One of my very first posts on this blog was about the “epidemic of mental illness“. In it, I discussed how I strongly feel that those of us in westernized cultures have created lifestyles that make us more prone to mental illness. I read an article the other day called, “CDC Says Mental Illness Plagues US Like Never Before“. Topics like this get me riled up. I find it absolutely startling that the CDC has found that even in modern day, 50% of all Americans will suffer from mental illness at some point in their lives. These same experts go on to say…
“There are unacceptably high levels of mental illness in the United States. Essentially, about 25 percent of adult Americans reported having a mental illness in the previous year. In addition to the high level, we were surprised by the cost associated with that — we estimated about $300 billion in 2002. …many of those suffering presently do not get help, experts say.”
Why are people not seeking help?
First, we should be examining why such a large amount of suffering people are not seeking help. A study at Iowa State University found that men who endorse dominant masculine “ideals” (such as being stoic, controlled, and self-sufficient) reported higher levels of self-induced stigma and showed less favorable attitudes towards seeking help for mental health issues using counseling (Vogel, Heimerdinger-Edwards, Hammer, & Hubbard, 2011). Gupta, Szymanski, and Leong (2011) also discovered that when Asian Americans internalizedpositive stereotypes (being ambitious, hardworking, intelligent, and self-disciplined) it still led to poor psychological health and was related to less-favorable attitudes about seeking help. In addition, according to this study, across several college campuses in the United Stated, of the students with mental health problems, only one-third sought out treatment within the past year, and only one in five students were currently receiving treatment. This same study found that Caucasian students are more likely than African American, Hispanic, and Asian students to seek out counseling services. Students who did not seek treatment stated they had “no need”, would “prefer to deal with issues on their own”, that “stress was normal”, or that they “don’t have enough time”. The researchers stated “ [These results] suggest that many students simply do not see treatment as urgent enough to compete with their other, more tangible priorities such as coursework and social activities,” (Eisenberg, Hunt, Speer, & Zivin, 2011).
Ileana Arias, Principal Deputy Director of the CDC states, “It isn’t clear why so many Americans suffer from mental illness. This is an issue that needs to be addressed. Mental illness is frequently seen as a moral issue or an issue of weakness. It is a condition no different from cancer or other chronic diseases. People need to accept the difficulties they are having and avail themselves of the resources that are available.” Arias is right in that, yes, unfortunately mental illness is frequently seen as a moral issue or issue of weakness. However, is it really that unclear why so many Americans are suffering from mental illness?
When reviewing these few research articles, I see one common denominator, stigma. Centuries ago, mental illness was seen as being possessed demons. Although the stigma of mental illness has come a long way since then, we still have more work to do. The stigma seems to be more prominent in minority populations, such as African, Asian, and Hispanic Americans. In addition, men appear to internalize our societies ideals that they are strong, controlled, and should not need to seek help, because if they do, they are no longer seen as strong. The National Alliance on Mental Illness is fighting the stigma on mental health using their “StigmaBusters” program. This program works to fight inaccurate and hurtful representations of mental illness, and to educate our society about the reality of mental illness (National Alliance on Mental Illness, n.d.).
Access to Services
In addition to fighting the stigma, we need to insure that people who need services have access to them. Most insurance companies only cover a very limited number of hospital days in psychiatric hospitals and therapy sessions. For example, with the EAP program in the state of California, you only get 3-7 counseling sessions per issue based your employee level. While working at a psychiatric hospital, I have seen case workers sitting on the phone, begging for more hospital days from insurance programs for patients who really, truly needed them.
As for access to psychiatrists, I have often seen people seeking services for the first time with a psychiatrist, and finding that the wait list, at least here in the Midwest, is very long. When asking patients entering the psychiatric hospital what brought them, I have, on several occasions, heard “well… the wait list to see a psychiatrist was over 2 months long. I am suffering, and I need help now. I can’t wait that long”.
More and more people these days are alienating themselves from others. We work from home, often completely cutting ourselves off from all social contact we would have otherwise received in a office setting. Many others are also using social media to replace being around other people. We sit at home and talk to each other through messenger, on Facebook, or Twitter; and yes, I am guilty of also utilizing these social media outlets in such a manner. However, it becomes a problem when we are using this to replace all communication with others. Our society holds stress up to high standard, we have to get that promotion, meet this deadline, get that raise. It’s almost as if our society has forgotten how to relax. Stress Addiction is becoming an issue that the psychological community is seeing more and more often.
