Mental health education aims to improve understanding, reduce stigma and help young people seek support when they need it. As schools develop whole-school approaches to mental health, an important question is emerging: how can we encourage help-seeking while also helping young people recognise that difficult emotions are a normal part of life?
In their paper, Are mental health awareness efforts contributing to the rise in reported mental health problems?, Lucy Foulkes and Jack Andrews propose the prevalence inflation hypothesis. It offers a way to investigate whether awareness campaigns could have effects that are helpful for some people and less helpful for others.
What is the prevalence inflation hypothesis?
The authors suggest two possible pathways. Greater awareness may help people recognise mental health difficulties that previously went unnoticed, increasing the number who report problems and seek help. At the same time, wider use of mental health language might lead some people to interpret ordinary distress as a symptom of mental illness. The paper proposes that this interpretation could affect how they understand themselves and respond to their emotions, potentially increasing distress for some.
These are proposed mechanisms, not established findings. The paper does not demonstrate that mental health awareness causes mental illness, nor does it argue that schools should stop discussing mental health. The authors call for research to test when awareness is beneficial, whether unintended effects occur, and for whom.
Why does this matter for a whole-school approach?
Schools have an important role in making mental health conversations accessible. Young people need to know that they can talk about difficulties without shame and that persistent or severe problems deserve support. They also need language that makes room for ordinary sadness, worry, frustration and stress, without treating every uncomfortable feeling as evidence of a disorder.
The challenge is to communicate both messages clearly. Mental health education can explain that emotions vary in intensity and duration, that context matters, and that needing help is not a failure. When a young person describes a difficulty, adults can ask what is happening, how it affects daily life, and what support might be useful, instead of assuming that a label alone tells the whole story.
This raises questions about how programmes are designed and evaluated. Measures of mental health literacy and willingness to seek help are valuable, but they may not capture how young people interpret the information they receive. Asking young people what messages they take away, and whether those messages help them understand their experiences, could offer a fuller picture.
Questions for reflection
- Does our mental health education distinguish clearly between common emotional experiences and difficulties that may need further support?
- Are we giving young people enough space to describe their own experiences, rather than asking them to fit a label too quickly?
- What happens after a young person is encouraged to seek help: is appropriate support available and clearly signposted?
- How do we learn from young people about the messages they have taken from our teaching?
The prevalence inflation hypothesis should not be treated as a verdict on mental health awareness. It is an invitation to examine the language we use, the support we offer and the impact of education on young people’s understanding of themselves. A thoughtful whole-school approach can take that question seriously while continuing to reduce stigma and make help easier to access.
Reference: Foulkes, L., & Andrews, J. L. (2023). Are mental health awareness efforts contributing to the rise in reported mental health problems? A call to test the prevalence inflation hypothesis. New Ideas in Psychology, 69, 101010. https://doi.org/10.1016/j.newideapsych.2023.101010