Mental Illness Is on the Rise

Millions of Americans have serious psychological distress. And even if they do have insurance, mental health care can be difficult to find—but there are solutions.

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Photo: Annamaria Kiss/Getty Images

More Americans than ever before are suffering from mental and emotional distress, according to the World Health Organization (WHO). What's more, many lack access to or experience delays in adequate treatment, especially those in rural areas, per data from the Substance Abuse and Mental Health Services Administration (SAMHSA).

Before the COVID-19 pandemic, research suggested that the rate of serious psychological distress (SPD) among US adults consistently ran between 3% and 4%—more than 8 million Americans—according to a study published in 2022 in JAMA Network Open.

SPD is a term that describes mental health issues that are severe enough to cause moderate to severe impairment in social, occupational, or school functioning—enough impairment to require treatment, per the Centers for Disease Control and Prevention (CDC).

While SPD isn't a medical diagnosis, it is a good measure of community mental health that overlaps substantially with conditions like depression and anxiety, according to Judith Weissman, PhD, a visiting assistant professor in the department of epidemiology for New York University and lead author of a 2017 study published in the journal Psychiatric Services.

While ranges for SPD were running in the 3-4% range, with the pandemic came rising numbers of people with mental health concerns. The WHO says that globally, anxiety and depression increased by 25% during the first year of the pandemic. In the US alone, 1 in 5 adults reported that the pandemic had a significant negative impact on their mental health, according to SAMSHA.

What might be causing this increase in mental health issues? Let's take a look.

Multiple Stress Factors

According to the WHO, many different factors caused the jump in SPD. Among them—and one of the top factors—was the social isolation people endured during the pandemic. Social isolation alone can have significant negative consequences on psychological wellbeing, according to research published in 2021 in the journal Nature.

Related to isolation and adding to the stress, said the WHO, were the "constraints on people's ability to work, seek support from loved ones, and engage in their communities." In other words, isolation didn't allow people to participate in life with other people—whether it was with work, socially, or out in the community.

Isolation can also cause loneliness, and loneliness is related to a host of both physical and mental conditions, among them, depression and anxiety, according to the National Institute on Aging (NIA). And while a lot of studies and information is on older adults and loneliness, young adults can struggle with loneliness, too. For example, a 2021 study published in Frontiers in Psychology states that young adults ages 16-24 are the loneliest group in Western countries—even more lonely than older adults.

Interestingly, in looking at the data for her study, Weissman said that the recession of 2008 appeared to have played a role in the increased prevalence of SPD during that time, but that it was surprising that so many people had not recovered by 2014. This begs the question: How long does it take for people to recover from a major life event like a pandemic or a recession? That remains to be seen, but in the meantime, there's another obstacle many have to hurdle: access to care.

Access to Care

In addition to an increase in the need for psychiatric care with the uptick in SPD, getting that care can be difficult, especially for rural Americans.

For example, according to the National Alliance on Mental Illness (NAMI), compared to suburban and urban residents, Americans living in rural areas have to drive twice as far to get to the nearest hospital. These same people are also twice as likely to lack high-speed internet, which decreases the availability of telehealth services for them. And according to NAMI, over 25 million rural Americans live in areas where there is a shortage of mental health professionals—so even if they have the means to talk to a professional, there might not be one available.

This data is despite people having more access to affordable healthcare via the Affordable Care Act (ACA). One 2022 study published in the journal PLOS ONE suggested that even with 20 million people in the US benefiting from the ACA, those benefits are not necessarily translating into improved access to care or improved outcomes for people with depressive disorders. So while people may have insurance that covers mental health services, if those services are unavailable, it kind of cancels out the benefits of having insurance.

"The trends seem to be diverging," said Weissman. "Poor mental health is increasing, and the number of mental-health providers cannot keep up."

Solving these problems won't be easy, said Weissman. It will require more mental-health screening and education at the primary-care level, providing more assistance to distressed people who can't manage health care on their own, and exploring ways to make more mental health professionals available to those who need them most.

If you feel you need help with your mental health, your primary healthcare provider is a good place to start. They can give you information on resources in your area and provide a referral to a mental health specialist if necessary. You can also check out the US Department of Health & Human Services mental health website for phone numbers and service locators for assistance in directing you to the help you need. If you don't have insurance, community clinics offer mental health services on an income-based sliding fee scale. And if you feel as though you might take your life or harm yourself, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

While mental health conditions are on the rise, and there can be some challenges in finding help, if you want help, it is out there. If you're having a difficult time finding the right resources, ask a trusted friend or family member to help you—the more support the better.

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