Omega-3 has been worked almost completely out of our modern day diet. I have mentioned the importance of this on multiple occasions, but people who are depressed or anxious have shown reduction of symptoms when receiving a therapeutic dose of Omega-3 fish oil. Are you still not convinced something as small as our diet can impact our mental health? Chilton et al. (2011) completed a research study funded by the National Institute of Health, in which a group of 36 cynomolgus monkeys were fed a ‘Western’ diet (diet enriched with saturated fat and cholesterol) for 27 months. By the end of the study, 42% of the monkeys showed signs of depression (showing a slumped body posture, lack of responsiveness to stimuli, and isolating behavior). When compared to non-depressed monkeys, these depressed monkeys also showed higher levels of anomega 6:omega 3 ratio. If diet does play such a large role, it’s no wonder the American population has high rates of mental illness when you also examine the high rates of diabetes and cardiovascular disease.
Therapeutic Lifestyle Changes
Many therapists are now instituting, “Therapeutic Lifestyle Changes” as a way to treat clients. This may not be the “cure” or treatment everyone needs; however, I do believe that if teaching lifestyle changes to our society was implemented, at least at a psychoeducational level, we would see a dramatic decrease in mental illness. Roger Walsh from the University of California, Irvine College of Medicine recently wrote an article for American Psychologist about these Therapeutic Lifestyle Changes. He goes on to explain that by increasing exercise, improving nutrition/diet, reducing unhealthy levels of media immersion/hyperreality, spending more time in nature, improving healthy relationships, and learning relaxation, that we would see a vast improvement in the mental health of our country. He adds…
“A culture’s technology has far-reaching effects on people’s psychology and lifestyles (Wilber, 2000), and modern technology is now affecting our psychology, biology, society and lifestyles in ways we are only beginning to comprehend…. Many of the resultant costs are doubtless as yet unrecognized, and this raises a disconcerting question: Could some of our patients be “canaries in the coal mine,” warning us of ways of life that may exact a toll on us all?”
It is clear that our country is seeing a significant increase in people with psychiatric illnesses, and it is clear that many of them do not seek help. Now that we are gaining a little bit of insight into why these people are not seeking help, we as psychologists, researchers, government officials, etc., it is our responsibility to do what we are able to try to correct this. We are gaining this new information, so let’s do something with it! Organizations like NAMI are on the right track with fighting to correct this mental illness stigma. I think we also need to ensure that our society has better access to mental health care, and that educational programs are instituted. Whether it be in schools, the workplace, or community based programs, I think these TLC programs would be go psychoeducational programs to institute community wide. While these options may not be the “cure all” answer, starting to take steps will at least get the ball rolling.
What are your thoughts on these new Therapeutic Lifestyle Changes? Do you think there are other reasons we seem to be seeing an increase in mental health in our country? And do you feel that there, in fact, an epidemic of mental illness, or does this idea seem to be blown out of proportion?
- California Department of Personnel Administration. (2003) DPA – Benefits – Employee Assistance Program. Retrieved from http://www.dpa.ca.gov/benefits/other/eap/sessions.shtm
- Chilton, F.H. et al. (2011). Depression and altered serum lipids in cynomolgus monkeys consuming a western diet. Physiology & Behavior, 104(2), 222-227.
- Eisenberg, D., Hunt, J., Speer, N., & Zivin, K. (2011). Mental health service utilization among college students in the United States. Journal of Nervous and Mental Disease , 199 (5), 301-308.
- Gupta, A., Szymanski, D. W., & Leon, F. T. (2011). The “model minority myth”: Internalized racialism of positive stereotypes as correlates of psychological distress, and attitudes toward help-seeking. Asian American Journal of Psychology , 2 (2), 101-114.
- Kraft, S. (2011, Sept 06). CDC says mental illness plagues us like never before. Medical News Today. Retrieved fromhttp://www.medicalnewstoday.com/articles/233944.php
- National Alliance on Mental Illness. (n.d.). Fight Stigma. Retrieved September 08, 2011, from NAMI: National Alliance on Mental Illness Website:http://www.nami.org/template.cfm?section=fight_stigma
- Vogel, D. L., Heimerdinger-Edwards, S. R., Hammer, J. H., & Hubbard, A. (2011). “Boys don’t cry”: Examination of the links between endorsement of masculine norms, self-stigma, and help-seeking attitudes for men from diverse backgrounds. Journal of Counseling Psychology , 58 (3), 368-382.
- Walsh, R. (2011, January 17). Lifestyle and Mental Health. American Psychologist. Advance Online Publication. DOI 10.1037/a0021769
Further Suggested Reading
Topics in Medicine: Mental Illness – discusses the NIH’s & Global Alliance for Chronic Diseases’s newly formed “Grand Challenges in Global Mental Health Initiative”
Nicole Paulie is a Counselling Psychologist, and co-author of “How to be Happy and Healthy – The seven natural elements of mental health.” She provides therapy in the Dublin city area. Contact us to learn more or to book an appointment.