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Mental Health: A Global Challenge We Can’t Ignore

March 08, 2016
   
   

To set the stage, the panelists shared some stunning statistics that depict why mental health truly cannot be ignored. According to the Global Burden of Diseases study, mental health is the leading cause of disability globally, and 75 percent of mental illness begins by a person’s early 20s. What this study fails to capture is the impact that a person’s mental health has on his or her family, community and life potential. People with mental illnesses die 10 to 20 years earlier than those without, and in high-income countries, there are only about nine mental health providers for every 100,000 people. In low-income countries, this number can be as low as one to three providers per 100,000 people. 

This bleak picture gets even worse when looking at mental health issues in children, one in five of whom has signs of a mental health problem in adolescence. Price, who runs the Center for Health and Health Care in Schools at GWU, reported that 75 to 90 percent of children with mental health needs fail to receive appropriate treatment or support. The panel also stressed that mental health conditions are often comorbid with diseases like HIV, cardiovascular disease and diabetes, and that mental health prevalence and access to treatment vary greatly with factors like socioeconomic status, adverse childhood events, education, race and many others. Comorbidities and social determinants of health make it difficult to fully understand mental health from a medical perspective.

Understanding that mental health is a massive problem, not only in the United States but also worldwide, the panel reported on policies and programs that are making progress. Del Vecchio detailed SAMHSA’s priority focus on preventing mental illness, increasing the mental health provider workforce and enabling the field to take advantage of emerging health technologies that are transforming treatment across the world. Ingoglia cited the Excellence in Mental Health Act, which would establish national standards for evidence-based, quality care for all federally funded treatment centers, something that does not currently exist. He also connected mental health efforts back to the Centers for Disease Control and Prevention Winnable Battles, where goals cannot be reached unless mental health is considered. For example, people with mental health conditions consume 40 percent of the cigarettes smoked in the United States; in order to have effective smoking cessation programs, treatments must consider mental health.

More than ever before policy-makers across the globe and in the United States are focusing on mental health; more than 20 pieces of legislation related to mental health are currently in Congress, and the World Health Organization has added mental health into the Sustainable Development Goals. With some progress in the policy arena, where else can we see evidence of change in mental health? Collins indicated that funding for mental health research has increased, but is still not enough to fill the needs. She sees promise in applying models of public health intervention that have worked for other conditions to mental health. Price echoed this sentiment, saying that mental illness may be the single most neglected condition in the United States, but mental health may be even more neglected. There is a need for the field of public health to step up and promote positive mental health, which could lead to lower rates of mental illness and better health for our society overall.

After covering many successful initiatives and promising policies, the session wrapped up with what is still missing to make progress in the field of mental health. Research on the brain is teaching us that mental illnesses are disorders of circuits, rather than lesions or specific chemical imbalances, Collins said. More research is needed to understand the complex relationships between genetic risk and experiences that lead to mental illness. Thinking is also changing to consider mental illness as a neurodevelopmental disorder – by the time symptoms are visible the risk and disease have been developing for many years. Collins believes that having a better understanding of the basic research and translating evidence into practice are the great challenges that the field faces right now. 

Price echoed this statement and added that greater effort needs to focus on sustaining successful programs that can have an impact. Beyond financial sustainability, we need to be building infrastructure, workforce, education and institutional practices that can prevent and treat mental health more effectively. To assist in creating sustainable funding streams, Ingoglia called for aligning payment policy with what the evidence base tells us about mental health. Creating streams of funding for evidence-based models of prevention, treatment and recovery will build the resources needed for implementation and preservation of effective programs. 

The final call for action came from del Vecchio: in order to make mental health a priority in our society and in the field of public health, people must be open to speaking about their personal experiences with mental health. Such a pervasive problem has the strength to change the hearts and minds of the public and policy-makers if we are able to reduce negative attitudes towards mental illness. We are already seeing this openness in today’s youth who are more open and accepting, and can be more resilient in the face of these kinds of adversities. 

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