Antidepressant use is surging in Britain

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BRITAIN APPEARS to be in the grip of a mental-health crisis. In the past decade no European country has seen a greater increase in the use of antidepressants; now only the Portuguese and Icelanders are popping more of the pills (see chart 1, showing European members of the OECD). Around 4.5m Britons were in contact with mental-health services in 2021-22, a rise of almost 1m in five years.

There are a few reasons why Britons might be glummer than their neighbours. One global poll found that teenagers in Britain were some of the loneliest in the world, with few supportive relationships and a low sense of purpose and meaning: all risk factors for poor mental health. Britain’s poorest households are also worse off than their equivalents in France and Germany, for example, which makes them more vulnerable to conditions such as anxiety and depression. And Britain’s health system can seem more overburdened than those in most other rich countries. In England alone, some 1.8m are waiting for mental-health treatment.

Those factors might explain why more people are turning to medication. Another reason is increased awareness. Campaigns around depression and anxiety have been particularly successful in Britain. That is broadly a good thing. A reduction in stigma has encouraged more people to seek help. Taking antidepressants—or using mental-health services—has become much more culturally acceptable.

But as The Economist recently reported, there is a flipside to this. Surveys suggest that Britons are increasingly relabelling common human emotions, such as stress and grief, as mental illnesses. In one survey in 2022 some 57% of university students claimed to have a mental-health issue. In another, 65% of Britons said they had experienced a mental-health problem. “You’re going to lose any sense of what mental illness is if you start to apply it to 30%, 50% of the population,” says Adrian Massey, author of a book called “Sick-Note Britain”.

While national surveys have found a huge increase in Britons self-reporting mental-health conditions, global studies based on diagnostic interviews have not (with the exception of the period during covid-19). Indeed, in 2020 the Global Burden of Disease (GBD), the world’s most comprehensive study on mental health, found that England, Scotland and Wales had some of the lowest rates of anxiety and depression in Europe, though Northern Ireland was an outlier (see chart 2, showing selected countries).

For all the focus on anxiety and depression in campaigns, severe mental illnesses—such as bipolar disorder and schizophrenia—still receive too little attention. This is a problem: according to the GBD, Britain has the highest rates of severe mental illness in Europe (see chart 3). The causes of such conditions are unclear, but seem to involve a complex interplay of genetic and environmental factors. Prescription or illicit drug misuse, for which Britain has among the highest rates in the region, also plays a role.

Cross-country comparisons of mental health can be tricky. Surveys may use different methodologies. And it is hard to estimate rates of mental illness, the severity of which lies on a spectrum, on the basis of diagnostic tests. All mental-health problems deserve attention. But what the data do suggest is that Britain’s mental-health campaigning is not reaching the people who need help the most.■