Lost in Awareness-land.

It’s Mental Health Awareness Month. Again.

I’m supposed to be encouraged. I’m supposed to share something hopeful. I’m supposed to do an Instagram square in a soft pastel that says YOU ARE NOT ALONE and link to a helpline.

I’m not going to.

Because I have been watching this industry for fifteen years. And I’m going to say the thing nobody in this industry seems to want to say.

Awareness is not the bottleneck. It hasn’t been the bottleneck for a long time. We’ve done awareness. We are awash in it. Every column inch, every campaign, every government strategy, every well-meaning corporate workshop, every soft-pastel Instagram square – awareness. Everybody knows mental health matters. Everybody knows trauma is real. Everybody knows we need to talk about it.

We have never had more mental health awareness. And we have never had worse mental health outcomes.

If awareness was the answer, we’d be the healthiest generation in human history. We are not. The numbers keep going up. The spending keeps going up. The despair keeps going up.

So what is going on?

I get to be this annoyed because

I have spent the last fifteen years actually moving the needle on this stuff. Quietly. In my home office. Sometimes on Zoom at 9pm on a Tuesday because that’s when somebody’s husband had the kids.

I have a client who came to me bed-bound with tokophobia. Forty fears cleared in two months. She has two children now.

I have a client whose Welsh accent I will never forget – tokophobia gone in two weeks. After two YEARS of being told by qualified professionals that this kind of thing took years.

I have a spreadsheet. People moving 200 points, 300 points on the Hawkins Map of Consciousness in months. Rachel: 249 → 504. Anna: 183 → 512. Hawkins himself said the average person moves five points in a lifetime.

I have charts.

I don’t have letters after my name. I have charts.

What awareness is actually for

Awareness has a job. It’s a small one.

When something is gripping your body and you can’t name it. When you’re depressed and you don’t know why. When anxiety shows up without warning. In that moment, knowing the name of the thing is genuinely useful. It orients you. It tells you you’re not alone, not insane, not the only one. It gives you a starting position.

That’s awareness doing its job.

Once you’re oriented, awareness has finished its work. The next stage is action – actually doing the thing that shifts the state you’ve now correctly named.

And this is where the entire industry got stuck. We stayed in stage one. We made stage one the whole game. We started behaving as if naming the thing was the same as fixing the thing.

It’s not.

Naming the thing ≠ fixing the thing

The assessment thing – let me have a moment

The standard tool for assessing anxiety in 2026 is something called the GAD-7. Seven questions about how often, over the past two weeks, you’ve felt nervous, restless, unable to stop worrying.

You fill it in. You score it. You are told, with great seriousness: yes, you have anxiety.

Brilliant. Thanks. Knew that.

What you actually need to know is where you ARE. Not how loud the alarm is going off – what is setting it off. What’s underneath. What’s been wired in. Where on the actual landscape of your internal world is the thing that’s running you.

You don’t get that.

You get a symptom score. And then you get sent off to “explore” it. For years.

If you were lost in a foreign city and you walked into a tourist office to ask for directions, you would not accept a piece of paper that said “yes, you are lost.” You would ask where you are. You would ask how to get out. You would expect a map.

In mental health, we hand people a piece of paper that says yes, you are lost. And we call it an assessment.

And then, the bit where you try to do something about it

So let’s say you’ve now been told you’re anxious. (Which you knew.) Now what?

Now you enter The Marketplace.

Therapy. Psychotherapy. Counselling. CBT. EMDR. Mindfulness. Breathwork. Journalling. Affirmations. Somatic work. Parts work. Hypnotherapy. Energy work. Ice baths. Plant medicine. The friend who knows a guy. The Instagram coach with the smile. The retreat in Portugal.

Some of it works. Some of it really, really doesn’t. Most people cannot tell the difference until they have spent the money, the months, sometimes the years – and clocked the fact that they are still in the same place.

And when it doesn’t work – which is most of the time – there are four explanations always on offer:

1. The modality wasn’t right.

2. The practitioner wasn’t right.

3. You weren’t ready.

4. These things take time.

Notice that the last one is always available.

Notice who that protects.

The hits

Here’s the bit that makes me twitchy and glitchy.

A lot of what’s being sold as healing is actually a hit. A retreat. A workshop. A session. A breakthrough moment. Something that produces a wave of relief, a feeling of insight, a sense that something has shifted.

And then a week later you’re back.

Hits feel like change. They’re not. Lasting change moves the baseline. A hit just moves the moment. Just like taking drugs for the hit.

The industry runs on hits. They’re easy to sell because they feel powerful. They’re easy to deliver because they don’t require follow-through. And they keep people coming back forever, because the baseline never actually shifted and the next hit is always needed.

This isn’t healing. It’s a treadmill. And people are exhausted on it.

What I’ve been doing for fifteen years

While the awareness campaigns have been running, I’ve been building two things.

One: a way to show people where they actually are.
Not their symptom score. Their position on the map. The Ladder of Growth assessments do this – different ones for different journeys, anxiety, professional growth, founder mental fitness, perinatal mental health. Each one tells you what’s there, what’s driving it, where you’d want to move to.

Two: a modality that moves people.
Head Trash Clearance. The one I built fifteen years ago in my kitchen because I had six months to change and no other option. The one that’s now moved hundreds of clients hundreds of points on a scale Hawkins said you couldn’t move on more than 5 points.

That’s what I’ve been doing while everyone else was running awareness campaigns.

I am not going to do a pastel square this month.

I am going to keep doing the work. And I am going to keep showing the charts. Because the receipts exist, the methodology works, and we are long past the point where awareness was going to save us.

It was never going to save us.

It was never supposed to.

It was supposed to be the start.

Alexia Leachman is a founder, methodologist, and the creator of Head Trash Clearance. She is co-founder of Ladder of Growth, the measurement engine for personal development, and host of Is It Bloody Working? with JJ Stenhouse.

This is her personal Substack. The ranty one.