Articles

Every May the conversation about mental health gets a little louder. Hospitals and offices put posters up around the building. A handful of brands tweak their logo colours for a few weeks. People who tend not to talk about how they are feeling get a quiet nudge to do so.

You could argue that most of this is surface-level marketing dressed up as care, and plenty of people do. The problem with that argument is that the data underneath the campaigns is genuinely sobering, and the case for paying attention is harder to dismiss once you have looked at the numbers.

What follows is a look at why May matters, what the evidence actually says about how common mental health difficulties are and the kinds of small daily tools that research supports. There is also a section on how MoodFire is built (along with what we are claiming about it and what we are not) ahead of our launch this month.

Why May is Mental Health Awareness Month

Mental Health Awareness Month has been observed in the United States every May since 1949, when it was established by Mental Health America (which was called the National Association for Mental Health at the time) [1]. The aim then was much what it is now: reduce stigma, encourage people to seek help earlier and bring the conversation about mental health onto roughly the same footing as physical health.

In the United Kingdom, the equivalent is Mental Health Awareness Week, which falls in mid-May and is run by the Mental Health Foundation. Each year picks a different theme. Recent ones have included loneliness, anxiety, movement and community, but the broader aim stays the same: helping people understand and look after their mental wellbeing [2].

The reason these moments still matter, decades on, is that the gap between how many people are affected by mental ill-health and how many actually get support is enormous. It also is not closing.

The numbers

The World Health Organization estimates that around 1 in every 8 people globally (roughly 970 million people) were living with a mental disorder in 2019, with anxiety and depressive disorders the most common [3]. In the first year of the COVID-19 pandemic, the WHO reported a 25% increase in the global prevalence of anxiety and depression [4], and those increases have not cleanly reversed.

In England, the NHS Adult Psychiatric Morbidity Survey reports that around 1 in 4 adults experience a mental health problem of some kind in any given year, and that 25.8% of 16 to 24-year-olds now meet the threshold for a common mental health condition like anxiety or depression [5]. The Mental Health Foundation puts the picture more starkly: in the UK, 1 in 6 adults experienced a common mental health problem (anxiety or depression typically) in the past week [6].

In the United States, the National Institute of Mental Health estimates that around 1 in 5 adults (23.1% in the most recent figures) live with a mental illness, with the rate substantially higher in young adults [7].

The treatment gap is just as striking. The WHO notes that in many countries more than 70% of people with mental health conditions receive no treatment at all. Stigma, cost and a shortage of trained professionals are among the main reasons [3]. In England, NHS Talking Therapies reaches only a fraction of those who would benefit, and waiting times remain a persistent issue [8].

None of this means everyone needs an app. Plenty of people need a therapist, a GP, a community or a change of circumstances. It does mean, though, that something has to fill the space between “I’m not coping” and “I’ve started therapy”, and that something often has to be small, accessible and available at 2am.

Why awareness alone is not enough

One of the standard criticisms of awareness months is fair enough. Knowing that anxiety is common, or that you are “not alone”, does not calm a nervous system at midnight. Insight and regulation are not the same thing. We have written about that gap before in our piece on why knowing you are anxious does not stop the anxiety.

What does help, the evidence suggests, is the regular use of small structured techniques. Awareness becomes useful when it leads to action you can take in the moment, and when it points you towards the kinds of support (professional, peer or self-directed) most likely to make a difference.

What the evidence supports for everyday self-help

None of the techniques below are a substitute for therapy. They are the building blocks underneath much of what therapists teach, and they have a strong evidence base in their own right.

Cognitive behavioural therapy (CBT) techniques

CBT is the most extensively researched form of psychological intervention and is recommended by the National Institute for Health and Care Excellence (NICE) as a first-line treatment for anxiety and depression [9]. A meta-analysis of 41 randomised placebo-controlled trials by Carpenter and colleagues found CBT effective across anxiety-related disorders, with effects that hold up well after treatment ends [10].

The evidence for digital and self-guided CBT is also strong. Andrews and colleagues’ 2018 meta-analysis of internet-delivered CBT (iCBT) for anxiety and depression concluded that it was effective, acceptable and practical, with outcomes broadly comparable to face-to-face therapy in many of the studies they reviewed [11]. Karyotaki and colleagues’ individual-participant-data meta-analysis reached similar conclusions for self-guided iCBT in depression [12].

