GIS ESSAY: Is the growing mental health crisis a “luxury problem” for the West on which the prosperous can focus after having met all their basic needs? Or is it the result of some more profound loss of social cohesion? And what could be the societal effects and solutions?

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Mental health crisis: Societal cohesion vs. economic progress

In a nutshell

• Adverse mental health outcomes are on the rise in developed countries
• Drivers are a quest for profits, digital alienation, broken homes, aborted lives
• Pharmacology and euthanasia are cynically touted as “cures”

Is the growing mental health crisis a “luxury problem” for the West on which the prosperous can focus after having met all their basic needs? Or is it the result of some more profound loss of social cohesion? And what could be the societal effects and solutions?

‘Black dog’

Throughout his life, Winston Churchill (1874-1965), the wartime leader of the United Kingdom, suffered from what he called his “black dog.” Today, we would call it depression or mental illness.

In 1911, while serving as home secretary, in a letter to his wife, Clementine, Churchill noted that he had heard a friend’s wife had received some help for depression from a German doctor. He wrote, “I think this man might be useful to me – if my black dog returns. He seems quite away from me now – it is such a relief. All the colours come back into the picture.”

Churchill was not the first or last leading public figure to suffer bouts of depression and mental health challenges.

Another was Harold Macmillan (1894-1986), who, in 1957, as British prime minister, told the people that “you’ve never had it so good.” Macmillan told voters in Bedfordshire: “You will see a state of prosperity such as we have [n]ever had in my lifetime – nor indeed in the history of this country.” What he called “the 64,000-dollar question” was how to maintain growth and employment while curbing inflation.

Reminding his audience not to forget wartime “rationing, shortages, inflation and one crisis after another in our international trade,” his speech struck home with a postwar public who shared his optimism and a general sense of contentment.

That contentment wasn’t just about money. A social sciences study by the University of Warwick and Social Market Foundation suggested that 1957 was the happiest year in Great Britain of the 230 years surveyed. The study ranked positive words, such as “peaceful,” “enjoyable” and “happiness,” against negative words, such as “unhappy” and “stress.”

Yet by contemporary 2024 standards, 1957 was a less affluent and prosperous time. It was a year in which few British men lived beyond the age of 70 (the average life expectancy was 66 years for men and 71 for women), and when many homes were in designated “slum clearance” areas and still had outside privies (outhouses). Things that we take for granted now, from central heating to family cars, were still beyond the reach of most people. Yet it was a time of happiness.

Coming to 2024, Macmillan’s “64,000-dollar question” of how to maintain growth while controlling costs is still relevant. Why, with so much material progress, are we so much less happy, more stressed and experiencing such poor mental health compared to people who seem to have had far less than we do? What are the factors leading to this crisis? How are we responding to it? And is our response making a bad situation worse?

Factors influencing mental health

Each year, the Global Mind Project publishes a map of mental well-being in 71 countries. In its fourth and latest assessment, it ranks the UK as one of the countries with the highest proportion of people in mental distress and at the very bottom of its league table.

Mental illnesses are complex conditions. The widely accepted biopsychosocial model of mental illnesses helps us understand how our biology (genetics, neurochemistry), social circumstances (relationships, societal norms) and psychology (coping mechanisms, perspective, adaptation) all interact and can give rise to illness. Protective and triggering factors in each domain compete to cause or reduce mental challenges.

Facts & figures

Worldwide prevalence of depression in people aged 15-49

https://datawrapper.dwcdn.net/6NAcQ/3

What has emerged is that our contemporary, fatalistic acceptance of societal factors (such as the breakdown of families) and the loss of culturally arising psychological factors (such as the wartime “Dunkirk Spirit” – the willingness of a group of people who are in a bad situation to all help each other, with the shared perspective granted by the tragedies of the 1940s) are undermining our ability to cure and prevent mental illness.

The Global Mind Project says mental health, especially among the young, plummeted during Covid-19 and has failed to get back to pre-pandemic levels:

The expectation may have been that once the lockdowns lifted and the threat of Covid-19 subsided, that our collective mental health would begin a recovery toward its pre-pandemic levels. However, the data across 71 countries argues otherwise – that the effects of diminished global mental well-being have become a new normal.

