I’ve never been one to say “I told you so”. Any prediction made about how events will unfold at the social level, which involves multiple individual humans reacting to their own circumstances, will always involve a significant element of luck/fluke. Insisting “I told you so” when something you predicted actually comes to pass completely ignores that.
我从来没有说过“我告诉过你”。任何关于事件将如何在社会层面展开的预测，涉及多个人类对自己的环境做出反应，始终涉及运气/fluke的重要因素。坚持要“我告诉过你”，当您预测的事情实际上是完全忽略的。
It’s like winning the lottery and then saying “I knew those would be the numbers, that’s why I picked them”. No, you just got monumentally lucky.
这就像赢得彩票，然后说：“我知道那是数字，这就是为什么我选择它们的原因”。不，您只是很幸运。
…however, despite all that, I’ll admit to a degree of ‘I told you so’ during this Mental Health Awareness Week.
…但是，尽管如此，我还是在这个心理健康意识周中承认“我告诉过你”的程度。
You might be thinking, “Didn’t we just have Mental Health Awareness Week?” No, we didn’t. That was World Mental Health day, which was back in October. Or Children’s Mental Health Week, in February. Or Time to Talk day, also in February. Or Stress Awareness Month, which was last month.
您可能在想：“我们不是只有心理健康意识周吗？”不，我们没有。那是世界心理健康日，早在十月。或2月的儿童心理健康周。或时间是二月份的时间。或压力意识月，上个月。
The fact that we can now legitimately end up confused about which mental health occasion is which suggest mental health awareness may have lost its value somewhat.
我们现在可以合法地对哪种心理健康场合感到困惑的事实表明，心理健康意识可能会在某种程度上失去其价值。
But then, this is me saying that. I spend almost every day immersed in the mental health discourse, so of course I’d find it a bit ‘omnipresent’.
但是，这就是我这样说的。我几乎每天都会沉浸在心理健康话语中，所以我当然会发现它有点“无所不在”。
It’s not just me though. There’s actual evidence for waning effectiveness of awareness campaigns. As recently flagged up by Dr Lucy Foulkes on Instagram, we’re seeing a tangible ‘backlash’ against mental health awareness. For instance, Dr Foulkes cites, a detailed study published in 2024 which reported a noticeable drop in positive attitudes to those with mental health problems since 2019, after a sustained decade-long trend of improvements.
不过，不仅是我。有实际证据证明了宣传运动的有效性。露西·福克斯（Lucy Foulkes）最近在Instagram上标记，我们看到了针对心理健康意识的有形“反弹”。例如，Foulkes博士引用了一项详细的研究，该研究于2024年发表，该研究报告了自2019年以来对精神健康问题的人们的积极态度明显下降，此前十年后的改善趋势持续了十年。
What’s happened? Presumably mental health awareness campaigns were a big part of the significant improvement in attitudes, so why would they suddenly lose their efficacy?
发生了什么事？大概是心理健康意识运动是态度显着改善的重要组成部分，那么为什么他们会突然失去疗效呢？
Leaving aside the sorts who actively want to spread stigma and judgment (and there’s no shortage of them lately), there’s no easy answer to this. But here are some likely factors to consider.
抛开积极想传播污名和判断的各种各样的东西（最近不乏它们），这并不容易答案。但是这里有一些可能考虑的因素。
Awareness is not enough by itself
意识本身还不够
The reason I ended up needing to quash a childish “I told you so” impulse upon learning that mental health stigma is increasing again, is that I warned about this outcome, a year before it showed up in the data.
我最终需要在得知心理健康污名再次增加的情况下，需要消除幼稚的“我告诉过你”的冲动，这是我警告了这一结果，这是一年的结果。
Specifically, I wrote a Guardian article in 2018 titled “Mental health: awareness is great, but action is essential”. My overall point was that increased awareness of mental health problems is to be celebrated, but it’s a first step, not a destination. Without accompanying action to actually do something about the ever-increasing rates of mental health problems, awareness will eventually lose its impact.
具体来说，我在2018年写了一篇《卫报》，标题为“心理健康：意识很棒，但行动至关重要”。我的总体观点是，要庆祝对心理健康问题的认识提高，但这是第一步，而不是目的地。如果没有采取任何行动实际上对不断增加的心理健康问题率做些事情，意识最终将失去影响。
Seven years later, here we are. Basically, if you spend years spreading awareness of mental health issues, but nothing beyond that, you may well end up with a population where many people say “OK, so depression etc. are real things… and?”
七年后，我们在这里。基本上，如果您花费数年的时间来传播人们对心理健康问题的认识，但是除此之外，您可能最终会成为许多人说“好的，抑郁等等的人口，所以是真实的事情……而且？”
After all, I and many others are ‘aware’ of, say, skirting boards. But this doesn’t affect my thinking and behaviour in any way that I’m aware of.
