Janet Daley
Sat, July 11, 2026 at 10:58 AM UTC
Are we in the midst of a mental health epidemic? You might, under ordinary circumstances, be inclined to think that this was entirely a question of moral and medical concern. But in a modern welfare state, where the government accepts responsibility for those whose conditions make ordinary functioning difficult, it becomes an urgent economic problem
Providing financial support for whole new categories of disability has become prohibitively expensive. The system of Personal Independence Payments has come under particularly furious examination because it is provided without means testing to anyone whose condition is judged severe enough to prevent full participation in normal life
An awful lot of people – particularly very young ones – are being put into categories which will provide them with indefinite state subsidy. This has produced, unsurprisingly, a deep suspicion that mental illness labels have become nothing more than a cover for deliberate benefit fraud, or at the very least a convenient form of self-deception
Pretty much everyone, even those who are defending the present arrangements, now agrees that there is a difficulty with diagnosing – and even defining – such conditions, and most critically with decisions about the precise degree of limitation that they present to any particular individual
This is hardly surprising. The symptoms (or patterns of behaviour) that we are dealing with here are, by definition, subjective and idiosyncratic. Many have until very recently been thought of as, perhaps extreme, manifestations of individuality: part of the wide spectrum of what constitutes human difference
Being more, or less, socially confident than your peers, more, or less, empathetic, more, or less, adaptable: these were the variations that made up the range of possible personalities. There was not just one “normal” way of dealing with the world
Of course there were personality handicaps and seemingly self-inflicted problems which were sometimes treated with unfair callousness. But there was a general understanding among families and communities of the acceptable limits: at what point those problems had become severe and unmanageable enough to require specialist care
But alongside that understanding – that watchfulness for extreme signs of abnormal behaviour – was a respect for the idea that people were permitted a considerable variety of ways of adapting to their own life conditions. Acute shyness or extreme extraversion, so long as they were not disruptive or incapacitating, could both find ways to get by. Particular phobias or obsessive orderliness could be managed and tolerated with enough good will
So when does introversion or habitual social awkwardness in an adolescent become classifiable as “autistic spectrum”? And how excitably active must you be as a child to qualify as ADHD? Being able to accommodate the differences between people – in family and work life – was once a recognised feature of maturity, especially in Britain, which prided itself on cherishing non-conformity and eccentricity. But what about those states of mind which seem to warrant particular sympathy?
There has, until very recently, been an understanding that depression and anxiety, now regarded as pathological conditions rather than responses to genuine life events, manifested themselves in very different ways in different individuals, sometimes alarmingly so
An apparently cheerful, competent person who is reluctant to ask for help may be stoically contemplating suicide, while someone who openly professes despair or trepidation may, in fact, be coping well – quite possibly by using the admission of those feelings as a therapeutic outlet
So forget the economic consequences for a moment. There is something bigger at stake. Even assuming that the proponents of this apparent mental health crisis and the welfare programme designed to deal with it are entirely well-intentioned, there is a real risk that we might be in danger of medicalising (effectively outlawing) the individual differences in character and behaviour – the frailties and eccentricities – which make us distinctively human
Economic pressure may, ironically, be making it necessary to have this deeper and more consequential debate. When do oddities of behaviour – failures in making relationships, problems in communicating, eccentric personal habits, inappropriate social responses – become pathological conditions which require intervention? Could such labelling help to seal the resigned fate of a young person who might, as the old-fashioned saying goes, have “outgrown” his emotional problems?
What about those children who are hyperactive and deliberately disruptive at school? Or the ones who become outcasts because they are incapable of holding their own against playground bullies?
The first group could very possibly be classified as ADHD because they seem immune to discipline. The second might be called borderline autistic due to their lack of social skills. But we all knew such children – perhaps we were such children ourselves
Full disclosure: I was once at a dinner with twenty or so major public figures when someone asked how many of us had been bullied at school. Every single person at the table raised their hand. I have often wondered whether our early experience of victimhood had been a marker of some particular character strength that aroused resentment, or rather that it had given us a determination to succeed
But in the end, having cast doubt on the proposition that there has been an extraordinary spike in genuine cases of mental disability, I will make something of a mitigating point. Something seriously disturbing did occur during that terrible period when a whole generation of young people were locked into their homes and prevented from experiencing the normalising social initiations of youth
Lockdown was not just an inconvenience for them: a temporary disruption of everyday expectations. It was the loss of all those forms of contact outside of their immediate families which are essential to healthy emotional maturity. When it ended, teachers reported that many children were entering primary school without basic verbal and behavioural skills
The assumption at the time was that children were resilient, that they would robustly make up the ground they had lost after what seemed to adults like a relatively short time. We may be discovering that this is not true
Children have developmental stages. If they miss the bus, they may not know how to catch the next one. Having bankrupted ourselves paying grown ups to stay at home, we might now be facing the cost of supporting the children who were incarcerated with them
