Mental Health: More Diagnoses, Fewer Answers?
The Michael Shermer Show
Michael Shermer
4.3 • 1K Ratings
🗓️ 10 January 2026
⏱️ 90 minutes
🧾️ Download transcript
Summary
What if the way we approach mental health is quietly making things worse?
Psychiatrist and psychotherapist Sami Timimi joins Michael Shermer to examine some of the core assumptions behind modern psychiatry. Why have diagnoses such as ADHD, autism, anxiety, and depression expanded so dramatically—and why hasn't increased access to treatment led to better outcomes at the population level?
Timimi describes how diagnostic categories have broadened over time and questions whether psychiatric labels function in the same way as medical diagnoses elsewhere in healthcare. Without clear biological markers, he argues, definitions can expand to include forms of distress that were once considered part of ordinary human experience.
The conversation also considers the role of meaning, identity, and culture in shaping how people understand psychological suffering. Timimi reflects on the limits of medication and therapy, the unintended consequences of the "mental illness as physical illness" model, and how social media may contribute to the spread and reinforcement of certain diagnostic categories.
Dr. Sami Timimi is a child and adolescent psychiatrist, psychotherapist, and Fellow of the Royal College of Psychiatrists. He has published more than 150 academic papers and authored or edited over a dozen books, including Naughty Boys, Liberatory Psychiatry, and The Myth of Autism. His new book is Searching for Normal: A New Approach to Understanding Mental Health, Distress, and Neurodiversity.
Transcript
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| 0:00.0 | There's something that's not working in the way that we approach mental health care. |
| 0:05.1 | What seems to be happening in mental health care is something that people refer to as the treatment prevention paradox. |
| 0:13.0 | The more people are accessing services, so there has been more and more access to assessments, different types of treatments, interventions, |
| 0:23.1 | more people getting mental health diagnoses. |
| 0:26.1 | So the prevalence of mental health conditions has been expanding and expanding pretty relentlessly. |
| 0:32.9 | And the amount of access that people are having to various types of treatments, |
| 0:36.7 | whether they're psychological, |
| 0:37.7 | social or pharmacological, has also been expanding rapidly. And if what we were doing in the |
| 0:43.8 | mental health sphere was successful, what you would expect would be at least a stabilization |
| 0:49.7 | of the prevalence rates, but hopefully the prevalence rates would start going down because we would be seeing |
| 0:55.4 | an improvement in outcomes. I've come across a lot of people who've been prescribed SSRIs, and in my |
| 1:01.9 | experience, I have not come across anyone yet where this has led by itself to lasting change. |
| 1:10.3 | ADHD starts out as a very rare condition called hyperkinetic disorder. |
| 1:15.7 | When I was training as a child psychiatrist, I didn't come across any child with this condition. |
| 1:20.4 | It was considered to be rare. |
| 1:21.7 | If you had a learning difficulty, that would be an exclusion criteria. |
| 1:25.5 | But then it goes through what I call a mutation of constructs. |
| 1:29.3 | And at no point was there any new scientific information coming forward to tell you that there is something empirically in common with people getting the diagnosis that you can find in their bodies or brains. |
| 1:43.3 | So expands to become, to include not just levels of activity, but also attention levels, and |
| 1:49.9 | expands to 3%, 5%, and now up to about 10% of children. |
| 2:00.1 | Hey, everybody, it's Michael Shermer. |
| 2:02.2 | It's time for another episode of the Michael Shermer show, which is hosted by the Skeptic Society and Skeptic magazine to support our work. |
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