Dr Lucy Foulkes

‘Tell us disorders are prevalant and we interpret our own symptoms in the same way’

up-front bill, there is the lost tax revenue, and the lost productive capacity in the economy; of the 2.6 million people economically inactive due to long-term sickness, over half report depression, bad nerves or anxiety.

The golden rule of economics is that people respond to the incentives you give them. And at the same time that Britain was busily encouraging its population to talk about its mental health, the Government was making a series of changes to the welfare system that made using that knowledge to claim disability benefits significantly more attractive.

While a series of cuts were made to the welfare system after 2010, “that hasn’t really been true for the disability system, and certainly for PIP,” Waters says. This means that “the relative value of getting on PIP has increased; it’s more of an economically rational thing to do when proportionately it will make up more of your income.”

This incentive may well have been strengthened by attempts to get people into employment. “If you’re on standard out-of-work benefits, you’re usually required to look for work as a

Where do we go from here?

Although well-meaning, Britain appears to have got itself into a muddle. Our efforts to talk more about mental health have had significant positive results, with our population more literate, more tolerant and better able to seek help. At the same time, we appear to be misdiagnosing everyday stresses as mental health issues, overcrowding services, directing people towards treatments that aren’t appropriate for them, and running up a huge benefits bill in the process.

How do we go about fixing this mess? Vicki Nash disagrees that “talking about mental health is damaging to people”. Instead, we’ve reached “an uncomfortable realisation that our mental health system can only support a fraction of those who need help… in no other health condition would we accept the fact that three quarters of people will never get treatment”. This will require “better investment in services”. Changes to the benefits system, meanwhile, are “brazenly motivated by a desire to save money, driven by baseless assumptions about disabled people”.

As Dr Foulkes puts it, the idea that talking about mental health can leave people worse off “is a possibility that we need to take more seriously”, but also one we need to be “very careful about”; there’s a risk that we undo the good work of the last two decades, and end up with “no one being believed”.

So how do we strike a balance between recalibrating our view of