There is a growing mental health epidemic, and the United States leads the world.  In recent years, we’ve seen significant increases in certain mental health disorders in youth, including depression, anxiety, and suicidal ideation.  We’ve also had a major increase in loneliness, especially in older people.  Many people have turned to opioids and become addicted, with deadly results as Fentanyl and other chemicals have made the drugs deadlier.  There is a good chance that people you know are struggling with mental health challenges, including your friends and family.  The good news is that we know how to deal with anxiety, depression, loneliness, and addiction…so let’s take action to resolve this crisis.

The Technology Paradox

As technologies like email, the internet, social media, and smart phones became prevalent, they seemed to have unlimited potential to better connect people.  Talking and meeting across long distances has never been easier.  Yet, there is a resulting paradox – as we’ve become more connected digitally, we’ve lost a lot of the deep connections that are built through personal interaction.  We’ve gotten sucked into our smart phones and computers, leaving less time for talking and gathering socially.  This trend is particularly concerning for young people.  A longitudinal cohort study of U.S. adolescents aged 12–15  found that adolescents who spent more than 3 hours per day on social media faced double the risk of experiencing poor mental health outcomes including symptoms of depression and anxiety. These trends were greatly accelerated during the COVID pandemic, as people were extremely isolated. The digital connections are more superficial, more curated, and less personal.  The polarized nature of our politics and the use of outrage in social media have also increased stress and strained relationships.

Mental Health Care – High Demand, Low Capacity

While anxiety and depression have been on the rise, our capacity to care for these conditions has decreased.  Mental health asylums have largely been shut down, but community care facilities that were supposed to take their place never fully materialized and were not fully funded.  Federal mental health funding was shifted to states, which used much of the funds for other purposes.  Between 1970 and today, the number of psychiatric inpatient hospital beds in the USA has decreased from over 500,000 to less than 40,000.  More than 150 million Americans live in a federally designated mental health professional shortage area.  The facilities that do exist are often stretched to the point that care suffers.  When people arrive at an ER with a mental health emergency, they can often wait 10 hours to be admitted. Many people with mental health issues end up homeless or in prison.

Mental Health Benefits of Personal Connection

We can improve our mental health, and the mental health of those around us by re-establishing personal connections, and performing acts of kindness.  A UK study found that 63% of adults agree that when other people are kind it has a positive effect on their mental health, and the same proportion agree that being kind to others has a positive effect on their mental health.  Evidence shows that helping others can benefit our own mental health and wellbeing. It can reduce stress as well as improve mood, self-esteem and happiness. Volunteering and civic engagement is a great way to help others and research shows that it benefits people of all ages, by increasing feelings of self-esteem, social connection, and well-being.  Reconnecting and helping our friends, neighbors, and loved ones can be a fun way to improve our mental state, and that of those around us.  Let’s reach out to have more conversations, get together more frequently with our friends and family, and show some kindness – we can make a difference!

Positive Policy Steps

From a policy standpoint, we are taking some positive and creative steps to improve access to care. The Bipartisan Safer Communities Act of 2022 committed $8.5 billion to fund a network of clinics dedicated to recovery for people with serious mental illness and substance use disorders in all 50 states. In 2021, Congress mandated a new national approach to the mental health crisis, designating 988 as a single phone number across the nation ensuring someone to call, offering someone to come, and providing someplace to go for those in a mental health crisis. Funding for psychiatry residents has been increased, although further increases are still needed.  By establishing Collaborative Care Models with primary care physicians supported by psychiatrists, we can expand patient access to psychiatric care.  Vermont’s hub and spoke model for treating opioid addiction has been an effective way to expand quality care for addiction.  Crisis centers and EmPATH units are being created as a better alternative to the traditional ER for mental health emergencies. By establishing mental health transition programs in jails like they have done in Cook County Illinois, we can help mentally ill people in jail recover and avoid returning to jail after they are released.  Tech can play a part in addressing the problems it helped create, deploying telemedicine and therapy apps to expand the availability of care. We need to continue to find and deploy creative and efficient ways to expand care to keep people off the streets and out of prison.

The Take-Away

• We need to reverse the trends of increasing mental health issues and decreasing capacity for care
• By connecting more personally with people and doing kind acts for others, we can improve our mental health and the mental health of those around us
• We need to increase the number of mental health care workers and multiply the effect of those we have by establishing models of collaboration between primary care doctors, psychiatrists, and therapists
• The national 988 hotline and alternatives to ERs like Crisis Centers are huge steps forward in helping those with mental health emergencies
• By addressing the mental health care needs of the prison population, we can return them more successfully to society and reduce the chance that they return to prison

Additional Information

• Americans Are Socializing Less—Is It Making Us Unhappy? (newsweek.com)
• Youth Mental Health — Current Priorities of the U.S. Surgeon General (hhs.gov)
• Our Epidemic of Loneliness and Isolation (hhs.gov)
• Kindness matters guide | Mental Health Foundation
• Number of State Psychiatric Hospital Beds Hits Historic Low (Medscape)
• A growing psychiatrist shortage and an enormous demand for mental health services | AAMC
• Mental Health Crisis Centers: offering care that busy ERs can’t (statnews.com)
• America’s Largest Mental Hospital Is a Jail – The Atlantic

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