Mental Health Epidemic
‘As a Nation, Our Healthcare Workforce, Especially in Mental Health, is Woefully Inadequate’
We have a very serious mental health epidemic in our country. It is impacting especially the young. Rates of drug abuse, shootings, violence in many forms, depression, and suicides (completed, attempted, and contemplated) continue to skyrocket.
Ever since Donald Trump’s election, I have publicly warned against “the poor state of collective mental health” that gave rise to his presidency, and an acceleration of “the public mental health crisis” that was to come as a result of his presidency. These two issues are interrelated, and I will have much more to say about this in the months ahead.
Today, I wish to bring to the reader’s attention a very thoughtful and insightful recent article in The Guardian by U.S. Senator Bernie Sanders.
He begins:
This country faces a longstanding mental health crisis, exacerbated by the isolation, fears and uncertainties of the pandemic. This crisis affects all generations, but has been especially devastating for young people.
He refers to the Centers for Disease Control and Prevention (CDC) survey showing nearly one out of every three teenagers in America reporting that the state of their mental health is poor, and two out of every five teenagers feeling persistently sad or hopeless. According to the National Alliance on Mental Illness, suicide is the second-leading cause of death among people age 15 to 24 in the United States. Nearly one in five high school students report serious thoughts of suicide and nearly one in ten have made an attempt.
He points out how the pandemic, the worst public health crisis in over a century, has brought about a massive disruption in their daily academic and social lives at the height of their development.
The pandemic itself is one of the effects of being under a mentally-imbalanced president, who not only exacerbated the pain of the pandemic but may have failed to prevent it from occurring in the first place. Before he gutted the CDC or axed a key American public health position in China, pandemics were generally prevented at the epidemic stage. I repeatedly emphasized that there was a “mental health epidemic” more serious than the Covid epidemic to tackle before the pandemic. Now, we are suffering the aftermath of both.
The children’s struggles were also happening alongside unprecedented economic anxiety, with millions of workers losing their jobs and fearing eviction from their homes, and families lining up for emergency food boxes. And young people also know that, even before the pandemic, the economy has been worsening for them, with the prospects of being employed, paying off student debts, buying a home, or affording health care growing slimmer, while the richest Americans continue to multiply their wealth.
And society has not protected them from the radical impact of screen time and social media on the minds of younger generation. Social media platforms are designed to be addictive and are associated with anxiety, depression, and loneliness, as well as emergency room visits for self-harm, suicide attempts, and completed suicides.
Sanders points to a recent survey in which 32 percent of teens said they were online for five to six hours, 17 percent for seven to eight hours, and 13 percent for nine or more hours a day. Nevertheless, when it comes to social media, we are up against the world’s most inventive algorithms. Clearly, the mental health damage they do to millions of young people is less important than the huge profits they are reaping.
Sanders, upon speaking with students, teachers, administrators and parents throughout Vermont, has found two other issues concerning young people: climate change and gun violence.
They are deeply concerned about … whether the planet that they and their children will be living on will be healthy or habitable. And they also question their government and the kind of political leadership in this country that has allowed this existential threat to occur.
And then … there have been well over 200 mass shootings in the United States this year. They have taken place in virtually every state in the country. Almost all public schools in America now have active shooter drills. For many kids, obviously, the thought of such an attack is extremely frightening and can have a profound impact on their mental health.
Young people are “barometers” of societal mental health. Not only do their sensitive, growing brains respond to society’s deficiencies almost immediately, they are not so corrupted as to accept the horrific, profit-driven systems we already have: be it the gun industry, the military-industrial complex, the subsidization of fossil fuels, the social media industry, our broken healthcare system, or our rigged political system. This, of course, creates greater reasons for depression.
Sanders highlights:
even with decent insurance, it is hard for many to find the psychiatrists, psychologists, addiction counselors or social workers where they live. As a nation, our healthcare workforce, especially in mental health, is woefully inadequate…. In my view, if we are truly going to resolve the mental health crisis that we face, we will need a political revolution that creates a society based on justice, compassion, human solidarity and a growing sense of community.
I have always emphasized in my writings, whether in my textbook, Violence, or Profile of a Nation: Trump’s Mind, America’s Soul, that structural violence, especially economic inequality, has mental health consequences. These mental health consequences have not been dealt with, but those most qualified to speak about them have been sidelined in the public sphere. What is little known is that democracy itself is a mental health issue (requiring the mental capacity of the public to desire it in the first place). Whether it concerns a psychologically dangerous president who poses a threat to the public, or politics or industries that exploit psychological vulnerabilities in the population, mental health professionals need to step up in their societal duty, and the nation needs to make room for them in public discourse. Only then will we properly prevent further spread of a serious mental health epidemic.
Dr Lee, Psychiatry is confined to OPDs, clinics and mental health institutions - that is micromanagement of mental health crisis of people. What modern psychiatry needs is macromanagement of societal/social mental health crisis - that is addressing the aggregate mental health crisis of society. The psychiatric drugs (along other interventions & treatments) may help individual but it cannot help to cure aggregate mental health crisis of society unless we address the underlying factors - the dysfunctional political system, socioeconomic disparity, poverty (the single biggest cause of all human diseases), institutional decay (courts, law enforcement, academics etc), unregulated social media are some of the factors.
Interestingly, some of our politicians have a good grasp of psychological vulnerabilities of society. But due to the malignant nature of these politicians, they exploit this and aggravate it for their political gains. Meanwhile institutions like APA refuse to step forward in educating society about why and how it's being exploited.
I think that we also need a dedicated office of Sec of psychological health - goals should be formulating policies, implementing programs and monitoring of psychological health on both macro & micro level in America. There is an office of Assistant sec of mental health & substance abuse (i don't know it's exact functions) in US Govt but i don't think it lives up to the task in doing anything concrete.
Dr Lee, what US needs is a mental health policy. US has tons of think tanks, advisers and consultants that formulate US foreign policy, Defense policy, Trade policy, Climate change policy etc. These policies are based on strategic US interests and long term sustainable goals. It's interesting that US doesn't have a national mental health policy (i haven't heard anything about it).
Our response to mental health crisis is reactive rather than proactive (preventive) because we lack a concrete national mental healthy policy (mental experts like you should define & formulate it). But i give some examples.
Reactive approach - We have these counselors in schools that are needed to deal with gun violence. After school shooting, the students go through counselings to treat their traumas.
Proactive (preventive approach) - Sensible gun laws to prevent school shootings. If we can make sensible gun control laws, we don't have to treat trauma of students from gun violence.
Reactive approach - Unregulated & harmful sewers of social media that encourages self harm. The algorithms are built to make users addicted to social media and suck their minds dry. Then kids behavior changes & parents take them to doctor for intervention.
Proactive approach - Sensible Social media regulations, transparency and full disclosure of their algorithms, cleaning up social media of misinformation.
Reactive approach - Law enforcement deals with growing violence in society. Rise of racial, political, sexual violence - constant need of locking up more & more offenders in prison.
Proactive approach - Clean political system from MAGA infection and Trumpism, enforce rule of law, judicial reforms, strengthening democracy etc. Make better economic policies to cut poverty & unemployment.
We really need a national mental health policy that should be designed by experts like you and to diagnose societal mental health problems, their causes and possible methods of treatment.