By Caitlin O'Brien
The scope of public health has grown tremendously over the past century. With the emergence of germ theory, the sanitation revolution, rise of chronic disease and new understandings of health disparities, the field has seeped into many aspects of society that affect our health. Despite this ongoing expansion, there is a serious threat to our health that is rarely discussed among public health professionals – mental illness.
One in 4 American adults have a diagnosable mental health condition – a rate that is only slightly less than obesity and more than double that of diabetes. Those living with serious mental illness have a life expectancy that is 25 years lower than the general population. Individuals with mental illness are more likely to be homeless and incarcerated. They are at higher risk of developing chronic physical health conditions, dropping out of high school and committing suicide.
And if you aren’t convinced by the health implications, be convinced by the economic ones: over $190 billion in earnings are lost every year due to serious mental illness; almost 32 percent of all disability recipients (both Supplemental Security Income and Social Security Disability Insurance) suffer from a mental health condition; and, due to the failure of Medicaid expansion in so many states, nearly 4 million individuals with mental illness will remain uninsured.
Think it’s time for public health to pay attention?
Unfortunately, the most common side effects of mental illness seem to be stigma and lack of funding. For reasons that are deeply engrained in our history and culture, discussion of these issues is off the table for many Americans. A CDC study done in 2007 showed that only 25 percent of those suffering from mental illness believed people were caring and sympathetic to the mentally ill population. And while most adults agreed that seeking treatment can help people lead perfectly normal lives, nearly 60 percent of individuals with mental illness fail to do so.
But even when someone is ready to seek treatment, they may be rebuffed by underfunded programs and lack of insurance coverage. From 2009-2012, 29 states cut their funding for mental health programs. Pennsylvania cut $6 million, which pales in comparison to New York’s $204.9 million cut and California’s appalling $764.8 million cut. Though the Mental Health Parity and Addiction Equality Act was passed in 2008, it took the federal government five years to finalize regulations. And, insurance comapanies are brazenly and unabashedly subverting the law.
As a field we need to be more thoughtful and strategic about how to approach the issue of mental health. Let’s pool resources to end stigma and fight to integrate treatment with the already existing physical health infrastructure. Let’s not hush the issue anymore.