毕竟，我和许多其他人都“知道”弹跳板。但这不会以我知道的任何方式影响我的思维和行为。
Maybe awareness campaigns have made mental health too commonplace? Or perhaps they’ve helped ‘sanitise’ the mental health crisis? It’s hard to say, but worth considering.
也许宣传运动使心理健康太普遍了？也许他们帮助“消毒”了心理健康危机？很难说，但值得考虑。
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Therapy speak, over-medicalisation, and the muddying of the waters
治疗说话，过度医学化和水域的混乱
It’s a common complaint that ‘therapeutic’ terminology is used far too much these days. I’ve made similar observations myself, most recently about the invoking of dopamine where it’s not warranted, and the mainstream tendency to label anything and everything ‘addictive’. My contention is that overuse of these terms dilutes their meaning and leads to greater confusion and misunderstanding.
这是一个普遍的抱怨，即当今使用“治疗”术语过多。我本人也做出了类似的观察，最近关于它不保证多巴胺的援引，以及主流倾向的倾向，将任何事物和所有事物都标记为“上瘾”。我的论点是，过度使用这些术语会稀释它们的含义，并导致更大的困惑和误解。
And so it is with the ever-increasing use of therapeutic terms, usually reserved for mental health treatment, being dropped into everyday conversation.
因此，通常用于心理健康治疗的治疗术语不断增加的治疗术语，被送入日常对话中。
Years of awareness campaigns and the subsequent acceptance they’ve led to will have contributed to this ‘leakage’ of vocabulary from the clinical to the mainstream. And it doesn’t help.
多年的宣传运动以及随后的接受，他们导致的措施将导致从临床到主流的词汇“泄漏”。而且这无济于事。
For instance, ‘trauma’ is a term which clinical psychologists wish people were more discerning about. Trauma is usually used to describe the emotional response to a significantly negative event, like an attack, car crash, loss of a home, etc. It typically shouldn’t be applied to the awkwardness of embarrassment, or mild criticism from someone who doesn’t like your output.
例如，“创伤”是临床心理学家希望人们更挑剔的术语。创伤通常用于描述对明显负面事件的情感反应，例如攻击，车祸，失去房屋等。通常不应将其应用于尴尬的尴尬或不喜欢您的输出的人的温和批评。
This isn’t to say those things can’t be traumatic, because they could. Trauma describes the emotional response, not the experience itself, and if someone has poor enough mental health that one more negative encounter is the proverbial straw that broke the proverbial camel’s back, then they could experience low-key trauma.
这并不是说这些事情不会造成创伤，因为它们可以。创伤描述了情感反应，而不是体验本身，如果某人的心理健康状况不佳，那么另外一个负面的遇到是打破众所周知的骆驼背部的众所周知的稻草，那么他们可能会遇到低调的创伤。
Unfortunately, such individuals would likely be lumped in with those who describe their experiences as traumatic just to add a bit of spice to their language, to hype up their own experiences and piece of mind, or who simply just don’t know better. Such people can be, admittedly, rather exhausting.
不幸的是，这样的人很可能会与那些将自己的经历描述为创伤的人，只是为了增加语言，炒作自己的经历和思想，或者只是不了解自己的经历和思想。诚然，这样的人可能会筋疲力尽。
This issue seems to be getting amplified by social media. It’s a common observation that countless people will post hashtags and memes about ‘time to talk’ or ‘be kind’ etc., whenever a mental health awareness campaign comes around, but never actually follow through with the offers of help and support, often straight back to posting their typical ‘less positive’ output the next day.
社交媒体似乎正在扩大这个问题。这是一个普遍的观察，无数人会发布有关“说话的时间”或“善良”等的主题标签和模因，每当出现心理健康意识运动时，但实际上从来没有真正遵循帮助和支持的提议，通常直接回到第二天发布他们典型的“积极积极”的输出。
If your regular experience of mental health awareness is irksome types using it to self-aggrandise, that likely would sour you on the concept.
如果您对心理健康意识的常规经验是一种令人讨厌的类型，则使用它来自我诱惑，那可能会使您对此概念感到不适。
Mental health influencers are another concern. It’s great that individuals who deal with mental issues on the regular have a much bigger voice these days (they didn’t in the recent past, and that often led to problems), and that those who endure them don’t have to do so alone.
心理健康影响者是另一个问题。很棒的是，如今在常规上处理精神问题的人的声音更大（他们最近没有，这常常导致问题），而且那些忍受他们的人并不需要一个人这样做。
But there’s the increasing problem of mental health influencers spreading misinformation. Presumably by accident? They’re likely just sharing their own experiences, and subsequent insights. But mental health is a very subjective thing, and what applies to one person need not apply to others. Or anyone else. Hence, people who follow such influencers end up believing inaccurate notions, and acting on them, with often unhelpful outcomes.
