What can we learn from social approaches to mental health?
“Collectively, we need ways to tackle systems and structures that exclude, divide, generate inequity and traumatise.“
On 6 December 2025, BBC News reported a study of GPs’ views on the so-called over-diagnosis of mental health issues.
They reported that: ‘Of the 752 GPs who chose to take part in our research, 442 said they believed that over-diagnosis is a concern.’
At the same time, they reported concerns about a lack of support for patients. The majority said that there was ‘rarely’ or ‘never’ good enough help available in their area.
Despite recent headlines about rising diagnosis rates, this is not a new discussion. Questions about the usefulness, relevance and power of diagnoses, and the language we use to describe mental health, have long been a passionate topic of discussion among activists, service-users and academics alike.
People have debated the language that we use to frame mental health, possible triggers and potential treatments. Some argue that mental health diagnoses are vital for understanding and accessing help, whilst others feel that diagnostic labels can be stigmatising and may overlook the context in which distress arises. Whatever language we settle on, it is clear that people are experiencing significant and meaningful levels of distress and that their voices should be at the centre of this conversation.
Barnwood Trust is a place-based charitable foundation and social change organisation, working with disabled people and people with mental health conditions in Gloucestershire. Barnwood’s work is informed by the social model of disability, and they were interested in what implications this has for mental health.
Barnwood asked us to review literature and strategies from different thinkers in the mental health landscape (activists, charities and academics) to inform their strategy. We reviewed literature from 34 key thinkers in total, and focused on how they talk about and understand mental health.
We found that most organisations and activists are calling for a major shift in the way that mental health is understood and responded to.
People want better consideration of the impact of social, economic and relational factors on mental distress.
However there were different opinions on how best to achieve this change. Some organisations were focusing on addressing inequality and societal issues that cause distress, whilst others were calling for radical change to mental health services.
A key message across the material we reviewed is the importance of people with lived experience of mental distress, in various forms, leading the conversation.
Matt Little, CEO of Barnwood Trust, said:
“We all need support at certain times in our life. We all have a right and need to be seen and understood as whole and complex human beings, to be valued, and for our experience to be centred. Collectively, we need ways to tackle systems and structures that exclude, divide, generate inequity and traumatise.”
We have also been thinking about how this informs NDTi’s own work around mental health.
Our work advocates for inclusion and self-determination in all areas of life, from education to employment, housing to health and care, supporting the conditions for people to live the lives they choose.
Through our focus on people’s voices, we support people with lived experience to lead and direct work that impacts upon them.
A few examples include:
- Learning Together training for peer led researchers and evaluators.
- The social, rights-based approaches of Time to Talk Next Steps Scotland.
- Youth-led research exploring how the education system impacts upon pupil wellbeing.
- A wide range of coproduction facilitation.
Together, these approaches help ensure that our work stays rooted in people’s lived experiences and aligned with our values of inclusion, human rights and coproduction.
