Mental health's in the spotlight

Now what?

We all have stories.

Early on in my career, I remember encountering a number of high profiled individuals who simply didn't understand why I was trying to do more for mental health. It was like this issue, which literally impacts everyone, was not even on their radar. And even worse, their understanding of the issue was naive at best and just flat out wrong at worst. For years, it felt like an uphill battle where most of my talks were all about convincing people why they should say the words “mental health” and why they should organize their strategies or their plans to do something about it.

Thankfully, and in large part due to a seismic cultural shift, we are no longer in a place where the topic of mental health is ignored. Sure, there’s always room for improvement (I am looking at you political debate prep people!), but we have made progress. Consider one survey that found 87 percent of Americans agreed that having a mental health disorder is nothing to be ashamed of. COVID-19, as pernicious as it was, did elevate mental health in new ways. Survey after survey during this time revealed that we were all having a hard time managing our mental health. This also helped normalize mental health and bring it much more to the forefront of our conversations.

When researching for this post, I found some interesting publications about awareness and what increased awareness does or doesn’t do for improving mental health. One fascinating article chased an intriguing hypothesis in the mental health field regarding the impact of public awareness campaigns. The prevalence inflation hypothesis, something I had not heard of before, suggests that many well-intentioned efforts around awareness might be contributing to an increase in reported mental health problems.

One paper highlighted how on the one hand, awareness campaigns lead to more accurate reporting of symptoms that were previously unnoticed or ignored, which is positive. However, on the other hand, they might also be causing some individuals to misinterpret and report minor distress as significant mental health issues. This misinterpretation could, in turn, exacerbate their condition, creating a self-fulfilling cycle where mild anxiety, for example, escalates due to behavioral changes like avoidance. The hypothesis further suggests that this increase in reported cases could spur more awareness efforts, creating a potentially intensifying loop. I found the authors of this paper to be smart in calling out how future awareness campaigns should to address unintended consequences to be more effective.

I’ve always believed that increasing awareness is important, but that the system has to change to be in an better position to help those who need it. Said differently, there’s nothing worse than getting a whole bunch of people ready to take action for their mental health when the system just isn’t capable of meeting their needs.

Google mental health and you’ll find any number of articles that speak to its importance. Progress. Now that mental health is more in the spotlight, what do we do? We’ve shifted to a place where increasing awareness has been largely achieved, and like the cliche metaphor of a dog actually catching a car, now what?

1. It’s time to stop seeing mental health as something to be solved only by health care: To be clear, there is a role and will always be a role for health care, but it plays an outsized role for mental health right now. We default to these traditional structures of care because they are all we have ever know despite an increased recognition that they are not working. When we back away from health care, we begin to see what really impacts our mental health and well-being, and most of these things can’t be touched by health care.

   Moving from awareness to action will require us to think a bit differently about what action needs to be taken for our mental health. Proactively identifying mental health issues before they escalate is a great place to start, and this will force us to look so far upstream we can’t help but see some of the community conditions that drive poor mental health. Beginning to place social issues in a position where they are foundational for our mental health means that some of our actions might be different than just “go find someone who can help.” We might need to advocate for safer communities, tax credits for poorer families, affordable housing, and even increase access to healthy foods. Who holds the responsibility for addressing these issues? Most of the time it’s not health care, which gives us a massive platform for making mental health the responsibility of others outside of health care.

   

2. Revolutionize mental health education: You might be thinking, “OK, Miller, you just told me that awareness is something we should move past - but isn’t education just that?” It feels that where we are now, education must go beyond awareness, the basics, and actually move to empower individuals with practical skills. This involves integrating comprehensive mental health education into school curriculums from a young age, focusing on emotional intelligence, resilience, coping strategies, and recognizing signs of mental distress in oneself and others, but perhaps most importantly, knowing what to do about it! This ain’t your parent’s wellness class where they talk about basic emotions (as important as those are to know); this is about rethinking our individual role in how we help ourselves, our friends, and our community with their mental health.

3. Expand access through technology to enable more robust community integration: When we look beyond traditional outlets of care, we can see new and exciting ways to leverage technology that allows us to democratize mental health resources. Sure, teletherapy and digital mental health platforms can provide support to those who may not have access due to location, financial constraints, or stigma, but that’s limiting the role of technology to only provide more traditional therapy. Using this technology to bring mental health services into community settings like libraries, community centers, and even places of worship can make these services more accessible and less intimidating. Building off of #2 above, this approach can also be used to train community leaders and volunteers in basic mental health skills to create a new network of grassroots support.

   

   What do you think? I am trying out the poll function below - weigh in. And yes, I know this is almost not a fair question to even ask as most of you will say “both.” But, if you had to choose right now for this moment, which would you choose?

In conclusion, our journey in mental health advocacy has evolved from raising awareness to actively seeking tangible, widespread solutions. The window for mental health reform is open like it’s never been, but that window will not stay open forever. We have to lean into the moment and think big about how we can take advantage of all these people paying attention to mental health who had ignored it before. I could not be more excited about the bright light being placed on mental health, and want to make sure we accomplish meaningful change that benefits all our communities.