Attitudes to Mental Illness

Ever wondered what the British public think about mental illness?

Well, the British government has, and the results of the 2010 Attitudes to Mental Illness Survey are out. I'm never sure how much faith to put in such data because what people are willing to say they think, and what they really feel, are not the same.

So while it's encouraging that only 20% of people say they agree with the statement that "Anyone with a history of mental illness should be excluded from taking public office", it would be naive to think that the other 80% would really be equally likely to vote for someone with a psychiatric history when push came to shove. We've moved on since McGovern, but maybe not all that much.

Worse, a lot of the questions are dubious. One asks whether you agree that "Mental hospitals are an outdated means of treating people with mental illness", the 'right' answer, that gets counted as a nice positive attitude, being to agree. I disagree, not least because inpatient treatment for depression helped my grandfather hugely when he was a young man. If that means I have a bad attitude to the mentally ill, so be it. I don't think it does.

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Another item asks "What proportion of people in the UK do you think might have a mental health problem at some point in their lives?" The approved answer, as Neuroskeptic readers may have guessed, was 1 in 4. But only 16% of the British public picked that option from the multiple-choice quiz. Most thought it was much lower:

How silly of them...or maybe not. There has in fact never been a study of the lifetime prevalence of mental illness in Britain. Studies in other English-speaking countries, such as the US and New Zealand, have repeatedly shown lifetime prevalence rates of 50%, or higher, for mental illness according to DSM-IV criteria. But these figures and these criteria have been credibly accused of overstating the proportion of people with a genuine psychiatric illness, maybe greatly so. There's a lot to say on both sides of this debate, but the point is that the question is open. Expecting the public to know the answer, when the experts don't, is rather unfair.

However, interestingly enough, this very survey asked whether respondents had ever suffered mental illness themselves. How many had? There's a 4 in it, but it's not 1 in 4, it's 4%.

I strongly suspect this is an underestimate. Some people are ill and don't know it or don't admit it. People with mental illness might be less likely to participate in the study. There'll be people will get ill at some point in their lives after they fill in the survey. And the format of the question was a bit odd (see page 64 and see what you make of it). But still, this is another point of data for the great prevalence debate.

The proportion of people with mental illness ultimately depends on how you define "mental illness". I don't think anyone has an entirely satisfactory definition, so any attempt to pin down the lifetime prevalence is problematic until we sort that out, but if I had to put it a number on it, it would be about 1 in 10 in Western countries.

I'm no expert on this topic so take this with a big pinch of salt. Still, I'd find it very hard to accept a figure much lower than this, from personal experience if nothing else. I'd be open to the idea that the true figure is much higher, but this would mean that tens of millions of British people are going around getting mentally ill and never receiving treatment, and it would take some very strong evidence to convince me of that.