Stress in days gone by

Covid undoubtedly left its mark on us, but the people to whom Macmillan was speaking in 1957 had something far worse to measure their lives against realistically. They had lived through Dunkirk, the Battle of Britain and the Blitz of their cities and homes, the horrific Battles of the Atlantic, El Alamein, Monte Cassino – and the rest. Some, including Macmillan himself, had also experienced the horrors of World War I and had seen many friends getting killed in the trenches, while he was severely injured.

Macmillan’s personal life was not easy either. He suffered a troubled childhood, the traumas of trench warfare and a sham marriage. At the time, this was well known in political circles, but in a pre-social media world, personal issues were not the subject of endless public speculation or ridicule.

In a world where religious belief was still potent, and despite his wife’s adultery, Macmillan – father of four and a devout Anglican – steadfastly refused a divorce. Unsurprisingly, even though he was spared public defenestration, he experienced chronic stress and ultimately, a nervous breakdown in 1931.

The acute anxiety and pressure of his personal life were mirrored in his political life. After losing and then regaining his north-of-England constituency – which had suffered grievously in the Great Depression – he denounced his party’s harsh economic policies. Some believed that his personal experiences had attuned him to the pain of those he represented – turning his mental condition into a strength.

Macmillan was left doubly isolated in his political life by his outspoken support for the then-isolated Winston Churchill and by their shared opposition to the appeasement of Adolf Hitler’s Nazi regime. Churchill’s encouragement of Macmillan and their personal and political affinity, however, were extraordinarily productive.

What I draw from this is that all these experiences, personal and political, did not destroy or emasculate Macmillan. Even his breakdown of mental health shaped and readied him for the next chapters of his life.

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Read more by Lord David Alton of Liverpool

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• What helped Macmillan to cope and overcome was support from others and his entirely realistic appreciation of just how bad things could get. Perhaps in 2024, the ravages of a new war in Europe and the plight of 114 million people displaced worldwide might give today’s generation a similar realistic perspective.

However, he was also helped by the prevailing attitudes and shape of the society in which he lived. He knew that as important as material attainment was, it was only one part of what makes for a good and healthy society with healthy people and minds.

He was a “one nation” conservative who believed that letting people fall through the cracks into the clutches of unforgiving neoliberal market forces (free market capitalism) was not an acceptable economic or political option. As Churchill’s housing minister, he built an unprecedented 300,000 new homes each year, demanding of civil servants “Action This Day.”

In Macmillan’s Britain, there was a stronger sense of common purpose and the common good, community cohesion and mutual dependence, both in the family and the wider context.

We lost something important when ‘me’ replaced ‘we.’

In 1957, now as prime minister and leader of his party, Macmillan’s “lived experience” enabled him to calibrate happiness and contentment against grievous suffering and hurt. His constituents believed him when he told them they had “never had it so good.” The backdrop for a child growing up in the 1950s was viewing “Watch with Mother” and “Mr. Pastry” on black-and-white television sets, listening to carefully curated BBC radio offerings on the Light Programme, conforming to regimented social norms or standing for the national anthem at the cinema.

This was also the inevitable prelude to an overdue loosening up in the decade that would follow. We baby boomers – born in the years after World War II – understand it is absurd to suggest that Macmillan’s 1950s was a perfect world, a mythical golden age full of people like those portrayed each weekday afternoon in the BBC’s Light Service radio drama, Mrs. Dale’s Diary. But it is equally absurd to suggest that we, in 2024, have created an idyllic halcyon age.

Enter the modern era

The 1960s heralded a more open society, a meritocracy in which class, ethnic, religious and racial origins began to challenge entitlement and prejudiced discrimination. Some of the reforms, including ending the death penalty and decriminalizing gay relationships, were long overdue.

But in the surge toward greater individual autonomy, we lost something, too. It is not just nostalgia that tells me that small acts like collectively singing a hymn and saying a prayer at the start of each school day created cohesion, meaning and structure. The abandonment of respect for something greater than ourselves and today’s drive for self-realization rather than the common good too often exacerbate the breakdown of families, communities, society and mental health. We lost something important when “me” replaced “we.”

