In the autumn of 2024, Karestan Koenen, a professor of psychiatric epidemiology and the leader of the Population Mental Health Lab, voiced her thoughts on the looming issue of mental health in the U.S. Statistics from the Centers for Disease Control and Prevention (CDC) suggest that approximately one in three people will suffer from a mental disorder at some point in their lives. Currently, around one in five individuals have a diagnosable mental disorder, highlighting the urgency of this situation.
Yet, discussing the importance of mental health often takes a back-stage to other health issues. Mental health problems are incredibly common and can significantly affect an individual’s physical health, lifespan, and risk of developing chronic ailments such as cardiovascular disease, diabetes, and cancer. Mental health issues can also impair one’s success in education, employment, and relationships. Quite alarmingly, these problems commonly emerge earlier in life in comparison to other chronic diseases, typically beginning during childhood or adolescence.
Questions around tackling the problem have centered around a lack of access to treatment. The unique quandary with mental health issues is that the nature of the problem makes it difficult to identify the right provider when one needs it. In Koenen’s observations, she notes that when individuals think about addressing mental health crises, they often overlook prevention and start with treatment. Access to treatment and the quality of that treatment is undoubtedly essential, but the existing treatment paradigm may need reassessment.
Highlighting the approach we’ve taken with motor vehicle-related deaths, where we did not get every individual a private driving instructor or coach, Koenen suggests we might need to focus on prevention when it comes to mental health. Instead of a one-on-one psychologist or social worker system, we need a nation-wide, population-based approach to combat these issues. By understanding that not everyone with mental health problems will need therapy or medication, we can explore non-traditional interventions such as certain types of exercise or mindfulness to reduce depression.
In terms of policy recommendations, Koenen believes that any economic policies to reduce the stress on families would naturally lead to an improvement in mental health. These might include paid family and parental leave policies and measures to decrease food insecurity and home foreclosures.
In support of these recommendations, multiple pieces of evidence link economic stress to declining mental health. Policies such as the temporary expansion of the Child Tax Credit during the COVID-19 pandemic served to enhance the mental health of parents. Also, data from the 2007-09 recession highlighted an increase in anxiety and depression due to home foreclosures, suggesting interventions preventing foreclosures could benefit both physical and mental health.
Moreover, beneficial effects have been linked to paid maternity leave on the mental and physical health of mothers and children. In contrast, issues like food insufficiency can lead to symptoms of poor mental health and can affect vulnerable populations in particular.
Koenen expressed hopes of empowering people with more knowledge about the things they can do to improve their mental health. She noted that it’s not just about medication and therapy. There is robust evidence that time spent in green spaces can improve mental health, something practiced by the Japanese in their practice of ‘forest bathing’. She also sees potential in technology fulfilling mental health care needs, such as digital tools for training health care workers to provide mental health care.
In conclusion, as we deepen our understanding of what an intervention might look like, the tides of change might begin to turn in favor of societal mental health. By seeing mental health as integral to overall well-being and not a separate entity, Koenen hopes substantial progress can be made in improving mental health in the next four years. However, the gravity of this issue necessitates that mental health must receive the same priority, funding, research, and access to care as other escalated health issues like cardiovascular disease or cancer.
