out to someone’s key worker in a mental health service. These actions can be vital and even life-saving.

But for non-urgent concerns, sometimes the most powerful way we can help is by being the catalyst that connects someone to a community. It might be encouraging them to join a local group, meet like-minded individuals, or try something new.

It sounds so cliché to say, but time and time again, being part of something can be as therapeutic as the best therapy—and then some.

References

BMA. (2024). Pressures in general practice data analysis. Retrieved November 14, 2024, from https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice-data-analysis

Grimm, F., Alcock, B., Butler, J., Fernandez Crespo, R., Davies, A., Peytrignet, S., Piroddi, R., Thorlby, R., & Tallack, C. (2022). Improving children and young people’s mental health services: Local data insights from England, Scotland, and Wales. The Health Foundation. https://doi.org/10.37829/HF-2022-NDL1

GOV.UK. (2023, October). Fifty million more GP appointments delivered by the NHS. Retrieved November 14, 2024, from https://www.gov.uk/government/news/fifty-million-more-gp-appointments-delivered-by-the-nhs#:~:text=In%20the%2012%20months%20to,million%20more%20appointments%20a%20year

Kontopantelis, E., Panagioti, M., Farragher, T., et al. (2021). Consultation patterns and frequent attenders in UK primary care from 2000 to 2019: A retrospective cohort analysis of consultation events across 845 general practices. BMJ Open, 11, e054666. https://doi.org/10.1136/bmjopen-2021-054666

Welsh Government. (2024). Draft Mental Health and Wellbeing Strategy 2024-2034. Retrieved from https://www.gov.wales/sites/default/files/consultations/2024-04/consultation-document-draft-mental-health-and-wellbeing-strategy