The Rising Mental Health Burden: Are We Missing the Point?

In the UK today, we are struggling. Over recent decades, we’ve seen more mental health professionals, more therapy, more awareness campaigns, and more medication being prescribed than ever before. Our public discourse around mental wellbeing is more open, visible, and widely supported. Government strategies and policy are written on it. We talk about trauma. We talk about boundaries. We talk about anxiety, depression, ADHD, and burnout with fluency.

All this presents a bit of a paradox: more therapy, more GP appointments, more medication, more mental health strategies, more awareness campaigns… and yet mental illness is more widespread than ever. Something is missing.

This is not an attack on professionals, therapists, or public health experts. There are brilliant people doing vital work across our NHS and voluntary sectors. We’ve made huge gains in many areas of health: smoking-related illness is down, cancer screening is better, and early detection has saved lives. We’ve shifted stigma around mental health in ways that would have been unimaginable a generation ago.

But at what point do we start asking deeper, more uncomfortable questions? Those of us who can need to wave this flag.

Maybe — and this is a deliberately oversimplified point — more of the same isn’t working. Maybe throwing more money, more strategy documents, and more campaigns into the swamp of modern malaise is not the answer. Or at least, not the whole answer.

Something feels broken.

The cynical among us point to the pharmaceutical-industrial complex, which thrives on lifelong medication rather than long-term recovery. Others highlight social media, ultra-processed diets, the collapse of local infrastructure, and the long shadow of COVID. These are all part of the picture. We’ve never had more podcasts, Instagram reels, or TikToks explaining trauma, ADHD, anxiety, or emotional regulation. More people than ever are taking SSRIs. More people are in therapy.

Could it be that those of us who work in mental health are part of a machine that is just making us more ill? Let’s look at some stats.

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A Surge in Medication

Antidepressant use is now higher than at any point in UK history. In 2022/23, over 86 million antidepressant items were dispensed in England, prescribed to around 8.6 million people — roughly 1 in 6 adults (NHS Business Services Authority, 2023). In Wales, the number of prescriptions has doubled in the past decade, rising from 3.5 million in 2010/11 to 7 million in 2022/23 (Mind Cymru, 2023).

These numbers point to increased diagnosis and more people seeking help — which is good in one sense. But they also raise questions: Are we medicalising distress at the expense of addressing root causes? And why is distress rising even as medication becomes more widespread?

Where Has All the Awareness Got Us?

We’ve made great strides in destigmatising mental illness. Surveys show that in 2024, 72% of UK adults said they’d be comfortable with someone who has schizophrenia marrying into their family — up from just 37% in 2007 (King’s College London, 2024). The willingness to talk about mental health, seek therapy, and support others is doing well.

But the King’s College report highlights a range of concerns. Despite all the efforts to improve public attitudes, attitudes have declined for the first time in a decade. The report makes for an interesting read.

Despite awareness rising over the years, the numbers tell a sobering story. It hasn’t worked. Among 17–19-year-olds in England, the rate of probable mental disorders has more than doubled — from 10% in 2017 to 26% in 2022 (NHS Digital, 2022). For children aged 7–16, that number has risen from 11% to 18% over the same period.

Something isn’t adding up. More awareness and openness — but also more illness, and worse attitudes toward mental health. Is there something deeper going on?

A System at Breaking Point

As more people recognise their mental health struggles and seek help, the services designed to support them are buckling under the pressure. In 2021, 4.3 million referrals were made to NHS mental health services — the highest ever recorded (Royal College of Psychiatrists, 2023). By 2023, around 1.4 million people were on mental health waiting lists in England (Royal College of Psychiatrists, 2023).

In Wales, thousands are waiting beyond target times. More than 10% of patients waited over 8 weeks just for an initial assessment in 2023 (Welsh Government, 2023). Even urgent referrals for children and young people can mean a wait of months. The system is overwhelmed, despite funding increases and workforce expansion.

