The Negative Impact of Mental Illness

The challenges that individuals with mental health concerns face on a daily basis are numerous and often majorly disruptive to everyday life. Issues can range from mild discomfort all the way to suicidal ideation (Mental Illness. (n.d.). Along with the direct side effects of mental health disorders, the challenges to accessing treatment such as therapy or medication are uniquely difficult and can be much more inhibitive than that of somatic illnesses or injuries (Glew and Chapman, 2016). Stigma compacted with a lack of recognition of the need for care creates a barrier at both the individual and the societal level for many who need help the most (Corrigan, Druss, & Perlick, 2014). The constant theme through all of the research conducted is that access needs to be improved in order to help reduce the high rates of mental illness in many societies. This paper will address the prevalence of mental illness in the United States, how certain SES statuses and sexual minorities are more likely to be affected my mental illness, and how stigma can be a crippling barrier to accessing care.

The prevalence of mental health in the United States is very significant. The CDC estimates that roughly 46.6 million people or 1 in 5 individuals are living with a mental illness in the US, and that number is significantly higher for many other countries around the world (“Mental Illness”, 2019). Certain populations are more at risk than others, and the difficulties of living with a mental illness can vary based on sex, race, socioeconomic status, sexuality, nationality, etc. For example, LGBT people are at significantly higher risk for developing a mental illness throughout their lifetime, particularly during adolescence (Green, Price-Feeney & Dorison, 2019). A meta-analysis conducted by Green, Price-Feeney & Dorison (2019) found that LGBT teens are three times more likely to report a depressive episode and four times more likely to report seriously considering attempting suicide. They further broke down intersections of LGBT identity along with race and socioeconomic status and found that the prevalence of suicidality and mental health concerns in these two populations is even higher. Racial minorities also have a uniquely difficult time in dealing with mental illness. Roughly 30% of African Americans with mental illnesses obtain treatment against 43% of the average population which shows that some racial minorities have more difficulties in obtaining treatment in comparison to the majority population (“African American Mental Health”). And when these minority identities intersect in individuals, the statistical chances of having a mental health concern significantly increase. Much of this is the result of structural and societal barriers that unfairly target minority populations, which stem from existing systems of oppression against racial and sexual minorities (Green, Price-Feeney & Dorrison, 2019). While we are managing to break much of these barriers down in recent years, much more work remains and needs to be done.

Regardless of one’s gender, race, or sexuality, mental illness is can be one of the most challenging burdens a person handles in their life. Just like many somatic illnesses, mental illnesses are often debilitating for people who must live with them every day. More “mild” cases of mental illnesses can cause mood changes, irritability, lethargy, and a litany of other physical symptoms (American Psychiatric Association, 2013). More “severe” cases of mental illnesses like schizophrenia can bring on hallucinations that can be incredibly distressing, or panic disorder which can cause crippling panic attacks that many state feel as painful as a heart attack (American Psychiatric Association, 2013). The list of disorders and symptoms could be dedicated to an entire paper in and of itself, but the examples here alone are evidence of the many symptoms that people with mental illness must manage daily.

Along with these side effects, suicidal ideation is one of the most challenging components for many individuals living with a mental illness. Rates of suicide have increased over the past 20 years by about 33% (Hedegaard, et al., 2018). The cause of this is difficult to assign to one specific factor, but many experts agree that accessibility to weaponry, social media, and an increase in drug use across the United States are some of the largest concerns (Bohnert and Ilgen, 2019). This is a worrisome trend that factors into a larger discussion of the risks of mental illness because, while conversations around mental illness may be increasing, so are suicide mortality rates which shows the need for more comprehensive and easier access to care by professionals.

Access to treatment is one of the most significant challenges for people who have mental illnesses. As stated previously, roughly 46.6 million people are living with mental illnesses in the United States, but only around 19.8 million people (42.6% of individuals with mental health issues) actually have made contact with a mental health professional to receive treatment (“Mental Illness,” 2019). And that number is only representative of people who have made contact which doesn’t necessarily mean they are receiving treatment. One of the biggest barriers to making that first step of reaching out to a mental health professional is stigma (Corrigan, Druss, & Perlick, 2014). The stigma surrounding mental illness is one of the most uniquely damaging aspects of living with a mental illness. Stigma itself can lead to shame and the suppression or denial of emotions and thought patterns that can be improved or fixed entirely with the right type of care (Rüsch & Thornicroft, 2014). An example of this is that many individuals report not feeling like their symptoms are serious enough for therapy without realizing that one’s symptoms do not need to be “severe” in order to obtain help (Corrigan, et al., 2014). This stigma is integrated into the social framework of our society. In many cases, it is a lack of knowledge about the symptoms of mental illness, and also shame for feeling the need to reach out for help that prevent individuals from accessing the care they need (Corrigan, et al., 2014). A study found that these beliefs result in unequal accessing of treatment for mental health concerns at the individual level as well as at the societal level where policies are created that affect certain populations disproportionally (Ahmedani, 2011). Additionally, these social stigmas surrounding seeking help can manifest in many different ways, some as simple as renting an apartment or accessing basic health services (Ahmedani, 2011).

