Managing the consequences of rising mental-health awareness-a commentary on Marcotulli et al. (2025)

The editorial by Marcotulli, Foulkes and Stringaris presents a dynamic-systems framework for understanding the effects of mental-health information campaigns. They argue that surges in help-seeking may lead to poorer diagnostic accuracy and reduced treatment efficacy, with potential harm to patients. Their systems-level approach is timely and valuable. The editorial's predictions rest on several assumptions: new help-seekers have lower severity, diagnostic thresholds drift downward and the benefit-harm ratio of treatment declines. Empirical evidence supporting these assumptions remains limited. Where these mechanisms do operate, several strategies may mitigate their impact. This commentary outlines key assumptions requiring empirical testing and discusses mitigation approaches, including targeted campaigns and effective triage systems, which may reduce the risk that increased awareness leads to net harm.