Across the world, healthcare professionals hail October 10 as World Mental Health Day. A program of the World Federation for Mental Health (WFMH), it has been observed since 1992.
WFMH’s mission is to promote the advancement of mental health awareness, prevention of mental disorders, advocacy and best practice, and recovery-focused interventions worldwide. World Mental Health Day is one way WFMH seeks to recognize the goals of this mission.
Each year, WFMH outlines a special theme for World Mental Health Day. This year, the WFMH has chosen, “Mental health is a universal human right,” as the 2023 theme.
Mental health inequities across the U.S.
In 2023, the KFF published a comprehensive study on the state of mental health in the United States. The study found that 90% of Americans believe there is a mental health crisis in America. Despite this near unanimous belief that mental health is an issue in the U.S., access to mental health care remains uneven. An overview of the KFF study found:
- 50% of uninsured adults are not able to get the mental health care they need.
- 80% of adults reported that cost of mental health care as a “problem” in attaining it.
- 51% of LGBTQ+ adults reported being unable to get the mental health services they need.
- 39% of Black Americans and 33% of Latinx Americans felt they were unable to get the mental health services they need.
- Of adults aged 18-29 who felt they needed mental health services, 47% were unable to get them.
The study highlighted issues relating to economic uncertainty. 61% of individuals living in low-income households (incomes ≤ $40,000/year) reported that their finances were a major cause of stress and anxiety.
The high cost of mental health treatment, including insufficient insurance coverage, was also highlighted in the study. A majority of the study participants saw cost and poor coverage as the top barriers for accessing mental health care.
Combating stigma around mental health
For many individuals living with a mental health condition, stigma has become a part of their daily lives. While science has done much to increase our understanding of mental illness, many continue to view it as a sign of weakness or as a reason to castigate others.
While stigma is certainly not the only reason for the inequities discussed above, it is certainly a factor. Those who live in an environment where mental health is not properly understood or where they are chastised for their mental illness will be reluctant to seek help. As Rola Aamar, PhD, Behavioral Health Solutions Consultant at Relias, has noted:
“Studies have found that when individuals with alcohol use disorder (AUD) perceive large amounts of public stigma around their condition, they are 50% less likely to seek treatment. And, unfortunately, researchers have observed very similar results across populations with SUDs and mental illness.”
Through this year’s campaign, the WFMH hopes to continue to combat mental health stigma through education. Years of research has found that education around mental health and mental illness leads to a reduction in stigma.
Recognizing social determinants of mental health
According to the WFMG, “Access to better living conditions, security, food, shelter and housing are all necessary for people’s mental health.”
Known as social determinants of health, access to basic human needs can greatly impact one’s mental health. Without access to adequate housing, food, clothing, and other necessities, individuals are far more likely to develop mental or behavioral health problems. Research has shown that individuals experiencing homelessness are more likely to also develop symptoms of depression, suicidal ideation, trauma, and substance use disorder.
Homelessness or home insecurity, food insecurity, and other social determinants of health are worldwide issues affecting billions. Until access to necessities are treated as a human right, it will be difficult for mental health to gain this type of recognition as well.
Mental and behavioral health professionals can help by advocating for these necessities in their communities, while also educating clients and others on recognizing social determinants.
Increasing access to mental health care
The WFMH and many advocates consider mental health care as a human right. Accessible mental health care acts a foundation for health care in general, and billions around the world urgently needed it.
There have been some improvements to mental health access over the last several years. Expansion of reimbursement of telehealth services, for example, has opened up access to many individuals who would otherwise not have been able to see a mental health provider.
However, the struggle for full access and equity continues. For example, just 40-50% of Medicare beneficiaries who experience mental illness actually receive treatment. What makes this statistic even more striking is that one-quarter of Medicare beneficiaries currently experience mental illness. This is a startlingly high number of people not receiving the care they need.
This lack of care seems to stem largely from restrictions placed on the Medicare system itself. One such restriction is a lack of in-network providers. Studies have found large percentages, often more than 20%, of Americans receiving Medicare do not have access to in-network mental health providers. To compound this problem, in order for a psychologist to receive reimbursement for services in an outpatient facility, they need supervision from a psychiatrist. This has created a care desert in many regions due to a shortage of licensed psychiatrists.
Carry these lessons forward
As we move into the latter part of 2023 and beyond, it’s important to carry the lessons discussed here forward into the coming months and years. Inequality in mental health care access is not going away any time soon. So, ask yourself, “What can I and my organization do to help?”
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