Review: The Prevalence Inflation Hypothesis: Are Mental Health Awareness Efforts Contributing to the Rise in Reported Mental Health Problems?

Mental Health Awareness Efforts photo

In recent years, there has been a significant increase in mental health awareness efforts aimed at reducing stigma, improving mental health literacy, and promoting help-seeking behaviours. However, paradoxically, reported rates of mental health problems have also been on the rise. In a thought-provoking research paper titled “Are mental health awareness efforts contributing to the rise in reported mental health problems? A call to test the prevalence inflation hypothesis,” authors Lucy Foulkes and Jack L. Andrews explore the possibility that these awareness efforts might be inadvertently contributing to the increase in reported mental health problems.

The authors present the prevalence inflation hypothesis, which suggests that mental health awareness efforts have a dual impact on reported mental health problems. First, these efforts lead to improved recognition, allowing individuals to better identify and report previously under-recognised mental health problems. This outcome is considered beneficial, as it promotes help-seeking and treatment for those in need. However, the second mechanism, known as overinterpretation, is more problematic. Overinterpretation occurs when individuals misinterpret milder forms of distress as mental health problems, leading to self-labelling and potentially exacerbating their symptoms.

The Role of Mental Health Awareness Efforts 

Mental health awareness campaigns often encourage individuals to recognise and seek help for negative psychological experiences, promoting the use of psychiatric terminology. While these efforts aim to reduce stigma and encourage disclosure, they may unintentionally contribute to the overinterpretation of everyday suffering and distress. Additionally, the glamorisation and romanticization of mental health problems in popular culture, particularly on social media, can further influence individuals’ perceptions and self-interpretation of their experiences.

The Self-Fulfilling Prophecy

The authors propose that overinterpretation can lead to a self-fulfilling prophecy, where individuals who label their distress as a mental health problem may inadvertently reinforce and intensify their symptoms. For example, someone interpreting mild anxiety as an anxiety disorder may start avoiding situations that trigger anxiety, further exacerbating their symptoms. This conceptualisation affects their self-concept and behaviour, ultimately leading to a genuine increase in anxiety over time.

Testing the Hypothesis and Future Considerations

To understand the impact of mental health awareness efforts on reported mental health problems, further research is needed. Studies should explore the prevalence inflation hypothesis and investigate the bidirectional relationship between mental health problems and awareness efforts. It is crucial to strike a balance between improved recognition and overinterpretation to ensure that awareness campaigns effectively target those who genuinely require support.

Implications for School Leaders

As school leaders, it is essential to be aware of the potential consequences of mental health awareness efforts on students. While promoting mental health literacy and destigmatising mental health problems are vital, it is crucial to foster a nuanced understanding of mental health and avoid inadvertently encouraging overinterpretation. Educators should strive to provide accurate information, promote healthy coping strategies, and emphasise the importance of seeking professional help when needed.


The prevalence inflation hypothesis presented by Foulkes and Andrews highlights the complex interplay between mental health awareness efforts and reported mental health problems. While these awareness campaigns have undoubtedly played a crucial role in reducing stigma and improving recognition, they may also inadvertently contribute to the overinterpretation of everyday distress. 

It is essential for school leaders to strike a balance between promoting mental health awareness and ensuring that students receive accurate support and intervention when necessary. By addressing the potential pitfalls of overinterpretation, school communities can create a healthier environment that supports genuine mental health needs.