Community spirit falls by the wayside

I saw some of the telltale signs first hand. Elected in 1972 to the Liverpool City Council while a student and a practitioner of what was dubbed “community politics,” I represented a neighborhood where half the homes had no inside sanitation. Some areas were designated slums, some streets were still lit by gas lamps. No one was wealthy, many were dirt poor.

Every week, I held advice sessions at which long queues of people with real problems would come seeking help. What was noticeable in the terraced streets where they lived was that front doors were rarely locked but often left open so that family or friends could walk in. There was little crime and less anxiety.

These were neighborhoods where people looked out for one another, where children without a father would be raised within the extended family, where grandparents, aunts and uncles were the social workers, where good neighborliness was a given and where shared rules and stable relationships glued families together.

But over the years that followed, as a city or county councilor and then as member of parliament, I saw that glue coming unstuck and the shocking consequences. Some of it was attributable to rapid deindustrialization and chronic unemployment. Yet there were many other new factors at work which continue today.

Elusive happiness

Notwithstanding the economic material gains, society has been blighted by shifts that are making people less happy, less content and more prone to mental illness.

Consider the following: our servile state and the role of market economics and neoliberalism; material advancement conditional on getting rid of unwelcome encumbrances; post-pandemic demographics; indebtedness that disadvantages the young; toxic loneliness, especially of the elderly; the curse of poor housing and planning policies; an epidemic of drug dependence, both prescribed and illegal; the growth of social media which is anything but sociable; and the implications of living in a post-Christian society.

The role of neoliberalism in leading the UK into collective mental breakdown is the central theme of a 2024 book by George Monbiot and Peter Hutchison, titled “The Invisible Doctrine: The Secret History of Neoliberalism (and How It Came to Control Your Life).”

Too far right

The authors have in their sights what has been called the unholy trinity: capitalism the father, consumerism the son and neoliberalism the holy ghost. They take aim at the belief that neoliberal economics and free market capitalism are the best mechanisms for making decisions in our modern, complex societies. They lay at its door the wave of mental health challenges we face today, including pressures to meet the expectations of consumerism, the danger of indebtedness and fear of redundancy in fragile companies and a fickle economy.

‘One day we will earn the economic security we crave; one day we will have more leisure time. Will this magic day ever arrive? Of course not.’

The anxiety this generates leads to a drowning in the “insidious” and “sinister” ideology of neoliberalism. The authors argue that we have been deceived into believing that “one day we will earn the economic security we crave; one day we will have more leisure time. Will this magic day ever arrive? Of course not.”

They maintain that the hopes of progress in the UK are “spiraling backwards” and, perhaps with the Macmillan era in mind, they say: “There was a time when almost everyone in the UK believed that a rising economic tide would lift all boats; that everyone would have a good home; that drudge work would diminish and jobs would become more interesting.” 

In a scathing rebuke to our political masters, the authors contend that the robust public services and economic security that most of us want the politicians to deliver were never part of the neoliberal plan – and that this has plunged us into collective depression. It is an interesting take on an old argument.

Too far left

Karl Marx believed that what he called the “immiseration of the working class” would always be the objective of the capitalist classes and that the workers would be held captive in misery. Forty years after Marx published “Das Kapital,” Franco-English writer Hilaire Belloc (1870-1953), a Liberal member of parliament, published “The Servile State” (1912).

Belloc linked personal fulfillment with the wider distribution of property: “If we do not restore the Institution of Property, we cannot escape restoring the Institution of Slavery; there is no third course.” He famously insisted that “the control of the production of wealth is the control of human life itself.”

Belloc critiques both capitalism and socialism. Although he hankers after a romanticized utopia of peasant farmers, content with their acre of land, he is certainly correct that most of the population are without the ability to own and control the means of production and are therefore compelled to work for those who do. Immiseration of the workers follows.

The question remains, is such a model always destined to grind us down and to turn us into little more than automatons obeying orders, making money for other people, and condemned to unfulfilled and anxious lives? Is this the critical issue contributing to the growing prevalence of mental health disorders?