Not only are barriers to treatment due to stigma and shame surrounding mental illness, but money is also one of the largest deterrents against getting professional help. Consultations with psychiatrists, therapy sessions, medications, and in-patient program costs can easily total to millions of dollars (Rowen, et al., 2013). Because the United States has a healthcare system that disproportionally favors the wealthy and makes treatment for lower SES individuals incredibly difficult to obtain, individuals without health insurance are forced to pay that money out of pocket, and the number of uninsured individuals in America is increasing (Santiago, Kaltman, & Miranda, 2012). Lower SES populations have the highest rates of mental illness, yet they are also least likely to receive care (Chan, n.d.). And oftentimes, the care that they do receive is the poorest in quality (Chan, n.d.). Even in privileged populations, access to therapy can be difficult to come by due to the relatively few number of mental health professionals in their community. For example, on Binghamton University’s campus, students often report difficulties in obtaining an appointment with the University Counseling Center (UCC) due to the high demand and relatively low number of therapists (Donovan, 2018). The UCC has 14 therapists, which equates to roughly one therapist for every 1,269 students (Staff - Counseling: Binghamton University, n.d.). Obviously, not every student is accessing care, but the figure itself is quite staggering. Even off campus, there are only a limited number of therapists who often have long waitlists for sessions. Across the board, access to mental health can be difficult across socioeconomic status. Even the wealthiest countries in the world like the U.S. have very high levels of mental illness relative to the availability of care and wealth. This disparity in treatment is largely attributed to income inequality between social classes. The greater the income inequality in a given country, the higher the rates of mental illness, as reported by the WHO (Pickett and Wilkinson, 2018). This is another example of how barriers can function at a societal level that make obtaining treatment difficult.

Lack of access to care is often a struggle for individuals in many different regions across the country and the globe. An extreme example of this is in the Democratic Republic of Congo (DRC) where there are only 11 clinical psychologists and 34 neuropsychiatrists in the entire country which has a population of over 2 million people (Ikanga, 2014). 30 out of the 34 of these neuropsychiatrists live in the capital city of Kinshasa, leaving four to service the remainder of the geographic region of the DRC which is the 11th largest country in the world, essentially the size of Western Europe (Ikanga, 2014). This sparsity of treatment is the case for many non-Western nations across the globe. An Instagram account titled @onedayinmyworld catalogues the personal experiences of people living with mental illness across the world, and it has published a photo series by National Geographic photographer Robin Hammond who focused on stories of people with mental illness in third world countries, particularly in sub-Saharan Africa. The photos highlight some of the biggest difficulties that people living in this region face, including the maltreatment many people struggling with severe mental illnesses receive by underfunded, understaffed, and undereducated institutions (In My World, n.d.). All of these examples are issues that many individuals face every day across the globe.

Finally, an issue at the heart of the mental health crisis is a lack of knowledge about where to go for mental health treatment. It can be difficult for many individuals who want to receive counseling or treatment and are unable to find a provider due to a lack of knowledge of where to go. For example, in a study conducted by Salloum et al., they found that the largest barrier to receiving treatment for childhood anxiety was, “not knowing where or from whom to seek services” (2016). They also noted that both stigma and transferred stress from parent to child was a treatment participation barrier. It can be difficult for many to access care due to a lack of knowledge about where to seek services, the distinctions between different mental health care providers (ex. clinical psychologist vs. clinical social worker), and whether or not the provider they have come into contact with is actually a good fit for the patient. These factors are all deterrents for people attempting to access mental health care.

The broad issue of negative impacts of mental illness can be broken down into several distinct areas that all contribute to the problem in a different way, and work together to create the negative atmosphere surrounding mental health access. Symptom management, lack of knowledge, stigma, and monetary restrictions all provide challenges for individuals to access much needed comprehensive treatments that could improve their quality of life overall. With this information, work needs to be done to help educate the public on the many ways mental illness manifests, that the stigma surrounding mental illness is damaging and work should be done to reduce its impact, and care itself is made more affordable and accessible to those who need it most.

