People (including I think some of the research at the Happier Lives Institute) often distinguishes “serious mental illness (SMI)” which is roughly schizophrenia, bipolar I, and debilitating major depression, from “any mental illness (AMI)”, which includes everything.
The term “mental health” lumps together these two categories that, despite their important commonalities, I think probably should be analyzed in very different ways.
For example, with SMI, there are often treatments with huge obvious effects. But the side effects are bad, and patients may refuse treatment for various reasons including lack of insight. Treating these diseases can have a huge impact—the difference between someone being totally unable to work or care for themselves and then dying young by accident or suicide, vs. being able to live an independent and successful life. But they are fairly rare in the population.
Whereas it seems that with the set AMI minus SMI, like generalized anxiety, etc., effect sizes of treatments are small and hard to measure. There’s often so much demand for treatment that rationing is required. Impairment and suffering can be really bad but not, I think, typically as bad as SMI. But these diseases are much more prevalent so even if effect sizes are smaller, maybe the total impact of an intervention is much greater.
This distinction is obvious, but I want to point it out explicitly, as I think even though everyone kind of knows this, it’s still underrated, and probably important for thinking about expected impact.
People (including I think some of the research at the Happier Lives Institute) often distinguishes “serious mental illness (SMI)” which is roughly schizophrenia, bipolar I, and debilitating major depression, from “any mental illness (AMI)”, which includes everything.
The term “mental health” lumps together these two categories that, despite their important commonalities, I think probably should be analyzed in very different ways.
For example, with SMI, there are often treatments with huge obvious effects. But the side effects are bad, and patients may refuse treatment for various reasons including lack of insight. Treating these diseases can have a huge impact—the difference between someone being totally unable to work or care for themselves and then dying young by accident or suicide, vs. being able to live an independent and successful life. But they are fairly rare in the population.
Whereas it seems that with the set AMI minus SMI, like generalized anxiety, etc., effect sizes of treatments are small and hard to measure. There’s often so much demand for treatment that rationing is required. Impairment and suffering can be really bad but not, I think, typically as bad as SMI. But these diseases are much more prevalent so even if effect sizes are smaller, maybe the total impact of an intervention is much greater.
This distinction is obvious, but I want to point it out explicitly, as I think even though everyone kind of knows this, it’s still underrated, and probably important for thinking about expected impact.