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Observations Medicine and the Media

“One in four” with a mental health problem: the anatomy of a statistic

BMJ 2012; 344 doi: (Published 22 February 2012) Cite this as: BMJ 2012;344:e1302
  1. Stephen Ginn, Roger Robinson editorial registrar, BMJ,
  2. Jamie Horder, postdoctoral neuroscientist researcher, Department of Psychiatry, University of Oxford
  1. jamie.horder{at}

Despite a lack of supporting evidence, the claim that one in four people will have a mental health problem at some point in their lives is a popular one. Where does this figure come from, and why does it persist, ask Stephen Ginn and Jamie Horder

“It’s time to talk” is a campaign currently being promoted by Time to Change, a charity whose aim is to change attitudes to people with mental ill health. On the charity’s website a banner tells us: “1 in 4 of us will experience a mental health problem at some point in our lives, but we still don’t talk about it. What are we afraid of?”

This “one in four” figure has also appeared in government speeches1 and NHS publications.2 It is the name of a short film and the title of a mental health magazine.

Yet it is not always clear to what the figure refers. Time to Change seems to be referring to lifetime prevalence, while a 2010 advertising campaign by Islington Primary Care Trust stated, “One in four people will experience mental health problems each year.” A statement on the Royal College of Psychiatrists’ website reads, “One …

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