但是，心理健康影响者传播错误信息的问题越来越大。大概是偶然的？他们可能只是分享自己的经验以及随后的见解。但是心理健康是一件非常主观的事情，适用于一个人的东西不适用于他人。或其他任何人。因此，遵循这种影响者的人最终相信不准确的观念，并以无助的结果对他们采取行动。
This isn’t to say the medical/clinical establishments are blameless, of course. The creep of medicalisation, of turning everyday traits into medical problems to be treated/cured, is has been flagged up for almost as long as awareness campaigns have existed.
当然，这并不是说医疗/临床机构是无罪的。只要存在宣传运动，就已经标记了医疗化的蔓延，将日常特征变成要治疗/治愈的医学问题。
To what extent overmedicalisation is a legitimate problem is hard to establish, given the vagaries of mental health problems and how they’re defined. But that’s not the issue; if enough people believe overmedicalisation is a problem, they’ll be increasingly likely to dismiss or scorn those with legitimate issues.
鉴于精神健康问题的变化及其定义方式，很难在多大程度上过度进行过度的问题。但这不是问题；如果足够多的人认为过度的问题是一个问题，那么他们将越来越有可能解雇或嘲笑那些有正当问题的人。
The Pandemic
大流行
Whenever a big societal change happens after 2019, you can’t avoid asking if COVID-19 may have played a wee part in it.
每当2019年以后发生重大社会变革时，您就无法避免询问Covid-19是否可能在其中发挥作用。
And it’s hard to imagine it didn’t here. Data suggests that the pandemic led to a massive increase in mental health problems worldwide. And honestly, why wouldn’t it? It was an incredibly stressful, often genuinely traumatic years-long period for so many. It would be a miracle if mental health problems didn’t spike dramatically in the wake of that.
很难想象它不在这里。数据表明，大流行导致全球心理健康问题大大增加。老实说，为什么不呢？对于许多人来说，这是一个令人难以置信的压力，通常是真正创伤的一年。如果心理健康问题在此之后没有急剧尖叫，那将是一个奇迹。
But the ripple effects of this are many and varied.
但是它的连锁反应多种多样。
Did constant exposure to just how deeply overwhelmed the medical system is, or can be, give people a more hard-line view of who is or isn’t ‘unwell’?
不断暴露于医疗系统的深入或可能使人们对谁是“不适”或不是“不适”的更加刻苦的看法？
Would round-the-clock coverage of a genuinely fatal respiratory illness make people less sympathetic to those revealing their own more subtle, less tangible mental ailments?
真正致命的呼吸道疾病的全天候报道会使人们对那些揭示自己更微妙，更明显的心理疾病的人的同情程度降低吗？
If far more people overall have experienced a decline in mental health and had to soldier on regardless, would they more readily expect others to do the same? If we’re ‘all in the same boat’, you’re not going to have much patience for those moaning about getting wet.
如果总体上越来越多的人经历了心理健康的下降，并且不得不士兵不管他们会更容易期望其他人这样做吗？如果我们“全部乘坐同一条船”，那么那些对湿wit的人来说，您不会有太多耐心。
…to clarify, I’m by no means claiming that those with mental health issues are complaining needlessly. But, again, the experiences of the pandemic may have led to more people believing they are.
…为了澄清，我绝不声称那些有心理健康问题的人不必要地抱怨。但是，同样，大流行的经历可能导致更多的人认为自己是。
There are no doubt many other aspects of the pandemic experience that will be shaping attitudes towards mental health. Suffice to say, it was a significant external shock that we’re still unpacking.
毫无疑问，大流行经验的许多其他方面将塑造对心理健康的态度。可以说，我们仍在打开包装是一个重大的外部冲击。
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The lack of concern from those with power
那些有权力的人缺乏关注
Photo by Lukas
卢卡斯摄影
This very morning as I write this, the current education secretary has announced that, to tackle the school mental health crisis, children will be taught to show some 'grit' (thanks to Natasha Devon for flagging this up).
在我写这篇文章的那天早晨，现任教育部长宣布，为了解决学校的心理健康危机，将教导孩子们表现出一些“毅力”（感谢Natasha Devon对此进行了标记）。
While the actual proposal does seem more measured and nuanced, the headline statement alone reveals the usual default assumption; people who claim mental health issues, especially young people, just lack fortitude. They’re throwing in the towel rather than grow some backbone, blah blah blah.
尽管实际提案似乎确实更为衡量和细微，但仅标题声明就揭示了通常的默认假设。声称心理健康问题，尤其是年轻人的人缺乏毅力。他们扔进毛巾，而不是种一些骨干，等等等等。
It’s a view that will resonate with many a middle-aged tabloid reader, sure, but it’s also deeply harmful, for obvious reasons. Like, the idea that young people are struggling mentally purely for reasons relating to being too soft, or whatever, completely ignores the vast range of other stressors and problems young people have to put up with on a daily basis, especially post-pandemic. Problems that the older generations in power never had to deal with, but are largely responsible for causing, or propagating.