Economics and life (dis)satisfaction

The linkage of a just economy and personal freedom to the enhancement of human dignity and, therefore, to human happiness was a theme that the Austrian School economist Friedrich von Hayek (1899-1992) took up in “The Road to Serfdom” (1944). It was also addressed by the economist E.F. Schumacher (1911-1977) in “Small is Beautiful” (1973), which has a lesser-known subtitle “Economics as if People Mattered,” providing a clue to understanding.

In a chapter titled “Economic Control and Totalitarianism,” Hayek quotes Belloc approvingly. He insists that “the most important change which extensive government control produces is a psychological change, an alteration in the character of the people.”

In contrast to Mr. Monbiot’s belief that all our ills can be laid at the door of neoliberalism, Hayek’s “Road to Serfdom” – a defense of classical liberalism – highlights the overwhelming impact that excessive government control can have on our behavior, on our attitudes and our state of mind. He warns that the supplanting of the market by central planning – and, in the worst cases, by the totalitarianism he loathed – diminishes individual autonomy, endangers society, compromises innovation and ingenuity and impedes economic growth. None of this is a recipe for human happiness.

Our frame of mind would be enhanced by ‘resisting the temptation of letting our luxuries become needs.’

However, Mr. Monbiot would be one with Schumacher’s thought-provoking and prophetic challenge (made half a century ago) to unlimited economic growth and his belief that human happiness and contentment were linked to human-scale technology and ecological balance. All of this is jeopardized by “soul-destroying, meaningless, mechanical, monotonous, moronic work: an insult to human nature which must necessarily and inevitably produce either escapism or aggression.”

Schumacher held that our frame of mind would be enhanced by “resisting the temptation of letting our luxuries become needs; and perhaps by even scrutinizing our needs to see if they cannot be simplified and reduced.”

Human contentment cannot be generated by an insatiable desire for bigger, faster, better and more, driven by greed, envy and sometimes fear. These are indeed antidotes to human happiness and a serene state of mind. So, as far as it goes, a nation’s economic priorities and model certainly contribute to its well-being and neoliberalist ideas combined with the obsessions of the current age are deeply connected with the epidemic of mental illness.

Mr. Monbiot quotes the findings of the Global Mind Project to support his case that we are all going to hell in a handcart, perhaps with a stop on the way at the notorious Bedlam madhouse or lunatic asylum (founded in 1247 as the Priory of St. Mary of Bethlehem) where treatments for the mentally ill included bloodletting from leeches, dunking in ice baths, strait jackets and the appalling rotational therapy.

Truths left unsaid

Tempting as it may be to view contemporary mental illness entirely through an economic prism, and notwithstanding my own belief in fairer distribution, economic justice and social market economics, there are other factors that deserve at least equal attention. These include a range of social challenges that are only in part driven by economic considerations. But, too often, those factors are overlooked or knowingly left unsaid.

The unrestrained neoliberal economics of some on the right have converged with the extreme liberal societal theories of some on the left. Such convergence is a dangerous mix, endangering the fragile balance and cohesion of civil society and hitting the most disadvantaged twice over. It is also an affront to academic freedom, free speech and intellectual curiosity.

Other taboo subjects that also require greater scrutiny and interact with mental health issues include the breakdown of functioning families and the impact of the absence of male parents on their children.

Ever since Macmillan’s days, the family has been under sustained attack. That is reflected in demographics, with falling birth rates in materially prosperous countries and a disinclination by some to bring children into the world.

In 1997, the psychiatrist and author Oliver James in “Britain on The Couch” argued that all of us seek harmonious and intimate relationships in our personal lives, “yet they can become the greatest single cause of despair.” He noted that clinical depression was 10 times higher in people born after 1945 than those born before 1914 and pointed to the paradox that, although young women had never been in a better position to succeed in life, those under the age of 35 had become the most vulnerable.

Unspoken repercussions

Beyond Mr. Monbiot’s concerns with the effects of neoliberalism, what might be contributing to the increasing vulnerability of women’s mental health? At the risk of being canceled or de-platformed, dare I at least ask whether there might be a link between declining mental well-being and the 10 million abortions that have taken place in Britain since 1967 (one every two and a half minutes)?

Note, too, that 95 percent of these abortions were claimed to have been performed on the grounds that abortion was to safeguard the mental health of women with unplanned pregnancies. But does it?

