One in four people will experience a mental health issue in a given year. It's a statistic that is almost a pre-requisite for any article about mental health, trotted out to add a neat quantifier. On the face of it, it makes it easy for us to think about the scale of the issue... but does it really? Is mental ill health something that only affects a quarter of us? Are there really 50 million people in the UK who are simply passers-by? I think it unlikely.
The statistic dates back to 2007 and the results of the Adult Psychiatric Morbidity Survey (APMS), research conducted for NHS Digital every seven years to determine the prevalence of mental illness. In reality, the figure reflects a subsection of the population that meets a fairly stringent clinical criteria and so, in isolation, projects a narrow view. Mental ill health is undoubtedly something that affects millions more than this figure suggests. It neglects and obscures those whose mental ill health wasn't recorded, those held back by stigma and those whose experience didn't meet the criteria.
Its use over the last decade matters because it has spread an inaccurate picture of the impact of mental ill health and poor wellbeing, and created a minority where there isn't one. The written word (or in this case number) has always had the power to create 'imagined communities', a term first used by sociologists. To my mind, the repeated use of this statistic has done exactly this, but to the detriment of mental health campaigners. History shows us that minority communities' struggles are often long and hard fought, so painting the mental health community in this light isn't doing it any favours.
In these struggles, its often the voices of those directly and worse affected that come to the fore first. However, in achieving lasting and meaningful change, civil rights campaigns of all kinds inevitably gain momentum when their ranks begin also to number those who aren't disadvantaged by the status quo. As this momentum grows, the balance of out-group and in-group shifts and culture change takes root. In the same way, those campaigning for parity of esteem between mental health and physical health need more than the voices of those who experience severe and chronic mental illness to drive change.
Working from a minority position is far from ideal, especially if we consider that mental health is something we all have, not just one in four. We can all relate to a need to have equal rights regardless of race, ethnicity and sexual orientation. Given that we all have mental health, we should also all be able to relate to a need for equality when it comes to how our society approaches mental ill health.
Despite this, the message that we all have mental health appears far less than it's one-in-four neighbour. Promoting this message means spreading an understanding that that 'mental health' is not a term reserved only for those with mental illness, but rather that it is a continuum on which we all sit and all move, some more than others. Although it's not as immediately intelligible or attention-grabbing as a statistic, seeding it more in literature on mental health, and in particular in the media, would drive an inclusive narrative that both appeals to everyone and helps to create a majority issue.
Culture change happens in the minds of individuals - individuals whose thoughts, attitudes and behaviours are shaped in part by the information available. Providing better information and reframing the narrow and simplistic picture that minority-producing statistics create will empower everyone to reflect on the wide-ranging impact of mental ill health and poor wellbeing in their own lives and others'. Subtly but surely, it will increase mental health campaigners' momentum, and most importantly, bring mental health that little bit closer to parity of esteem.