Are We Playing Whack-a-Mole with Mental Health? Spoiler: Yes, and It’s Time to Change the Rules

One HealthTech
Oct 20
5 min read

At a recent One Health Tech panel discussion titled "Are We Playing Whack-a-Mole with Mental Health?", panellists Meera Moore Danowski, Chris Hazen, and Breda Spillane came together to tackle a pressing question: why does our approach to mental health keep producing the same stubbornly limited results despite a century of innovation? The conversation revealed an uncomfortable truth: we're treating mental health like it's a broken bone, when in fact it's more like trying to fix a house while the neighbourhood is on fire, demanding solutions that address the whole environment, not just the immediate damage.

The discussion set the stage for an honest look at what’s really keeping recovery rates stubbornly low and what systemic changes are needed to create lasting impact.

You can find the key highlights from the discussion below, diving into the insights, debates, and proposed solutions that emerged during the event.

The 85% Problem Nobody Wants to Talk About

Let's look at the numbers. NHS Talking Therapies aims to reach at least 30% of people experiencing common mental health conditions (mostly anxiety and depression) with at least one contact. Of those, recovery is measured from people with two or more contacts, with a target of a 50% success rate. If you do the math, that's roughly 15% of people with anxiety and depression starting the journey to "recovery." And even for them, there’s no guarantee they will complete that journey as resources are limited.

Which means 85% are left... where exactly? Playing therapeutic roulette? Quick fixes on social media, chatbots, or trial-and-error self-help strategies. The system isn't just falling short, it's designed to leave most people out in the cold. If we want to stop mental health crises from escalating, a systemic redesign is needed. We must build solutions that reach the majority of people in need, not just a fraction.

Your Therapist Can't Fix Your Landlord

Here's where reality hits the hardest. Around 70% of mental health issues stem from social determinants: housing, money, relationships, the everyday pressures of modern life. Yet we've neatly tucked mental health into the "healthcare" box, letting every other system off the hook.

The panel painted a vivid picture: clients attending therapy while facing poverty, homelessness, or domestic violence. In these situations, "therapy" often becomes containment and advocacy work, not actual therapeutic healing. It's like trying to practice mindfulness while your house is literally burning down, and someone keeps asking you to rate your anxiety on a scale of one to ten.

A provocative question emerged: shouldn't banks have some responsibility for their customers' financial mental wellbeing? After all, a mentally well customer is theoretically better for business. Unless, of course, a stressed, desperate customer is more profitable. Recognising this is uncomfortable, yes, but it also points the way toward systemic solutions that could change the game.

The Measurement Trap

One of the most striking paradoxes emerged around measurement. Mental health is unique because your subjective experience is the only valid measure of your wellbeing, nobody else can truly inhabit your mind. Yet this creates a tricky situation: you must convince others you're unwell enough to deserve help, or well enough not to need it, using only your own words.

Compare this to physical health. Broken bone? X-ray. High cholesterol? Blood test. Depression? Fill out a PHQ-9 form at the start of every session (which, for some, might actually feel more destabilising).

Numbers reveal the scale of the challenge: The number needed to treat for talking therapies has remained at seven for decades, despite CBT, DBT, and lots of other innovations. For every seven people treated, only one recovers because of the treatment. Two more recover spontaneously, for reasons we can’t explain. Four don’t recover at all, they even deteriorate. We don’t know why treatment works when it does.

We don’t know why people recover on their own. It’s like training pilots when we don’t understand aerodynamics. Imagine you’re the passenger: three planes out of seven lands safely, but the pilot’s training only mattered for one of those flights. Four never reach their destination. Would you board?

The good news? These numbers don’t have to define the future. By identifying the measurement trap, we are making the first step toward rethinking measurement and treatment to redesign interventions and produce meaningful change.

Technology: Silver Bullet or Expensive Distraction?

The AI question hovered over the discussion like an awkward dinner party guest. From the practitioner perspective, scepticism ran deep: the therapeutic relationship is the core healing factor, and we already have digital tools while loneliness rates skyrocket. The tech and systems view offered more nuance: use technology for prevention and mild cases but keep humans firmly in charge as severity increases.

The reality? People are already using ChatGPT and other AI tools for mental health support, whether professionals like it or not. The question isn't whether to allow it, but how to make it safer. Though everyone agreed: benchmark new tools against "no access" rather than perfection. A chatbot that helps someone avoid descending into crisis is worth having, and if considered as part of a planned care pathway prioritising prevention going forward, could support more people to stay well effectively and efficiently.

The Burnout Factory

Perhaps the clearest signal that change is overdue comes from workforce pressures. Mental health vacancy rates in the NHS hover around 17-18%, double the rest of the healthcare system. Therapists face an impossible balancing act: encouraged to innovate and provide person-cantered care while held personally accountable when things go wrong. Short, rigid protocols clash with messy, complex human needs.

Support workers, paid £25-30k, carry enormous non-clinical responsibilities and experience extreme churn. Clinical staff at £60k+ still lack the infrastructure to address practical barriers. It's a system that asks therapists to hold whole human lives in hour-long weekly sessions, then wonders why burnout is rampant.

The workforce challenges extend beyond the UK. In the US, there's significant resistance to delegating tasks to community health workers, despite a forecast 20-30% shortfall in trained therapists over the next decade. The pay gap is stark: $100+ per hour for therapists versus $20-25 for community health workers who, properly trained in mental health first aid, could handle skill-building and triaging.

The opportunity is clear: reallocating responsibilities and investing in support staff could expand access, reduce strain, and improve outcomes across the system.

A Modest Proposal

The panel offered a radical metric shift: if someone reaches crisis, the system has already failed. Not failed a person, failed full stop. Success shouldn't be measured by recovery rates but by prevention. Nobody should be getting mentally unwell in the first place.

It's audacious, possibly naive, and absolutely the right way to think about this. We have “Couch to 5K” for physical fitness and brilliant smoking cessation apps and programmes. Where's the equivalent for mental resilience? Where's the national-scale prevention strategy for mental health?

The discussion concluded what many secretly suspect: mental health is roughly where physical medicine was pre-World War One, a bit of a lottery, hampered by ignorance, under-resourced, with language as our only diagnostic tool. We're trying to solve a biopsychosocial problem with a biomedical model, and we're genuinely shocked it's not working.

So yes, we are playing whack-a-mole, but the game isn’t over. With better prevention, smarter use of technology, and systemic redesign, perhaps we can tip the balance. The work ahead is urgent and difficult, but far from impossible and well worth doing because this is our biggest health problem by a long way. While our network alone cannot solve the issues presented above, the discussion offered valuable framing for the broader challenges we face.

As a community focused on innovation, equity, and technology-enabled solutions, there’s a real opportunity to turn these insights into action. We encourage you to join the conversation, connect with peers, and share your ideas. Together we can strengthen the mental health networks, spark collaboration, and shape potential solutions.

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