The core technique, which involves catching an anxious or self-critical thought, looking at it honestly and writing down a more accurate alternative, is something most people can practise on their own. Our guide on how CBT works for anxiety walks through it in detail.

Naming what you are feeling

UCLA’s affect labelling research found that putting feelings into words measurably reduced amygdala activity, which is the part of the brain that drives the threat response [13]. Labelling something specifically as “I’m anxious about the meeting” rather than sitting in vague distress quietens the alarm system, even when nothing about the situation has changed.

Slow breathing

A systematic review in Frontiers in Human Neuroscience found that slow breathing (around six breaths per minute) activates the parasympathetic nervous system and reduces self-reported anxiety, often within minutes [14]. A 2023 randomised study at Stanford by Balban and colleagues found that just five minutes of cyclic-sighing breathwork per day improved mood and reduced anxiety more than mindfulness meditation did in the same window [15].

Grounding

Sensory grounding techniques are designed to bring attention back to the present moment when distress, panic or dissociation pulls it elsewhere. The most widely used is the 5-4-3-2-1 method, which originates from dialectical behaviour therapy (DBT). It features in NHS-recommended self-help materials for anxiety and PTSD [16].

Gratitude practice

Positive psychology research, including work by Emmons and McCullough, has found that brief regular gratitude practices are associated with measurable improvements in mood and life satisfaction [17]. The effect is small but consistent, and it works against the brain’s natural negativity bias rather than trying to override it.

Where MoodFire fits in

MoodFire is launching this May. We do not have a confirmed release date yet, but the app will be on iOS and Android within the coming weeks. The easiest way to find out when it goes live is to keep an eye on moodfire.io.

We have tried to be careful about what we say MoodFire does. It does not treat, cure or diagnose anything, and it is not a replacement for therapy. What it is, instead, is a free-at-launch CBT self-help app, supplemented by DBT-derived distress tolerance techniques, that gives people a structured place to apply the kinds of techniques described above when they need them.

Each feature maps to a specific evidence base:

• Mood: morning and evening check-ins drawn from affect labelling research and ecological momentary assessment, so the feeling has somewhere to land.
• Reframe: structured cognitive restructuring, the core CBT technique for catching and testing unhelpful thoughts.
• Breathe: guided slow breathing patterns based on parasympathetic activation, including paced breathing at around six breaths per minute.
• Unwind: bilateral audio and binaural beats, drawn from the bilateral stimulation principle in EMDR-adjacent research. We unpack the evidence base in our article on what bilateral stimulation actually is.
• Ground: the DBT-derived 5-4-3-2-1 sensory grounding technique for moments of overwhelm or panic.
• Spark: a brief daily gratitude practice based on positive psychology research.

What we are not claiming, and will not claim until we have the data to support it, is that MoodFire produces specific clinical outcomes. We are working to change that. As outlined on our About page, we are working towards UK Digital Technology Assessment Criteria (DTAC) compliance and integrating validated outcome measures (the GAD-7 for anxiety and the PHQ-9 for depression) so we can measure the real impact of MoodFire on user wellbeing rather than rely on assumption.

That distinction matters. There is strong evidence that the techniques inside MoodFire help. We will do the work to show what MoodFire specifically contributes on top of those techniques, and we will publish what we find.

If you take one thing from Mental Health Awareness Month

Awareness on its own is a starting point. If any of the patterns in this article look familiar, the most useful thing you can do this May is pick one small evidence-based technique (a two-minute breathing practice, a single thought-reframe before bed or a brief mood check-in) and stick with it for a week.

If you are struggling more than feels manageable, please talk to your GP, contact a clinician or use one of the support lines linked below. If you are in immediate crisis in the UK, you can call Samaritans on 116 123 free of charge any time. In the US, you can call or text 988 for the Suicide and Crisis Lifeline.

If you are looking for a free, evidence-informed place to put your attention in the moments in between, that is what MoodFire is for. We will see you here later this month.

MoodFire is a CBT self-help app and is not a medical device, diagnostic tool or substitute for professional care. If you are in crisis, please contact a clinician or your local emergency services. Mental Health Awareness Month and Mental Health Awareness Week are run by Mental Health America and the Mental Health Foundation respectively; MoodFire is not affiliated with either organisation, and references are editorial and for educational purposes only.