Mindfulness sessions and mental health first aiders may seem little more than workplace irritants, but the rise of office therapising could be doing more harm than good, writes Phoebe Arslanagic-Little
From the email your company sends exhorting you to “to take care of yourself” to the harassed university staffer administering a session on mindfulness, many of us have been the subject of well-intentioned preventative mental health measures.
For my part, though irritated by suggestions from HR that I should “take a walk” or “pet a dog”, I have largely borne these communiques without complaint because I know that there is a mental health crisis. I also know that young people in particular are suffering. Analysis from Jonathan Haidt tells us that in the UK there has been a 134.5 per cent increase in depression among girls aged 11-15 since 2004. In 2011, 688.5 girls per 100,000 aged 13-16 were hospitalised for self-harm per year; this jumped rapidly to 1,235 in 2013, an increase of nearly 80 per cent, and rates have remained high since.
With the incidence of mental health problems increasing across the population, the simultaneous proliferation of various mental health initiatives to improve mental resilience and wellbeing is understandable. Having been on the receiving end of one or two of these, I have harboured suspicions that some may be of little use, with limited evidence to support common employer measures such as the training of mental health first aiders.
What I did not suspect is that milquetoast mindfulness classes might be actively harmful. But there is a growing body of evidence showing just that, for young people at least.
A paper published in 2022 set out to evaluate the effectiveness of school-based mindfulness training in improving mental health. With 8,000 British teenagers across 80 schools, the study compared those in classes that underwent a year-long programme called MYRIAD (standing for ‘My Resilience in Adolescence’) to those who did not. MYRIAD consisted of ten lessons across the year, focused on mindfulness and learning about mental health and wellbeing.
Astoundingly, after a year, the students in classes randomised to attend these harmless sounding lessons reported worse mental health, including anxiety. Their teachers were also more likely to report them as having emotional problems.
Similarly, in 2023 a paper was published investigating an Australian programme called WISE Teens that wanted to improve teenagers’ social and emotional skills using a type of cognitive behavioural therapy called dialectical behavioural therapy (DBT). Though it consisted of a mere eight sessions, the study found that teens who underwent the programme were “immediately” significantly more likely than those in the control group to report increased anxiety and depression. The authors concluded that “enthusiasm for DBT-based universal interventions in schools is currently ahead of the research evidence”.
What explains these results?
It could be the case that these programmes appear to make the mental health of young people who participate worse because participants become better at identifying and reporting when their mental health is poor. Equally and perhaps simultaneously, the programmes might cause over-reporting, leading some young people to mistakenly identify a brief episode of low mood as depression. But there might be other mechanisms which increase a young person’s risk of mental ill health after an intervention expressly designed to decrease that risk. Perhaps the real problem is that the programmes were badly administered or some other element of their content.
As we attempt to understand this, we must take the results seriously and learn to tread more cautiously than we have been. For now, it might be wisest to reach for the boring things that the evidence tells us clearly are good for our mental health: exercise, seeing our friends, getting enough sleep.
As for the employers considering whether or not to invest in training a mental health first aider or hiring a mindfulness instructor, I helpfully point them to a survey (carried out by a caterer) which indicates that free food at work is a promising way of raising employees’ wellbeing.