Subsidizing solutions which make a small problem bigger

From Are We Talking Too Much About Mental Health? by Ellen Barry.  The subheading is Recent studies cast doubt on whether large-scale mental health interventions are making young people better. Some even suggest they can have a negative effect.

File under "You get more of that which you subsidize."  And in an attention economy, talking about something as a crisis or danger is a form of subsidy.  The more you talk about a nascent or marginal problem, the more you are likely to create a real one.  See also, Trans movement and Sex Identification in general.

Now, some researchers warn that we are in danger of overdoing it. Mental health awareness campaigns, they argue, help some young people identify disorders that badly need treatment — but they have a negative effect on others, leading them to over-interpret their symptoms and see themselves as more troubled than they are.

The researchers point to unexpected results in trials of school-based mental health interventions in the United Kingdom and Australia: Students who underwent training in the basics of mindfulness, cognitive behavioral therapy and dialectical behavior therapy did not emerge healthier than peers who did not participate, and some were worse off, at least for a while.

And new research from the United States shows that among young people, “self-labeling” as having depression or anxiety is associated with poor coping skills, like avoidance or rumination.

In a paper published last year, two research psychologists at the University of Oxford, Lucy Foulkes and Jack Andrews, coined the term “prevalence inflation” — driven by the reporting of mild or transient symptoms as mental health disorders — and suggested that awareness campaigns were contributing to it.

“It’s creating this message that teenagers are vulnerable, they’re likely to have problems, and the solution is to outsource them to a professional,” said Dr. Foulkes, a Prudence Trust Research Fellow in Oxford’s department of experimental psychology, who has written two books on mental health and adolescence.

Until high-quality research has clarified these unexpected negative effects, they argue, school systems should proceed cautiously with large-scale mental health interventions.

“It’s not that we need to go back to square one, but it’s that we need to press pause and reroute potentially,” Dr. Foulkes said. “It’s possible that something very well-intended has overshot a bit and needs to be brought back in.”

Barry goes on to note that there is still widespread support for interventions, even if they have not yet proven successful.  The researcher in the UK alludes to a core problem for any government program - it creates its own financial ecosystem in which all participants must assume success because of their own financial interests.

The results were disappointing. The authors reported “no support for our hypothesis” that mindfulness training would improve students’ mental health. In fact, students at highest risk for mental health problems did somewhat worse after receiving the training, the authors concluded.

But by the end of the eight-year project, “mindfulness is already embedded in a lot of schools, and there are already organizations making money from selling this program to schools,” said Dr. Foulkes, who had assisted on the study as a postdoctoral research associate. “And it’s very difficult to get the scientific message out there.”

My impression is that once again, we have taken a very marginal issue (a small percentage of young people do suffer real psychological problems) and we have built an immense and expensive edifice of stakeholders whose financial well-being and social status is largely dependent on the small problem being bigger than it is.  And because of that contra-incentive, we end up making the small problem bigger.