In any given year, about 1 in 4 adults suffers from a diagnosable mental illness, with many people affected by more than one cooccurring mental disorder at a time. Nearly 10% of American adults will deal with a depressive illness (major depression, bipolar, etc.), and almost 1 in 5 adults will deal with an anxiety disorder (panic disorder, generalized anxiety, post-traumatic stress disorder, etc.). You almost assuredly know at least one person whose life has been in some way affected by mental illness, some lives more than others. According to the U.S. Department of Housing and Urban Development, on any given night in 2015, approximately 550K people were experiencing homelessness. Of that number, at least 25% of these people had a Serious Mental Illness, and 45% had Any Mental Illness. Among the general population, about 25% of adults have Any Mental Illness, while around 5% suffer from a Serious Mental Illness, meaning both categories are heavily overrepresented in the homeless population. Homelessness might be considered an extreme case, but mental illness doesn't discriminate; your friends, family, neighbors, and coworkers aren't immune to mental health woes. In June 2020, 13% of adults reported new or increased substance use related to Covid-19, and 11% reported thoughts of suicide within the last 30 days, and Covid has led to increases in adults experiencing stress, anxiety, depression, and other mood disorders, not to mention the collective trauma we're all experiencing. If you weren't already aware of these numbers, you are now, so...great, so you're aware; your awareness of mental health is increasing. You're possibly more aware of the problem than you previously were, and that's good. Heck, it's great! My personal awareness of K-Pop has gone from "not at all aware" a few years ago, to "it is a thing I know exists, and I kind of know some things about it." My awareness has increased, and K-Pop continues to exist, just like mental illness goes right on existing. Pure awareness of a problem, absent accompanying action to address aforementioned problem, is useless, and, for many, it feels like that's where we currently stand in addressing our country's mental health problems. People are more aware of mental illness' existence, its prevalence, its effects and symptoms, even some of the more systemic issues with access to care, staffing shortages, care shortages, and things like homelessness and veterans' healthcare as they relate to mental health. Significant strides are being made in the effort to destigmatize mental illness, especially with Gen Z, and seeking out mental health services isn't seen as the shameful act it once was. And that's wonderful, that's absolutely fantastic, but what do we do with all this awareness? It's fantastic that I feel more comfortable talking about my mental illness, but I still have to wait three months or more to get an appointment with a psychiatrist. How do we turn awareness into meaningful action to improve the lives of the mentally ill?
In 2020, of the 52.9M adults with a mental illness, less than half (46.2%) received mental health services, and only 42% of young adults (18-25) received mental health services. Of the 14.2M adultswith a Serious Mental Illness, still only 64.5% received mental health services, and young adults were again worse off with only 57.6% receiving treatment or other mental health services. Access to mental health care is a significant problem in the United States, and, though things like the Affordable Care Act have led to improvements, the situation is still far from ideal. Over 4.7M of adults with a mental illness, more than 10%, remain uninsured, making it nearly impossible to afford the care they need. In some places, it's even worse, with 22.9% of Wyoming's mentally ill going without health insurance. And it's not as simple as just getting insurance; in 2020, 57.2% of adults with a mental illness received no treatment. There are many reasons someone might not be able to access treatment, including no insurance or not enough insurance, shortages in mental health professionals, especially in rural areas, lack of access to appropriate treatment, inability to pay for care, increasing difficulties in qualifying for programs meant to improve access and coverage, and more. Increased awareness of the importance of mental health, the existence of mental illness, and how to recognize mental health issues all promote seeking help, receiving mental health services and care, and recognizing and addressing mental health needs. Sadly, recognizing the need and seeking out mental health services doesn't guarantee the ability to actually access mental health services, and that's where awareness falls short.
Many mental illnesses occur on a spectrum, meaning those living with mental illness experience a range of symptoms and severity, at both the macro and micro levels. By this, I mean a depressed person is not constantly the same level of depressed, and the symptoms they experience will vary over time and in severity. I also mean that depressed people, as a population, are not uniformly depressed and don't all experience identical symptoms. For instance, not everyone with depression is driven to suicide, but many of them struggle with experiencing suicidal thoughts. As such, the need for mental health services, even for an individual, isn't always constant; many with mental illness will experience periods of increased or diminished severity of symptoms, with an accompanying increased or diminished need for mental health services. Unfortunately, the current state of mental health services isn't designed for flexibility and accommodation, with patients often waiting months to see a mental health professional. This is further complicated by incomplete or nonexistent insurance coverage for mental health services, with restrictions on providers, visit frequency, medication coverage, age differentiated coverage plans, and more. Projections from the Health Resources and Services Administration suggest an imminent, exponential, and immense shortage of mental health professionals in the coming years, with demand slated to far outweigh supply by 2030. Shortages make it more difficult to find care, access providers, high burnout among providers, and increasingly long waits for, sometimes life-saving, treatment. Access to necessary care is even worse among some of the most vulnerable, America's youth. Nearly 60% of young Americans with major depression receive no mental health treatment, with only about 28% of youth with severe depression receive even a modicum of consistent treatment, a minimum of 7 visits a year. As someone who once was a depressed youth and young adult, I can tell you I am much better equipped to deal with my mental illness now than when I was younger. Research shows that 46% of people who commit suicide have a known mental health condition. Children experiencing homelessness are three times more likely to commit suicide than those living at home with a parent or guardian. The suicide rate among those experiencing homelessness is ten times higher than among the general population. Additionally, it's been shown that homelessness can be an exacerbating factor and partial cause of mental illness. Suicide is the second leading cause of death for children, adolescents, and young adults aged 15-24, and more than half of young Americans with major depression continue to receive no treatment. What are we doing with all this awareness?
So things are kind of terrible; I've hopefully made you a bit more aware than you previously were, but that's nothing by itself, so what do I want you to do with your newfound, increased, shiny, and new awareness? Bring it to bear in elections, in your views of public policy and social services. Remember it when you're trying to decide whether or not to support universal healthcare, when you see Congress try to impose earning caps on travel nurses, when Thedacare sues nurses to try and stop them from taking another job. I want you to write, call, tweet, email, and send carrier pigeons to your elected representatives telling them you support increasing access to mental health services, making it easier for those in need to get the help and care required, recognizing mental illnesses as just as "real" a disability as physical disabilities, and increasing supports for our children, students, and youth who are going horribly underserved. I selfishly want everyone to stop telling depressed people to "go outside" or "try positive thinking." I want people to demand substantive changes to our country's mental health infrastructure, to demand increased access, modernized policies and care, and research into promising treatments. I want the FDA to ease restrictions on drugs like MDMA, ketamine, and psilocybin, all of which have shown incredible potential as treatments for multiple mental disorders. I want action, and I want you to help, to vote, to tell our elected representatives we have enough awareness. What we're lacking is action.
Statistics and other information found here -
https://www.nimh.nih.gov/health/statistics/mental-illness
https://www.bbrfoundation.org/blog/homelessness-and-mental-illness-challenge-our-society#:~:text=According%20to%20a%202015%20assessment,percent%20had%20any%20mental%20illness
https://mhanational.org/issues/2020/mental-health-america-access-care-data