当然，这种观点会引起许多中年小报读者的共鸣，但出于明显的原因，这也是有害的。就像，年轻人在精神上挣扎的想法纯粹是出于与太软或其他任何事物有关的原因，完全忽略了年轻人每天必须忍受的许多其他压力和问题，尤其是大流行。掌权者不必处理的问题，而是在很大程度上造成或传播的问题。
It’s basically yet more evasion of the fact that genuinely effective mental healthcare that would actually tackle to problem is expensive, time consuming, and would take a very long time to deliver nuanced results. Basically kryptonite to most modern governments.
基本上，实际上会解决问题的真正有效的心理保健是昂贵，耗时，并且需要很长时间才能提供细微差别的结果，这基本上是更多的逃避事实。基本上是对大多数现代政府的k石。
But it also reveals a deeper, more persistent problem, with those with the power to make actual, effective changes; a lack of drive to do so, and a resultant tendency to put the responsibility for dealing with mental health issues on those experiencing them.
但这也揭示了一个更深，更持久的问题，那些有能力进行实际有效的改变的问题。缺乏这样做的动力，以及由此倾向于将心理健康问题处理的责任承担责任。
It’s common enough from any government, using slogans instead of actual investment. And you regularly hear of companies and organisations who ‘take mental health seriously, by offering employees workshops and classes on things like ‘resilience training’. There’s nothing wrong with this in isolation, as long as employers don’t end up treating it as a blank cheque to pile more work on employees. Judging from the ever-increasing rates of workplace burnout, I’m not optimistic about that.
使用口号而不是实际投资，任何政府都足够普遍。您会定期听到有关“认真对待心理健康”的公司和组织，通过为员工提供有关“弹性培训”等课程的讲习班和课程。只要雇主最终不将其视为空白支票即可将更多工作堆积在员工上，这并没有错。从工作场所倦怠的不断增长的速度来看，我对此并不乐观。
There’s a more sinister version of this too; the whole ‘toxic positivity’ angle. The idea that, with just some happy mindsets and inspiring slogans, you too can ‘choose your mood’. After all, ‘the only disability in life if a bad attitude’.
还有一个更险恶的版本。整个“有毒阳性”角度。您的想法只有一些快乐的心态和鼓舞人心的口号，您也可以“选择自己的心情”。毕竟，“如果态度不好，生活中唯一的残疾”。
And logically, if we can choose to be happy and capable, those who say they aren’t, are choosing not to be. And that’s on them.
从逻辑上讲，如果我们可以选择幸福和有能力的人，那些说他们不是的人，那就是选择不这样做。那就是他们。
Attitudes often flow from the top, and if those who run your country, pay your wages, and influence you online, are constantly saying those with mental health issues are responsible for their own problems, that’s going to sink in eventually. And increasingly negative attitudes towards them will be the most likely outcome.
态度通常从顶部流动，如果那些经营您的国家，支付您的工资并在线影响您的态度一直在不断地说患有心理健康问题的人对自己的问题负责，那将最终消失。对他们的越来越消极的态度将是最有可能的结果。
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And so on.
等等。
There are no doubt countless other factors that could be causing the decline in positive attitudes towards mental health matters. Please feel free to flag them up in the comments if you know one I’ve not included that’s probably very important.
毫无疑问，无数其他因素可能导致对心理健康问题的积极态度下降。如果您知道我不包括在评论中，请随时在评论中标记它们，这可能非常重要。
I will stress, though, that a decline is not a full reversal. We’ve still come a great distance, and remain far ahead of where we were when even I started writing, some 20-ish years ago.
但是，我会强调的是，下降并不是完全的逆转。我们仍然走很远的距离，并且在大约20年前我开始写作时仍处于领先地位。
But if we concede that a lot of people are now aware of mental health problems, maybe it’s about time we started doing something more nuanced, more practical, and more useful with it? We’ve filled the awareness fuel tank, to the point that it seems to be sloshing over the sides. So let’s see if we can use it to actually go somewhere.
但是，如果我们承认很多人现在已经意识到心理健康问题，那么也许是时候我们开始做一些细微差别，更实用，更有用的时候了吗？我们已经装满了意识箱，以至于它似乎在侧面晃动。因此，让我们看看我们是否可以使用它实际去某个地方。
I discuss mental health matters in all my books, including the most recent one, which you could give young people, instead of ‘grit’.
我在所有书籍中讨论了心理健康问题，包括您可以给年轻人而不是“勇气”的最新一本书。
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