Progress still battles prejudice when it comes to mental health

In April this year, as part of our three-year partnership with the Nominet Trust, we set out on 12 months of research and development around mental illness, which is the largest single burden of disease in the UK, with a massive human and social cost, as well as an estimated economic cost of £105 billion a year

Skipping to the end of this process, we aim to emerge with 1-2 tested prototypes of new digital products that have the potential to appeal to large audiences, can sustain themselves through social business models and contain positive mental wellbeing behaviours and measurable impact.

The Nominet Trust partnership gives us the freedom to apply our social innovation model to issues that we feel we can make a meaningful contribution to. During this shortlisting bit of our process, when we work through a set of criteria to reach potentially relevant areas of R&D, we have to make some assumptions based on an initially superficial look at the relationship between behaviours and issues and the role of an implicit, product based approach.

In March, some those assumptions included:

1. Our approach would be much better suited to neuroses, such as depression, stress and anxiety rather than psychoses, such as schizophrenia or bi-polar disorder, because the relationship between common mental health disorders and everyday behaviours is stronger. As a result, our focus on universal, preventative interventions had potential to contribute more meaningfully to behaviours related to neurosis.

2. The social stigma attached to mental illness most likely limits the reach of an explicit approach to interventions (i.e. that looks and sounds like a mental health campaign, project or service), which creates a need for more implicit interventions (i.e. built into something with a different type of appeal). This would run parallel to vital work to challenge these negative perceptions and undermine these taboos, by organisations such as the Mental Health Foundation, Mind and Rethink Mental Illness.

3. There seems to be a relative lack of understanding or consensus around what represents behaviours that support good mental well-being, compared to behaviours that support good physical well-being. This looked like an area of substantial future growth as the scale and impact of mental illness catalyses more interest and investment in preventative solutions for all.

4. Efforts to bring mental well-being to mainstream audiences have often tended to come across as alternative (normally involving some kind of guru) rather than relevant to all. Our work on healthy eating, pro-environmental behaviour change and other similar areas has seen that this tendency can easily become culturally consolidated, which traps behaviours in cultural niches, which ultimately limits their capacity to become normal.

After 6 months of research, through which we have defined our scope for the do1.wawwd.infoelopment of concepts, these assumptions have been refined, but mainly held true.

Within this, I’ve been particularly struck by both the progress that is being made across many areas of psychological research and the wall of outdated thinking and approaches that are holding us back.

The progress is fundamental and hugely inspiring.

There have been major advances in understanding the contribution of genetics and environment to mental health, concluding that environmental factors can affect the expression of genes, and changes in the expression of genes can be passed down from one generation to the next.

Our understanding of the ‘wiring’ of the brain has improved significantly over the last 30 years. Advances in technology, such as brain scanning, have enabled us to explore the neurological correlates of emotional experiences such as fear, disgust etc. We now have a much better understanding of how fear affects us, for instance.

We now know that the brain is plastic in adults. So, neurological pathways can be changed by altering behaviours and thought patterns, through meditation for example, which in turn affects habitual thoughts and perception. Norman Doidge’s “The Brain that Changes Itself” is a great introduction to this.

There is clear evidence that cognitive bias, or selective attention, is connected to aspects of personality. As Winston Churchill said “a pessimist sees the difficulty in every opportunity, an optimist sees the opportunity in every difficulty” and we now know that these differences run deep, down in the networks and pathways that make up our rainy brain and our sunny brain.

There is now a lot of evidence that CBT is effective as a treatment for anxiety, and other common mental health disorders. In a review of meta-reviews of the effectiveness of CBT, it was found that the evidence-base for CBT is very strong and 84% of the studies they identified had been published since 2004, showing the extent of recent interest.

This list could go on and on and is constantly being added to. But while much is changing, much is not.

There are still widely held public perceptions that those suffering from psychiatric illness are unpredictable, potentially dangerous and best given a wide berth and those with common mental disorders should really just pull themselves together. Given that conditions such as depression and anxiety affect so many of us at various times, doesn’t seem to be having much of a modernising effect on that judgemental reflex, with the mainstream media too often concluding that the scale of this problem is symptomatic of a modern culture that wallows in self-pity, spoilt by too many years of peace and prosperity and in need of a dose of stiff upper lip. The resulting reluctance of admitting to a mental health problem or discussing mental well-being make progress much harder.

The medical and scientific communities have some traditions of their own to fight against, set within a culture that that hasn’t always been comfortable with fuzzy edged, subjective things like feelings and emotions. Behind this, perceptions of psychology are still shrouded in snobbery. Members of the hard science communities (physics, chemistry and biology) often dismiss psychology as wishy-washy (in fact, not even a science, according to Alex Berezow in the LA Times), revealing a culture that can struggle with the fact that humans are not neutrons. Psychology is to the traditional hard scientist what the stoned guy with the fake ID is to the nightclub bouncer.

By the time all of this trickles down into work on preventative, universal interventions, which is where our R&D is focussed, you find a lots of interesting groups and organisations working on new approaches, but very few examples of proven, scaled solutions.

Innovation Labs, which is taking youth insights into mental health to create digital tools, is an example of the the new work going on and the commitments of an impressive group of partners to this kind of process is exciting. NESTA’s Innovations in Mental Health is another good example. Amongst all of this, we’ll be looking on to see which can has the potential to reach genuine scale and what we can learn from them as we do1.wawwd.infoelop our own.

By the end of September this year, we’ll have a clear brief for the development of concepts for new digital products and services and we’ll look forward to sharing that, as well as the ideas we start to work on between October and December.

2 thoughts on “Progress still battles prejudice when it comes to mental health

  1. As a psychologist (who formerly worked in the media) I was intrigued to read your analysis. Mental well/ill health is multi-faceted with many interacting causes which is perhaps why proven, scaled solutions have been difficult to find. Developing a product or service that could create behaviour change at scale is a tough challenge. Something that encourages reflection, provides some breathing time between the thought/feeling and the behaviour would be a good starting point.

  2. Thank you for your thoughtful response Harriet and there’s no doubt that the complexities of the issues connected to mental health make a scalable, product based response challenging. We’re finding our way into some very interesting areas with the help of some great partners and an emphasis on embedding behaviours that have each have a good base of evidence behind them, but we expect to be working on this for a number of years before we can contribute something at scale. We’ll keep you posted

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