May is “Mental Health Awareness Month”. In a crowded contest for the most pointless of all profession-peddled observances, this might be the winner. Mental Health Awareness Month is actually worse than pointless, though. That’s because excessive attention to mental wellness is over-medicalising the healthy and neglecting the seriously mentally ill.

Mental Health Awareness Month was officially proclaimed in 2013 by former president Barack Obama to “shine a light” on “debilitating illnesses”. Obama put “anxiety, depression” and “bipolar disorder” all in that same category, erasing the line between common distress and serious disorder. An ever-inflating “DSM” — the mental health field’s diagnostic tool — has formally done the same. The DSM was originally around 100 pages, listing around 100 diagnoses. Now in its fifth version, it’s ten times longer and clinically classifies everything from jetlag to bad premenstrual syndrome.

Psychiatric disorders can appear on a range of severity, but few — and few cases — are truly debilitating. Serious mental illness most often is, and typically includes schizophrenia (affecting less than 1% of adults) and bipolar disorder (less than 3%).

The seriously mentally ill face many bad outcomes. They live 15-20 years less, on average, and are disproportionately homeless, incarcerated, drug- and alcohol-addicted, uneducated and unemployed. They’re often said to have “fallen through the cracks” as if unnoticed, but social service agencies know exactly who they are. It’s therefore hard to buy the justification for such pervasive awareness efforts: mental disorder goes untreated because it goes unrecognised.

Do people lack awareness of mental disorders? Nearly one in four American adults — and one in three adolescents — received mental health services in 2023. “Mental health” has been searched on TikTok over 67 billion times. It’s fashionable to self-diagnose: the DSM is an Amazon bestseller, while a common green flag for dating is being in therapy.

Given that half of all adults will eventually receive a mental diagnosis, anything still considered to have “gone unrecognised” could only be the most mildly symptomatic, functional cases — or normal human eccentricities yet to be reclassified as psychiatric problems.

Awareness has us thinking that we are sick. Members of Generation Z, who have grown up “aware”, are the most treated and most open to discussing mental health, but the least likely to say their mental health is good. Older generations, who weren’t constantly encouraged to focus on their feelings, are happier on average. Paying less attention to mental health, it seems, reduces overmedicalisation and protects against actually feeling bad.

Treatment doesn’t help those who aren’t sick, so calling everyone with emotions “mentally unwell” only misdirects resources away from the people who are most in need. Take the perpetrator of the 2012 Sandy Hook school shooting, which motivated Obama’s awareness efforts. The “predisposing factor in this tragedy”, a psychiatrist involved in the case said, was that the shooter’s mental illness went untreated. But not because it hadn’t been spotted. His “profound emotional disabilities” were identified six years before he killed 20 children and six adults.

More recently, a seriously mentally ill man went off his medication for schizophrenia and bipolar disorder. His family had been trying to have him hospitalised, without success, when he was arrested for trying to kill Pennsylvania Governor Josh Shapiro last month.

Awareness campaigns downplay the link between violence and mental illness, supposedly to reduce “stigma”. In reality, serious mental illness, when left untreated, increases the risk of violence and self–harm. Distracting from this reality undermines the systemic reform needed to reduce mental illness-related violence — which is what really perpetuates stigma.

If greater distinction were made between schizophrenia and mild depression, it would be easier to demand accountability from the mental health system as to why it so routinely fails to treat those at risk of danger to themselves and others. Instead, Mental Health America, the publicly-funded industry group behind this month’s “celebration”, is offering colouring pages and tips for “eliminating toxic relationships”. Hope that makes you feel better.

A flood of emails and ads have been sent out in recent days to encourage practices like “focusing on you”. Ignore them. What really needs attention is how badly we are failing the seriously mentally ill.