References

Ahmedani B. K. (2011). Mental Health Stigma: Society, Individuals, and the Profession. Journal of social work values and ethics, 8(2), 41–416.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

African American Mental Health. (n.d.). Retrieved February 19, 2020, from http://www.nami.org/find-support/diverse-communities/african-americans

Ahmedani, B. K. (2011). Mental Health Stigma: Society, Individuals, and the Profession. Journal of Social Work Values and Ethics, 8(2).

Berchick, E. (2019, November 8). Health Insurance Coverage in the United States: 2018. Retrieved February 19, 2020, from http://www.census.gov/library/publications/2019/demo/p60-267.html

Bohnert, A., & Ilgen, M. (2019). Understanding Links among Opioid Use, Overdose, and Suicide. New England Journal of Medicine, 380(14), 1379–1380. doi: 10.1056/nejmc1901540

Chan, M. (n.d.). Mental Health and Development: Targeting People with Mental Health Conditions as a Vulnerable Group. Retrieved February 19, 2020, from https://www.who.int/mental_health/policy/mhtargeting/development_targeting_mh_summary.pdf

Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychological Science in the Public Interest, 15(2), 37–70. doi: 10.1177/1529100614531398

Donovan, A. (2018, October 22). University Counseling Center adds new counseling positions, increases mental health resources. Retrieved February 19, 2020, from https://www.bupipedream.com/news/98851/university-counseling-center-adds-new-counseling-positions-increases-mental-health-resources/

Glew, S., & Chapman, B. (2016). Closing the gap between physical and mental health training. The British journal of general practice : the journal of the Royal College of General Practitioners, 66(651), 506–507. https://doi.org/10.3399/bjgp16X687157

Green, A. E., Price-Feeney, M., & Dorison, S. H. (2020, February 6). Suicidality Disparities by Sexual Identity Persist from Adolescence into Young Adulthood. Retrieved February 10, 2020, from https://www.thetrevorproject.org/2020/02/06/suicidality-disparities-by-sexual-identity-persist-from-adolescence-into-young-adulthood/

Hedegaard, H. (2018, October 3). Products - Data Briefs - Number 330 - September 2018. Retrieved February 19, 2020, from https://www.cdc.gov/nchs/products/databriefs/db330.htm

Ikanga, J. (2014, December). Psychology in the Democratic Republic of the Congo: Its struggles for birth and growth. Retrieved February 18, 2020, from https://www.apa.org/international/pi/2014/12/congo-birth-growth

In My World [@onedayinmyworld]. (n.d.) Posts [Instagram Profile]. Retrieved February 5, 2020, from https://www.instagram.com/onedayinmyworld/.

Kidd, S. A., Howison, M., Pilling, M., Ross, L. E., & Mckenzie, K. (2016). Severe Mental Illness in LGBT Populations: A Scoping Review. Psychiatric Services, 67(7), 779–783. doi: 10.1176/appi.ps.201500209

Mental Illness. (n.d.). Retrieved February 19, 2020, from http://www.nimh.nih.gov/health/statistics/mental-illness.shtml

Pickett, K. E., & Wilkinson, R. G. (2010). Inequality: an underacknowledged source of mental illness and distress. British Journal of Psychiatry, 197(6), 426–428. doi: 10.1192/bjp.bp.109.072066

Rowan, K., Mcalpine, D. D., & Blewett, L. A. (2013). Access And Cost Barriers To Mental Health Care, By Insurance Status, 1999–2010. Health Affairs, 32(10), 1723–1730. doi: 10.1377/hlthaff.2013.0133

Rüsch, N., & Thornicroft, G. (2014). Does stigma impair prevention of mental disorders? British Journal of Psychiatry, 204(4), 249–251. doi: 10.1192/bjp.bp.113.131961

Salloum, A., Johnco, C., Lewin, A. B., Mcbride, N. M., & Storch, E. A. (2016). Barriers to access and participation in community mental health treatment for anxious children. Journal of Affective Disorders, 196, 54–61. doi: 10.1016/j.jad.2016.02.026

Santiago, C. D., Kaltman, S., & Miranda, J. (2012). Poverty and Mental Health: How Do Low-Income Adults and Children Fare in Psychotherapy? Journal of Clinical Psychology, 69(2), 115–126. doi: 10.1002/jclp.21951

Staff - Counseling: Binghamton University. (n.d.). Retrieved February 19, 2020, from https://www.binghamton.edu/counseling/staff.html

Originally Written for PSYC 361: Lab In Psychotherapy