By Marty Morris, SKMC Class of 2021
The other day, I came across a Venn diagram depicting access to mental health services. In one circle was “Sorry, you’re not mad enough”, in the other “sorry, you’re too mad”. What struck me the most was what was in the middle: “You are the correct amount of mad. Here, we will put you on an 18 month waiting list.” (1) While the drawing pokes fun at how mental health is currently treated in our healthcare system, it brought an important question to mind – how can we get help with our mental health if and when we need it?
At the heart of the discussion is the prevalence of mental health problems and the subsequent cost to our healthcare system. (2,3) From stricter gun laws to treating neurological disorders, politicians and medical professionals alike have proposed methods to improve how mental health is handled in our current healthcare system. An article in Scientific American even recently proposed changing the title “Psychiatrist” to “Mental Health Physician” to help reduce the stigma around mental illness, based on studies of the effects of such a name change. (4) Yet, most of these arguments are centered around changing the stigma of mental illness to subsequently improve early psychiatric diagnosis and treatment. This, in turn, is hoped to decrease long-term costs to the healthcare system.
But, what if we instead approach mental health care reform from the opposite side? Rather than working to change the stigma, we should first work to make psychiatric services available to anyone and everyone who desires it. The reasons behind this approach are evident. In 2010, 89.3 million Americans were living in federally-designated Mental Health Professional Shortage Areas. (5) Even for those with services available, federal researchers found that cost acted as a significant barrier for 45 percent of people not receiving care. If we make efforts to improve access for therapy and treatment services – whether it be for a minor social stress or a major depressive episode – could this change our outlook on mental health?
Now, as someone raised by two physicians, I can understand the dichotomy of the diagram. As a child, it was often difficult to get my parents to listen to my health concerns. My worries were often met with “You’re fine. Take some ibuprofen.” With mental health, these concerns were even easier to brush aside. Individuals are often told by friends and family: “Just relax - tomorrow is a new day”. Yet, mental health is different from the rest of medicine because of this very point, when individuals no longer know when and how to discuss their real concerns. While an untreated physical illness may lead to debilitating symptoms and eventual medical intervention, the same severity of mental health illness often ends at debilitation. To prevent these downward spirals, we must reach a point where any mental health concern is a valid mental health concern.
The good news is that this movement has already started. For example, employers and universities have increasingly recognized the importance of mental health, and some even adopted approaches like “mental health days”. This has allowed individuals to take responsibility for their own mental health while increasing productivity and decreasing lost days of work in the long-term. In addition, the growing attention of the press has increased laypersons’ awareness and understanding of mental health issues. Even the sports world, an arena where mental illness has been highly stigmatized, has recently brought mental health awareness to the public eye. Players and coaches have taken ownership of their mental health and are calling for mental healthcare reform. (6)
However, even with social progress, we need the healthcare system to adapt with us. Over 5 million people end up in emergency rooms every year due to mental illness (7), costing our healthcare system approximately 456 million dollars. So my original question expands – how can we get help if and when we need it, before an emergency room?
To start, increasing access to mental health services is a step we can take. Of course, opening more therapy and counseling centers will burden the healthcare system in the short-term. However, this can also be done within pre-existing institutions, such as mental health screening in high schools and universities. Especially with the inclusion of community health centers, individuals of all demographics and socioeconomic status would gain access to mental health services. This is a risk we ought to take if we want to change how mental health is approached in this country.
Simply put, both our societal norms and healthcare have to change for reform to be effective. Efforts toward individual education, prevention of early symptoms, and an openness to listen to others will only suffice so long as there is legislation supporting funding for early therapies and prevention centers. Likewise, without introspective individual attention, legislation is likely to hold no value. I understand that this is no small undertaking, but mental health can and ought to be thought of on equal terms with physical illness. By increasing individual access and decreasing waiting list times, our notion of mental illness will slowly start to shift. Only then will the two circles of the Venn diagram become one, and anyone who wants help from mental health services will hear: “Come on in - how can we help?” It’s time we each play a part to make sure that happens.
- Ruby. "Instagram Photo." Instagram. Rubyetc, Web. 27 Nov. 2016.
- "Mental Health Myths and Facts." MentalHealth.gov. MentalHealth, Web. 27 Nov. 2016.
- "America's Highest Healthcare Cost in 2016? Mental Health." HealthCare Recruiters International. 10 Oct. 2016. Web. 27 Nov. 2016.
- Morris, Nathaniel P. "Maybe We Should Call Psychiatry Something Else." Scientific American Blog Network. 20 Oct. 2016. Web. 27 Nov. 2016.
- Kliff, Sarah. "Seven Facts about America’s Mental Health-care System." Washington Post. The Washington Post, Web. 27 Nov. 2016.
- Love, Kevin. “Everyone is going through something.” The Players Tribune. Web. 6 Mar. 2018. https://www.theplayerstribune.com/kevin-love-everyone-is-going-through-something/
- Szabo, Liz. "Cost of Not Caring: Nowhere to Go." USA Today. Gannett, 12 Jan. 2015. Web. 27 Nov. 2016.