In 2006, 15 specialists in psychiatry, obstetrics and gynecology called upon both the Royal College of Psychiatrists and the Royal College of Obstetricians and Gynecologists to revise their guidance on the link between abortion and mental health. Vested and ideological interests ensured it has never happened even though the specialists cited strong evidence, reviewed in the journal Triple Helix, that women who choose abortion suffer from higher rates of depression, self-harm and psychiatric hospitalization than those who carry their babies to term.

From a purely scientific point of view, these studies are hard to conduct rigorously. You cannot easily compare and quantify the mental health of these two groups of women. So, is the cause of that increase in mental illness the abortion itself or the life circumstances (the personal crises, the lack of stability)? Whether abortion is directly responsible or whether this reflects chaotic relationships, a lack of social support, and the pressure that feckless men often apply (which often causes women to see no other choice than abortion) is disputable.

In the UK, studies which could answer these questions more fully are neither funded nor encouraged. However, a robust study in New Zealand demonstrated that women who had abortions experienced twice the level of mental health problems and three times the risk of major depressive illness as those who had either given birth or never been pregnant.

The same silencing of legitimate questions recently led to political parties in the UK refusing to support the creation of a scientific committee to examine the level of sentience and pain that an unborn child can experience.

If one doubts the consequences of even exploring whether the decision to end the life of one’s child might carry negative mental health issues, consider the row that erupted in 2011 when the Royal College of Psychiatry permitted the publication of conclusions of the U.S. psychologist, Professor Priscilla Coleman. She said women who have had an abortion ran an 81 percent increased risk of developing mental health problems. Those conclusions are still making waves today.

Broken homes, broken spirits

There are other equally controversial yet unaddressed questions to ask when you put 2024 Britain on the couch. What about the potential link between the breakdown of families and marriages and the mental health of those affected?

It is estimated that approximately 2 million children in the UK have no meaningful contact with their fathers. The admirable Centre for Social Justice says that a child finishing secondary school today is more likely to own a smartphone than to be living at home with their father.

The situation of children in the most economically disadvantaged households is even worse: 65 percent of children aged 12-16 in the low-income group do not live with both parents. Increasingly, they live in “men desert” wildernesses without male role models to mentor, foster, encourage or love them.

School-aged children who enjoy good relationships with their fathers are less likely to experience depression or exhibit disruptive behavior.

Unsurprisingly, young people who have an absent father are five times as likely to be held in custody by law enforcement agencies. Studies have also shown that “dad deprivation” is linked to lower levels of achievement at school and to issues around self-esteem. In contrast, school-aged children who enjoy good relationships with their fathers are less likely to experience depression or exhibit disruptive behavior in school.

The American experience bears this out. The U.S. social activist David Blankenhorn, in “Fatherless America: Confronting Our Most Urgent Social Problem” (1996), warned that “fatherlessness is the most harmful demographic trend of this generation. It is the leading cause of declining child well-being in our society. It is also the engine driving our most urgent social problems, from crime to adolescent pregnancy to child sexual abuse to domestic violence against women.”

Fifteen years later, following the 2011 riots in London, the prime minister of the day, David (now Lord) Cameron said, “I don’t doubt that many of the rioters have no father at home … where it’s normal for young men to grow up without a male role model, looking to the streets for their father figures, filled up with rage and anger.”

Studies link fatherless children to an increased risk of suicide and self-harm, with one study suggesting that young people from fatherless homes are four times as likely to commit suicide. Suicide is the leading cause of death in young people under the age of 35 in the UK.

Recent data shows that 1,796 young people under the age of 35 took their own lives in the UK in 2022, and suicide rates for 15- to 19-year-olds have reached their highest in 30 years.

Sadly, the UK is also seeing the highest-ever number of referrals to Child and Adolescent Mental Health Services. The number of under-18s needing National Health Service (NHS) treatment was 23 percent higher in 2022 than in 2021. No less than 241,791 young people were referred to the NHS in just three months. In the U.S., the prevalence of mental health issues among young adults is also on the rise, according to the American Psychological Association.

Simply dishing out hundreds of millions more pills on repeat prescriptions without addressing the root causes is a dismal response to a cry for help.

