Mental health Do we really have a problem with overdiagnosis? Or just the opposite?

When the health secretary, Wes Streeting, suggested that "overdiagnosis" of some mental health conditions was a factor in the government's welfare changes, many saw the comments as playing into an unhelpful culture-war stereotype of coddled younger generations.

- Hannah Devlin

It was an echo, they suggested, of Rishi Sunak's claim a year ago that a "sicknote culture" was plaguing the economy.

But media coverage of Dr Suzanne O'Sullivan's book, The Age of Diagnosis, has amplified and lent credibility to the idea that a diagnosis, in itself, can risk limiting an individual's life prospects.

Streeting's comments came amid plans for substantial cuts to personal independence payments (Pip), after the government concluded that the overall bill for disability benefits, which rose by nearly £13bn to £48bn between 2019-20 and 2023-24, was on an unsustainable trajectory. Much of the increase was linked to a huge rise in working-age adults claiming disability benefits linked to mental ill health - a situation that demands a policy response. At the heart of the debate is the question of what has caused this increase and how it might be reversed.

Worsening mental health

In 2002, mental and behavioural problems were the main condition for 25% of claimants. By 2024, this had risen to 44%, with 55% of the post-pandemic rise in disability benefits accounted for by claims primarily for mental health, according to a report by the Institute for Fiscal Studies.

The thinktank found "compelling evidence that mental health has worsened since the pandemic" and experts agree with this assessment.

"We observe clear trends of increasing mental ill health," said Dr Dario Moreno-Agostino, who researches mental health at UCL and King's College London. His team's analysis of longitudinal data, tracking cohorts born in 1970, 1958 and 1946, suggests that after the pandemic all three generations reached or surpassed the worst mental health levels in 40 years.