Research
My research group explores whether efforts intended to reduce mental health problems, such as awareness-raising campaigns and school interventions, have had unintended consequences. Current research projects are organised into three strands, detailed below.
Potential harm from school mental health interventions
There is currently considerable enthusiasm for teaching young people about mental health in schools. In some respects this can be very helpful, but there is now a solid evidence base that some interventions – particularly universal interventions, which deliver mental health content en masse to all students – can have negative effects. Our group has brought together this evidence, and now argue that universal mental health interventions should be dropped in favour of more effective alternatives.
Key papers:
Andrews, J. L., & Foulkes, L. (2025). Debate: Where to next for universal school‐based mental health interventions? Time to move towards more effective alternatives. Child and Adolescent Mental Health, 30(1), 102-104.
Foulkes, L., Andrews, J. L., Reardon, T., & Stringaris, A. (2024). Research recommendations for assessing potential harm from universal school-based mental health interventions. Nature Mental Health, 2(3), 270-277.
Foulkes, L., & Stringaris, A. (2023). Do no harm: can school mental health interventions cause iatrogenic harm? BJPsych Bulletin, 1-3.
Guzman-Holst, C., Davis, R. S., Andrews, J. L., & Foulkes, L (accepted). Scoping review: Potential harm from school-based group mental health interventions. (Currently available as a preprint; accepted by CAMH; publication due soon)
Effects of mental health awareness efforts
Today, adolescents are inundated with messages about mental health, both online and offline. The general assumption is that this is beneficial: that it will reduce stigma, help them better understand themselves, and enable them to access support. However, there has been limited research to test what the actual impact of these messages are. In our group, we have proposed that mental health awareness efforts may be contributing to the increase in reported rates of mental health problems, an idea we term the prevalence inflation hypothesis. We are currently collecting data to assess this hypothesis, as are other groups internationally.
Key papers:
Foulkes, L. (2024). The problem with mental health awareness. The British Journal of Psychiatry, 225(2), 337-338.
Foulkes, L., & Andrews, J. L. (2023).Are mental health awareness efforts contributing to the rise in reported mental health problems? A call to test the prevalence inflation hypothesis.New Ideas in Psychology, 69, 101010.
Self-diagnosis of mental health problems
In the context of increased mental health awareness, more adolescents today are self-diagnosing with mental disorders, compared with in the past. We’re interested in understanding this phenomenon in more detail: why individuals self-diagnose, the costs and benefits it might have, and societal attitudes towards it. What we’ve found so far is that public attitudes towards those who self-diagnose are often very negative and dismissive. We’re keen to promote the complexity of reasons that contribute to self-diagnosis, and we’re working to understand how adolescents who do this can be best supports by school staff, parents and clinicians.
Key papers:
Cunningham-Rowe, C. & Foulkes, L. (submitted). Adolescents' Self-Diagnosis of Mental Disorders: A Qualitative Study of Clinicians' Perspectives. (Currently available as a preprint; manuscript submitted to journal)
Ndour, A., & Foulkes, L. (under review). The romanticisation of mental health problems in adolescents and its implications: A narrative review. (Currently available as a preprint; manuscript under review at journal)
Underhill, R., & Foulkes, L. (2024). Self-diagnosis of mental disorders: A qualitative study of attitudes on Reddit. Qualitative Health Research, 10497323241288785.