This begs the question of whether the absence of a father in the lives of children is linked to the mental well-being and development of a child. Given the evidence, it is a question which deserves an answer.

Pharmacology substituting for families

And then consider the standard state-sanctioned response to depression when someone in our contemporary society – male or female, young or old – asks for help. Should the first-line response to depression be to fill the bodies of those who feel neglected, rejected and unloved with endless amounts of prescribed (or illegal) drugs?

I recently asked UK health ministers about the number of pills prescribed for depression by the National Health Service – and at what cost to the public purse. The answers were staggering.

Facts & figures

Consumption of antidepressants in the United Kingdom from 2011 to 2021

https://datawrapper.dwcdn.net/4f9r6/1

In 2023, some 730 million pills were given to depressed British citizens at a phenomenal cost of around GBP 2.5 billion. My questions led to correspondence from young people who told me that their lives had “been ruined” by some of the side effects, including sexual dysfunction. Prescribed drugs have a place in treatment, but simply dishing out hundreds of millions more pills on repeat prescriptions without addressing the root causes is a dismal response to a cry for help. The corresponding decrease in the number of psychiatric care beds in the UK over the last 20 years confirms that care is being usurped by pharmacology.

Facts & figures

Number of psychiatric care beds in the United Kingdom from 2001 to 2022

https://datawrapper.dwcdn.net/Ab4SC/2

In faceless and drab blocks of public housing, I have met residents whose frame of mind reflects the soulless accommodation in which they have been dumped. There is no sense of community when you live in concrete isolation from your neighbors. Endless supplies of Valium or its equivalents are no substitute for human interaction and access to a garden or a park.

In response, we have hamstrung our medical services’ and doctors’ ability to advocate for their patients, instead replacing this key societal pillar with pill-pushing learned helplessness. Holistic solutions, which consider not only the biological, but the social and psychological, are urgently needed. Man cannot live on bread (or selective serotonin reuptake inhibitors) alone.

Who is the pusher?

Meanwhile, on the street, other drugs proliferate. Heroin and synthetic opioids like fentanyl (50 times more potent than heroin) are fueling a new opium war – with licit and illicit Chinese pharmaceutical and chemical companies producing and exporting laboratory-made drugs into Western countries. Inadvertently ironic or deliberate?

In 2022, more than 70,000 Americans died from fentanyl overdoses. A U.S. congressional committee says the Chinese Communist Party provides subsidies to “wholly state-owned” companies openly trafficking illicit synthetic drugs. It was a subject recently raised by Secretary of State Antony Blinken when meeting China’s Wang Yi, whose government denies all knowledge.

In the UK, the National Crime Agency says drug dealers are mixing synthetic opioids with drugs such as heroin. Over the past nine months, there have been more than 100 deaths linked to nitazenes, synthetic opioids that the BBC has tracked to Chinese manufacturers, couriers and dealers.

The UK already has one of the highest rates of drug-induced deaths in Europe – around 4,500 deaths annually – and there is no doubt that people who are already vulnerable or susceptible can quickly become fatally addicted. Isolation and disconnection and the dependency, addiction and mental illnesses to which they can lead are no respecters of age.

Depression among the elderly is often the precursor of a decline in physical health and well-being. The charity Age UK says that more than 2 million people in England over the age of 75 now live alone – with more than a million saying they go over a month without speaking to a friend, neighbor or family member.

Fatal pharmacology

Believing themselves to have become worthless or a burden, they hear from commentators and lawmakers that they need a “compassionate” way out – which can be the lethal injection of euthanasia. Canadians are debating whether to expand their law to include those with mental illness. The Netherlands has been doing it since 2010, when two people were euthanized on grounds of mental illness. In 2023 there were 138 such cases, which represented 1.5 percent of the total 9,068 euthanasia deaths that year.

On May 22 of this year, a Dutch woman, Zoraya ter Beek, aged 29, who had chronic depression, anxiety, trauma and an unspecified personality disorder, was euthanized. Illness needs care, not the gallows. It is a terrible indictment when death becomes a “cure” for mental illness. Instead, we should be mending and strengthening broken safety nets.

