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Thrive: How Better Mental Health Care Transforms Lives and Saves Money
A compelling argument for improving society's mental health through increased services and better policy
Mental illness is a leading cause of suffering in the modern world. In sheer numbers, it afflicts at least 20 percent of people in developed countries. It reduces life expectancy as much as smoking does, accounts for nearly half of all disability claims, is behind half of all worker sick days, and affects educational achievement and income. There are effective tools for alleviating mental illness, but most sufferers remain untreated or undertreated. What should be done to change this? In Thrive , Richard Layard and David Clark argue for fresh policy approaches to how we think about and deal with mental illness, and they explore effective solutions to its miseries and injustices.
Layard and Clark show that modern psychological therapies are highly effective and could potentially turn around the lives of millions of people at little or no cost. This is because treating psychological problems generates huge savings on physical health care, as well as massive economic savings through more people working. So psychological therapies would effectively pay for themselves, generating potential savings for nations the world over. Layard and Clark describe how various successful psychological treatments have been developed and explain what works best for whom. They also discuss how mental illness can be prevented through better schools and a better society, and the urgency of doing so.
Illustrating why we cannot afford to ignore the issue of mental illness, Thrive opens the door to new options and possibilities for one of the most serious problems facing us today.
Mental illness is a leading cause of suffering in the modern world. In sheer numbers, it afflicts at least 20 percent of people in developed countries. It reduces life expectancy as much as smoking does, accounts for nearly half of all disability claims, is behind half of all worker sick days, and affects educational achievement and income. There are effective tools for alleviating mental illness, but most sufferers remain untreated or undertreated. What should be done to change this? In Thrive , Richard Layard and David Clark argue for fresh policy approaches to how we think about and deal with mental illness, and they explore effective solutions to its miseries and injustices.
Layard and Clark show that modern psychological therapies are highly effective and could potentially turn around the lives of millions of people at little or no cost. This is because treating psychological problems generates huge savings on physical health care, as well as massive economic savings through more people working. So psychological therapies would effectively pay for themselves, generating potential savings for nations the world over. Layard and Clark describe how various successful psychological treatments have been developed and explain what works best for whom. They also discuss how mental illness can be prevented through better schools and a better society, and the urgency of doing so.
Illustrating why we cannot afford to ignore the issue of mental illness, Thrive opens the door to new options and possibilities for one of the most serious problems facing us today.
- GenresPsychologyNonfiction
392 pages, Hardcover
First published September 15, 2015
About the author
Richard Layard
74 books46 followersPeter Richard Grenville Layard, Baron Layard FBA, is a British labour economist, currently working as programme director of the Centre for Economic Performance at the London School of Economics.
His early career focused on how to reduce unemployment and inequality. He was Senior Research Officer for the famous Robbins Committee on Higher Education. This committee's report led to the massive expansion of UK university education in the 1960s and 1970s.
Following research on happiness begun in the 1970s by economists such as Richard Easterlin at the University of Southern California, he has written about the economics of happiness, with one theme being the importance of non-income variables on aggregate happiness, including mental health.
His main current interest is how better mental health could improve our social and economic life. His work on mental health, including publishing The Depression Report in 2006, led to the establishment of the Improving Access to Psychological Therapies (IAPT) programme in England. He is co-editor of the World Happiness Report, with John F. Helliwell and Jeffrey Sachs.
His early career focused on how to reduce unemployment and inequality. He was Senior Research Officer for the famous Robbins Committee on Higher Education. This committee's report led to the massive expansion of UK university education in the 1960s and 1970s.
Following research on happiness begun in the 1970s by economists such as Richard Easterlin at the University of Southern California, he has written about the economics of happiness, with one theme being the importance of non-income variables on aggregate happiness, including mental health.
His main current interest is how better mental health could improve our social and economic life. His work on mental health, including publishing The Depression Report in 2006, led to the establishment of the Improving Access to Psychological Therapies (IAPT) programme in England. He is co-editor of the World Happiness Report, with John F. Helliwell and Jeffrey Sachs.
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Displaying 1 - 6 of 6 reviews
January 29, 2026
Depression and anxiety account for more of the misery in Western societies than physical illness does. They also account for much more misery than is due to poverty or unemployment. Psychological therapies taking less than 16 sessions produce 50% recovery rates that are often permanent and when they are not, they greatly reduce the risk of relapse.
August 1, 2026
Thrive presents a powerful case for expanding access to psychological therapies in the UK. Layard and Clark clearly demonstrate the scale of mental ill-health, its impact on quality of life, and the economic costs of failing to treat it. Their argument that mental health has been chronically underfunded compared with physical health is persuasive, and the discussion of the Improving Access to Psychological Therapies (IAPT) programme is one of the book's strongest sections.
Unfortunately, the book is undermined by its relentless advocacy of cognitive behavioural therapy (CBT). Almost every discussion of treatment returns to CBT, with the authors relying heavily on NICE guidance while giving little attention to competing evidence or alternative therapeutic approaches. There is virtually no engagement with the wider psychotherapy literature, including the "dodo effect"—the long-standing debate major psychological therapies produce broadly comparable outcomes. The result is a highly one-sided account that gives the impression CBT is the only serious evidence-based option.
This bias is particularly frustrating given that a substantial proportion of IAPT services are delivered through counselling and other non-CBT therapies. The authors never attempt to explain this apparent contradiction or critically examine the limitations of CBT itself. Instead, alternative approaches receive little more than passing mention. For readers unfamiliar with the evidence, the book presents a misleadingly narrow picture of psychological therapy.
