I went on Andrew Eborn’s show last week to talk about the thing that’s been driving me mad for the last decade.
Britain is spending more on mental health awareness than at any point in its history. Campaigns. Hashtags. Awareness weeks. Schools. Workplaces. Royal speeches. And in the same period, the prevalence of anxiety and depression in UK adults has climbed from 17.6% in 2007 to 22.6% by 2024.
If that were a brand campaign, you’d have been fired by year three.
But here’s the bit I went on telly to say: I think the awareness work has done its job. And carrying on doing more of it might be making things worse.
There’s a hypothesis in the academic literature called prevalence inflation. It says that as we get better at naming mental health conditions and talking about them, more people start interpreting ordinary distress as clinical illness. We hook onto the label, we identify with it, and then we start spiralling around it.
I gave Andrew an example. Imagine you’re about to walk on stage to speak in public. Stomach churning, hands a bit shaky, heart quick. Someone leans over and says: that’s excitement. You absorb it, your nervous system aligns to it, and within thirty seconds you’re a slightly faster, slightly sharper version of yourself, ready to go.
Now imagine the same scene. Same body. Same stomach. Same hands. Different prompt: careful – that’s anxiety kicking in. You absorb that, and within thirty seconds you’re spiralling. Maybe you don’t go on at all.
Same physical sensation. Two completely different stories told about it. Two completely different outcomes.
This is what well-meaning awareness work, applied indiscriminately at population scale, does. It hands people clinical labels for sensations that weren’t pathological – and once someone’s hooked onto the label, the label tends to stay.
I’m not anti-awareness. I’m not anti-therapy. The therapists I train in Head Trash Clearance tell me it pairs beautifully alongside their existing work – they don’t compete, they complement.
But the data on the front-line model we’re sending most people to is uncomfortable.
NHS Talking Therapies reports recovery rates of around 45–52% for adults who complete a course of treatment. That’s the published number – and “complete” is doing a lot of work in that sentence.
In my own practice, with clients who do the work, the success rate sits at 80–90% – and we’re typically resolving severe anxiety, including tokophobia, in three to four months. Not three to four years.
I’m not telling you that to be impressive. I’m telling you that because we have a public health crisis on our hands and the system is still defaulting to the slowest, most expensive, lowest-yield option in the toolbox.
Talk therapy is doing essential work for the people it’s right for. But talking engages the conscious mind. It works with what you can remember, what you can articulate, what you can reflect on.
A lot of what’s actually driving severe anxiety isn’t there.
I asked Andrew on the show whether he remembered his own birth. He said of course, I was there. Lovely. But most of us don’t. And one of the deepest root traumas behind tokophobia – the pathological fear of pregnancy and birth that affects up to one in five women – is the trauma of your own birth. An experience nobody can talk through, because nobody can recall it.
If your healing work needs to happen at a level beneath language, then language is going to take you to the edge of the territory and stop. You can have brilliant insight and still be exactly as anxious as you were three years ago.
Insight is necessary. It is not sufficient.
Andrew called the other half of this problem Pandora’s box, and he was right. A lot of people hesitate at therapy not because they don’t want to feel better – but because they don’t want to crack the box open and rummage through it on a Tuesday afternoon. The work I do doesn’t require them to. We work with the charge – the energetic reaction stored in the body – and clear it. The box stays closed. The reaction dissolves.
So what would actually move the needle?
We need to give people tools they can use on themselves, so they’re not stuck in a referral queue for nine months while their lives quietly fall apart.
We need to train NHS practitioners in faster, more effective approaches, so that completion isn’t the only variable standing between recovery and relapse.
And we need a way to measure whether any of it is actually working. That’s why I co-founded Ladder of Growth. Because right now, when someone goes into therapy, the standard metric for “is this working” is usually I think I feel a bit better – which, on a sunny day with a nice compliment from a colleague, anyone might say. That is not a metric. That’s a mood.
I have charts. I’m building the ruler the industry never built.
Near the end of the interview, Andrew said something that nails it.
“Awareness got us here. But it won’t get us out.”
I told him he’d nailed it in one sentence. Because that’s the whole thing.
We are not the generation that needs to be told mental health matters. We’ve been told. We agree. We’ve hashtagged it, ribboned it, run it round Hyde Park.
We’re the generation that has to actually move the needle.
The interview is above. Have a watch and tell me what you think – particularly if you work in the system and you’re already feeling the strain of the current model.
If any of this landed, share it with someone who’s still being told that awareness is the answer.
Alexia