According to the World Health Organization, the United States ranks third in the world for countries most affected by anxiety, schizophrenia and bipolar disorder with about one in five adults experiencing some sort of mental illness each year. Yet even with the number of cases on the rise due to societal and economic stresses, many Americans are not getting the help that they need. For example, the National Surveys on Drug Use and Health found that only
62.9 percent of adults nationwide with serious mental illness received treatment in the year they reported this illness and it is getting worse. In fact, The Centers for Disease Control and Prevention in Atlanta recently released federal data showing that suicide rates among Americans from 1999-2016 have been increasing for years in almost every geographic region of the nation, and across socio-demographic lines.
Why the increase in mental illness?
Hopelessness: There is a belief that the American dream does not exist anymore and that people will not be better off than their parents. During the 2007 recession, many people lost their jobs and have not been able to recover financially since then. Middle class jobs that once paid good wages such as in the manufacturing sector have all but disappeared. Many people are chronically underemployed or need to work several minimum wage jobs to make ends meet and that is not likely to change anytime soon.
Increase of Veterans: Another factor is the large number of veterans that have returned home with physical or mental traumas and are not receiving adequate treatment. Since 2001, over 2.5 million men and women served in Afghanistan and Iraq alone and many of them served more than one tour of active combat duty. They have come back with their lives permanently altered by what they have experienced and yet they are expected to transition back to a normal life with little or no support.
Lack of early intervention: Lastly, studies show that early intervention is extremely important but uncommon. Ronald Kessler, professor of health care policy at Harvard Medical School's Department of Health Care Policy states that, "Issue number one is that we can't wait as long as we do to get young people into treatment. People with mild mental disorders, if left untreated, have a significant risk of future serious outcomes, such as attempted suicide, hospitalization, and work disability.”
Why is mental illness not being treated?
Lack of access: Many people in rural areas feel isolated both socially and economically which leads to higher rates of depression. Yet residents of these areas of the country also have less access to mental healthcare. Nationwide, Americans have fewer mental health professionals than other Western countries. According to the World Health Organization, the U.S. has about 13 psychiatrists per 1000 people vs. 20 to 40 per 1000 people in Europe.
Cost of treatment: Treatment in the U.S. is strongly related to the ability to pay and less to the need for care compared to other countries. For those that have insurance, many plans do not cover long term care and for those that don’t have insurance, the cost becomes prohibitive. As Andrew Romanoff, CEO of Mental Health Colorado stated, "Treating mental illness is a lot cheaper than ignoring it or criminalizing it or watching a loved one suffer or struggle or die on account of it."
Inability to seek help: Unfortunately, for chronically ill patients, their mental health has declined so severely that they cannot even explore treatment options. Many of those same people have either alienated or lost touch with family and friends (who might have been able to help them) or they did not have a support system in the first place. When they are left untreated, they are at increased risk of permanent homelessness, long term health issues, as well as the possibility of being a victim of serious violence.
What can be done?
Unfortunately, instead of increasing funding for mental illness, we have seen a decrease in spending at the state and national level. Studies from the National Alliance on Mental Illness show that states cut $1.8 billion from their mental health budgets during the recession. Spending cuts have also been more severe on long-term patient care treatment facilities and most of the current budgets are spent on out-patient treatment and/or prescription medication. However, when people are suffering from severe mental illness, they may be not able to take their medication without supervision, resulting in sporadic use or none at all. That also decreases the likelihood of them continuing any other form of treatment as well.
If we really want to reverse the trends we are seeing in the rise of mental illness and homelessness, there are three things that could help:
Focus on early prevention
Additional support for veterans
More funding and access to in-patient treatment facilities
If we do not take action in any of these key areas, we are more likely to see this trend become permanent. If you don’t believe it, spend a day in any major city in the U.S. and you will come face-to-face with thousands of people living on the street who are suffering from mental illness. It is hard to understand how a country as rich as the U.S. can treat their mentally ill so poorly.