The final chapters broaden into Layard's familiar arguments about well-being and happiness economics, which felt less original than the earlier sections. Overall, Thrive makes a compelling case for investing in mental health services, but its ideological commitment to CBT weakens what could otherwise have been a much more balanced and convincing book.
Unfortunately, the book is undermined by its relentless advocacy of cognitive behavioural therapy (CBT). Almost every discussion of treatment returns to CBT, with the authors relying heavily on NICE guidance while giving little attention to competing evidence or alternative therapeutic approaches. There is virtually no engagement with the wider psychotherapy literature, including the "dodo effect"—the long-standing debate major psychological therapies produce broadly comparable outcomes. The result is a highly one-sided account that gives the impression CBT is the only serious evidence-based option.
This bias is particularly frustrating given that a substantial proportion of IAPT services are delivered through counselling and other non-CBT therapies. The authors never attempt to explain this apparent contradiction or critically examine the limitations of CBT itself. Instead, alternative approaches receive little more than passing mention. For readers unfamiliar with the evidence, the book presents a misleadingly narrow picture of psychological therapy.
The final chapters broaden into Layard's familiar arguments about well-being and happiness economics, which felt less original than the earlier sections. Overall, Thrive makes a compelling case for investing in mental health services, but its ideological commitment to CBT weakens what could otherwise have been a much more balanced and convincing book.
February 7, 2021
gave me massive insight into the potential solutions to the mental health crisis
July 17, 2026
Minuteman. See notes in books.
December 6, 2015
Very few of us can, if we are honest, say that we have never, ever suffered from some form of mental illness at one time or another, or that we won’t in the future. It may just be a matter of degree. Statistics, despite being shocking, probably don’t tell the true picture: over 20 per cent of people in developed countries suffer from a mental illness – the leading cause of suffering – which reduces life expectancy as much as smoking does and is responsible for a tremendous amount of sickness and disability claims.
So anything we can do, as a society, to reduce the problems mental illness can create and improve the conditions for those who suffer from it, the better it will be. A win-win if you will. The authors believe that wide-ranging, fresh policy changes and a perception shift over mental illnesses can yield benefits, noting that many new therapies can be highly effective and pay for themselves in the longer term.
“Mental pain is as real as physical pain. It is experienced in the same areas of the brain as physical pain and is often more disabling. Yet these two types of pain are not treated equally. While nearly everyone who is physically ill gets treatment, two in three of those who are mentally ill do not. If your bone is broken you are treated automatically, but if your spirit is broken you are not. This is a shocking form of discrimination, which occurs in every health care system in the world. It is particularly shocking because we have very good treatments for the most common mental health problems, which are depression and crippling anxiety disorders. The treatments – modern psychological therapy and drugs when appropriate – are not expensive,” wrote the authors, who obviously focus on the more acute levels of mental illness. There are many others who suffer mental illnesses such as stress, mild depression, burnout and bullying who also need help but are often side-lined.
The book itself is interesting, even to a general “concerned citizen”. It is not something written for psychologists or politicians. It uses clear, decisive and open words to describe a rather large problem and offers some considerate thoughts as to how the problem can be reduced, mitigated or managed.
We should not need a book like this. Sadly we do. As long as mental illness is either hidden away in the shadows, partially out of shame and partially due to the “unpleasantness” of it all, we cannot go forward. By treating successfully even a proportion of those who are suffering, as a society we would be making the everyday lives of many so much different and they would be able to contribute back to society a lot more than their “costs” thus far.
Maybe this book will encourage slowly a change in how we think about mental illness. For all those who suffer, often in silence, one hopes so.
Autamme.com
So anything we can do, as a society, to reduce the problems mental illness can create and improve the conditions for those who suffer from it, the better it will be. A win-win if you will. The authors believe that wide-ranging, fresh policy changes and a perception shift over mental illnesses can yield benefits, noting that many new therapies can be highly effective and pay for themselves in the longer term.
“Mental pain is as real as physical pain. It is experienced in the same areas of the brain as physical pain and is often more disabling. Yet these two types of pain are not treated equally. While nearly everyone who is physically ill gets treatment, two in three of those who are mentally ill do not. If your bone is broken you are treated automatically, but if your spirit is broken you are not. This is a shocking form of discrimination, which occurs in every health care system in the world. It is particularly shocking because we have very good treatments for the most common mental health problems, which are depression and crippling anxiety disorders. The treatments – modern psychological therapy and drugs when appropriate – are not expensive,” wrote the authors, who obviously focus on the more acute levels of mental illness. There are many others who suffer mental illnesses such as stress, mild depression, burnout and bullying who also need help but are often side-lined.
The book itself is interesting, even to a general “concerned citizen”. It is not something written for psychologists or politicians. It uses clear, decisive and open words to describe a rather large problem and offers some considerate thoughts as to how the problem can be reduced, mitigated or managed.
We should not need a book like this. Sadly we do. As long as mental illness is either hidden away in the shadows, partially out of shame and partially due to the “unpleasantness” of it all, we cannot go forward. By treating successfully even a proportion of those who are suffering, as a society we would be making the everyday lives of many so much different and they would be able to contribute back to society a lot more than their “costs” thus far.
Maybe this book will encourage slowly a change in how we think about mental illness. For all those who suffer, often in silence, one hopes so.
Autamme.com
September 23, 2018
This book answers the question why we don't threat mental health the same way as physical health, and what would be the benefits on society if we didn't. A must read for anyone who's involved in decision making in the (metal or physical) healthcare.
Displaying 1 - 6 of 6 reviews