We seem to be chasing symptoms downstream — with not enough focus on prevention, lifestyle, connection, or upstream change.

Lonelier Than Ever

Loneliness is a key part of the picture. According to national data, about 7% of UK adults (3.8 million people) experience chronic loneliness — that is, they feel lonely often or always (Campaign to End Loneliness, 2022). In Wales, that number sits at 13%, with a further 48% saying they feel lonely “sometimes” (Welsh Government, 2023). That’s over 60% of the population admitting some level of social disconnection.

This isn’t just sad — it’s a public health issue. Chronic loneliness has been shown to be as damaging to health as smoking 15 cigarettes a day. And while we pump millions into mental health interventions, we’re still struggling to answer the question: Why are so many people feeling so alone in a world more connected than ever before?

So, What’s Missing?

Grim reading. It’s evident that the system is losing. Despite its efforts — the policies, the funding, the services, the strategies, and the treadmill of academic research — the mental health burden has worsened. All the progress in the last decade or two has failed to deliver. Some would argue it’s made things worse.

There are many possible reasons why the war is being lost and I mentioned these earlier; social media, income inequality, ultra-processed food, COVID-19 fallout, or the pharmacological-industrial complex. Take your pick. But in my experience, one thing comes up again and again:

We are lacking real, human community — and there is no substitute.

Not an app. Not a campaign. Not a new model of care. Not even a better pill. What makes us well is other people. Being needed. Being known. Having a role to play. Feeling like we belong somewhere.

We’ve overcomplicated our approach to collective wellbeing. Connection, belonging, and shared purpose should be the foundation. Without them, system-wide measures risk becoming expensive, bureaucratic band-aids. Should the system cede more power to those on the ground — the ones who stand face-to-face with distress every day? The real humans, who talk like real humans to each other?

This isn’t about romanticising the past or blaming the present. It’s about remembering that healing often starts close to home — in our communities, clubs, faith groups, football teams, gym floors, local parks, choirs, and quiet cups of tea with a neighbour. We desperately need a bit of that back.

Until we rebuild that foundation, no amount of awareness or therapy will be enough.

References

Burns, C. (2022). Antidepressant prescribing increases by 35% in six years. The Pharmaceutical Journal. https://pharmaceutical-journal.com/article/news/antidepressant-prescribing-increases-by-35-in-six-years

Campaign to End Loneliness. (2022). The state of loneliness 2022. https://www.campaigntoendloneliness.org/the-state-of-loneliness-2022/

King’s College London. (2024). Attitudes to mental illness: Tracking public perceptions in the UK. https://www.kcl.ac.uk/news/public-attitudes-to-mental-health-decline-for-the-first-time-in-10-years

Mind Cymru. (2023). The big mental health report: Prescribing trends in Wales. https://www.mind.org.uk/about-us/our-policy-work/the-big-mental-health-report-2024/

NHS Business Services Authority. (2023). NHS releases mental health medicines statistics for 2022/23 in England [Press release]. https://media.nhsbsa.nhs.uk/press-releases/b2c7078e-0b11-416e-b87a-a45212ce16b0/nhs-releases-mental-health-medicines-statistics-for-2022-2023-in-england

NHS Digital. (2022). Mental health of children and young people in England, 2022: Wave 3 follow-up to the 2017 survey. http://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2022-follow-up-to-the-2017-survey

Royal College of Psychiatrists. (2023). Record 1.4 million people waiting for mental health treatment. https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2022/03/15/record-4.3-million-referrals-to-specialist-mental-health-services-in-2021/

Welsh Government. (2023). National Survey for Wales: Loneliness 2022-23. https://gov.wales/national-survey-wales-loneliness-april-2022-march-2023

Welsh Government. (2023). NHS mental health waiting times data – 2023 Q2. https://statswales.gov.wales/Catalogue/Health-and-Social-Care/NHS-Hospital-Waiting-Times