Self-Assessment: Empowerment or Pathologization?

What Haslam actually argues

Haslam begins with a puzzle. By almost every visible measure, mental health complaints are rising—especially among young people, and especially for specific diagnoses. Autism is the clearest example: the CDC's latest monitoring data put autism prevalence at 1 in 31 eight-year-olds in 2022, up from 1 in 36 just two years earlier and 1 in 150 in 2000. ADHD diagnoses and stimulant prescriptions have climbed steeply on a similar trajectory.

Yet here is the puzzle: epidemiological studies generally show that the prevalence of “major” mental disorders has been broadly stable over recent decades. Treatment-seeking has risen far faster than any measurable rise in underlying illness—the so-called “treatment prevalence paradox.” If more people are being treated than ever before, why haven't population mental health figures improved?

Haslam's proposed answer is concept creep: the gradual broadening of harm-related concepts over time. Concepts like trauma, anxiety, and addiction expand “horizontally” to cover new situations, and “vertically” to capture milder and milder experiences. Combined with the growing reach of the mental health industry—what he calls “psychiatrization”—our shared concept of what counts as illness has quietly stretched. Broader concepts make people more likely to interpret ordinary distress as a disorder, to self-diagnose, and then to seek treatment. And, crucially, that reinterpretation can become self-fulfilling. This dovetails with Foulkes and Andrews' prevalence inflation hypothesis, which argues that mental health awareness efforts can inadvertently lead some people to over-interpret mild distress as pathology.

Concept creep is not an insult

It would be easy to read all this as a grumpy complaint that people are “making it up”, bur no serious mental health researcher endorses this. Broadening a concept is not inherently a bad thing. The expansion of “bullying” to include cyberbullying, or “trauma” to include indirect exposure, was well justified by genuine evidence. Broader concepts reduce stigma and lower the barriers that have historically kept people from seeking help. These are real gains, and I don't want to lose sight of them.

The key distinction—one I make constantly in clinical practice—is between distress and disorder. Distress is a normal, often healthy, response to a difficult life. It is not the same thing as a diagnosable condition. Recognizing your own emotional states more clearly is genuinely empowering. The problem is not that people are paying attention to their inner lives; it is when ordinary distress gets quietly relabeled as pathology, and a passing state gets mistaken for a permanent identity.

People have a right to self-knowledge

This is the heart of what Insightable Mind is for. People have a legitimate right to understand themselves, and psychological science offers some of the best tools ever developed for doing so. We use clinical constructs—and clinical language—because they are the most rigorously validated vocabulary we have for describing human experience.

But I want to be unambiguous about one thing: the only people who can diagnose am mental health disorder are qualified mental health professionals. Psychologists and psychiatrists working with the full clinical picture of a real person in front of them. Online assessments are not a diagnosis. They are instruments for self-discovery. They can tell you something useful and scientifically grounded about how you compare to others, what your patterns might be, and what questions are worth bringing to a professional. They cannot, and do not, tell you who you are.

The risk: asking the wrong question

If there is one caution I want every Insightable Mind user to absorb, it is this: a measure can answer a narrow question accurately while being the wrong question entirely.

Consider someone who can't concentrate, feels restless, and is constantly behind. An ADHD screener might return a high score—and that score might be perfectly valid as far as it goes. But the right question may not be “Do I have ADHD?” It may be “Why is my environment so chaotic?” A demanding job, poor sleep, financial stress, a new baby, or grief can all produce the same surface pattern. Situation has an enormous impact on mental health, and a self-assessment measures almost none of it. If you ask the wrong question, you will get a confident answer to something you weren't really asking.

Psychological research points to a further trap. People who hold broad concepts of mental illness are, independent of their actual distress, more likely to self-diagnose. And the online environment actively encourages this: studies of ADHD content on TikTok find that most popular videos describe features that don't match official diagnostic criteria, yet viewers overwhelmingly recognize themselves in them. The deeper danger is essentialism—treating a label as a fixed, biological, defining truth about yourself. The evidence suggests that this kind of identification can entrench distress, undermine coping, and foster a quiet hopelessness about ever changing. A label meant to bring relief can become a cage.

How we've built Insightable Mind responsibly

Knowing all this, we have tried to design against these failure modes rather than exploit them. Every assessment we offer is grounded in the psychometric science and clinical tools used by thousands of real practitioners. But good science is also honest about its limits, so we are explicit about what each instrument can and cannot claim.

That means framing results as a snapshot rather than a verdict; emphasizing functional impact, not just the presence of symptoms; reminding people that they are dynamic and context-bound, not the sum of a score; and pointing clearly toward a qualified professional when that is the appropriate next step. We would rather a user leave with a better question than a false certainty.

A balanced ledger

So—empowerment or pathologization? Honestly, self-assessment can be either, and which one it becomes depends almost entirely on how it is designed and how it is understood. On the risk side of the ledger sit over-identification with a diagnosis, self-pathologization, and the hopelessness that can follow. On the benefit side sit better self-understanding and more appropriate, better-targeted help-seeking.

The idea of concept creep is not to tell us to stop looking inward. It is to insist that we do it with our eyes open—aware that the words we use to describe ourselves are not neutral, and that more awareness is not automatically more truth. That is a standard I am glad to be held to. It is precisely the standard we are trying to build Insightable Mind to meet.