Euthanasia and pharmacology allow society – whether in the UK, Europe, North America or elsewhere – to shirk its responsibilities to the ill. Worse still, they allow those who believe that disabled or ill people are a drain on society to justify their lethal injections or endless pharmaceutical prescriptions by pointing to the economic advantages. That is cold-blooded neoliberalism at its worst.

Facts & figures

Total U.S. expenditure for mental health services from 1986 to 2020

https://datawrapper.dwcdn.net/IscFB/1

Online and under pressure

The ending of vulnerable lives is now also driven by a frenzy of social media messaging, which brings me to yet another factor in the disruption of mental health and well-being: social media.

As a new kid on the block, social media plays a significant role in driving anxiety and exacerbating mental illness. One research study of teenagers aged 12-15 in the U.S. found that those who are using social media for over three hours daily experience twice the risk of a negative mental health outcome. This included symptoms of anxiety and depression, which then too often lead to chronic use and abuse of antidepressants.

Of course, social media can also be beneficial, but during an important phase of brain development, too much time spent on digital platforms (some of which specialize in disinformation, manipulative content and data-harvesting) or in interactions that substitute for sleep or physical exercise, has malign effects.

Young people struggling with identity issues, body-image anxiety or behavioral challenges, such as eating disorders, can have their anxieties amplified by cyberbullying and social media algorithms – which can lead young people to sites about suicide. There have been reports of deaths linked to suicide and self-harm – including cutting, partial asphyxiation, intimate image exchanging and risk-taking.

In 2022, Pew found that up to 95 percent of teenagers surveyed (aged 13-17) reported using social media, and more than a third of them used it “almost constantly.”

In 2017, the UK was shocked by the death of 14-year-old Molly Russell. The coroner said Molly died from an act of self-harm while suffering depression and negative effects of online content. The inquest found that social media content contributed “more than minimally” to her death. He said the images of self-harm and suicide which she had viewed “shouldn’t have been available for a child to see.” Molly’s father, Ian Russell, said the “toxic corporate culture at the heart of the world’s biggest social media platform [Meta]” needs to change.

Instagram and Pinterest use algorithms that lead to “binge periods” in the viewing of their content, some of which was selected and provided for Molly without her having requested it. The coroner said, “In some cases, the content was particularly graphic, tending to portray self-harm and suicide as an inevitable consequence of a condition that could not be recovered from. The sites normalized her condition, focusing on a limited and irrational view without any counterbalance of normality.” A smartphone in the hands of a vulnerable child can create anxiety and doubt and become a lethal fast lane. Suicide is the ultimate tragic expression of mental illness.

In some instances, these risks have led to parents providing their children instead with a “dumbphone,” a mobile phone for voice and text that doesn’t have email, applications, internet access and other features found on smartphones.

The founder of the Global Mind Project, Dr. Tara Thiagarajan, is emphatic that “the younger the age of first smartphone, and more frequent use, the more likely students are to have mental health problems as young adults – particularly problems with the ‘social self’ (the dimension of mental well-being concerning how one relates to others) and specifically with suicidal thoughts and feeling detached from reality.”

What to do?

Such considerations will need to be extended as we start to think about further fast-moving new technologies – such as artificial intelligence – and what it might mean for personal well-being if robots and machines displace people from their occupations.

Displacement, isolation and intensive febrile messaging have taken the place of shared values – particularly the shared religious beliefs which once held our society together and played a significant part in personal and communal healing. The deleterious fragmentation of society is mirrored in the fragmentation of our anxious and stressed minds.

We must do better and be more honest in weighing up what we have lost, abandoned and need to reclaim. 

Doubtless, Macmillan could once again convincingly say that we have never been more materially affluent. But modern living seems less and less able to meet our expectations and to realize our hopes and aspirations. That is destabilizing for individuals and for society at large. Too many people feel like losers even though, in material terms, so many may look like winners.

Note, too, that millions of others in “poorer” countries, in Africa and Latin America, are listed by the Global Mind Project as among the countries least affected by mental illness.

We must do better in admitting why that is and be more honest in weighing up what we have lost, abandoned and need to reclaim. 

Mental health must become a much higher priority. If we are to banish Churchill’s black dog and return color into lives darkened by depression or mental illness, we must give urgent thought to the many complex factors and root causes involved.