Mental health professionals like me often write about things such as the discrimination we call stigma, or the need for greater awareness of and funding for treatment services, or the powerful, life-changing work accomplished by treatment and service professionals every day throughout our state and nation. While all this is solidly true, let’s think about it in a new way: We need a public health approach to mental health, every bit as organized and urgent as the COVID-19 pandemic, to reverse some alarming trends in the health of our population.
Much data paints the picture of this trend. Consider, for example, that the CDC projects 2022 to have a record number of suicide deaths. The number is over 49,000 which, if you think about it, is about 12,000 more than the seating capacity of Fenway Park. For young people between the ages of 10 and 34, this is either the second or third reason for the end of life. In 2021, over 1.7 million of us reported at least one suicide attempt.
Related to this, the CDC also reports that there has been a sharp increase in deaths by poisoning between 2006 and 2020 – from less than 10 deaths per 100,000 to almost 27 deaths. This is related to overdose deaths from drug addiction. On top of that, a new report reveals that only 39 percent of Americans feel they are very connected to others. Loneliness and the lack of social connection increases the chance of premature death by up to 29 percent.
Close to home, in 2021, just under 14,000 New Hampshire kids participated in the national Youth Risk Behavior Survey, reports Traci Fowler of the NH Charitable Foundation. Like children and teens all over the U.S., the pandemic hit mental health hard. Some 44 percent reported feeling sad or hopeless and a quarter of respondents said they seriously considered suicide, an increase of 18 percent from 2019. Assuming that Granite State students are typical of their counterparts in the other 49, it explains why U.S. Surgeon General Vivek Murthy maintains that “mental health is the defining public health and societal challenge of our time.”
According to the World Health Organization, public health is “the art and science of preventing disease, prolonging life, and promoting health through the organized efforts of society.” If we are smart, our organized efforts will factor in the social drivers of mental health problems, as well as access to affordable, sustainable, and effective community mental health services.
Social drivers encompass things not often associated with “health.” They are factors including behaviors that either support or reduce health (tobacco use, diet and exercise, drug use, sexual activity, food security), the environment we live in (transportation, nature, pollution), and socio-economic elements (education, job status, family and social support, income, community safety). Together, these drivers account for 80 percent of health, while access to care and the quality of that care is only 20 percent of the influences.
With that in mind, it would do well if our New Hampshire public health strategy on mental health for both young people and adults adopted an approach that did more to prevent disease and not just treat it. The United States health care industry has not been built on a public health strategy; most often, we wait for someone to become sick before we step up. Then, some party spends money and some other party earns revenue.
A public health approach to mental health needs to involve everybody: young people, family members, educators, health care professionals, print and social media, community organizations, employers, funders, and foundations.
Neither the full power of state government nor the entire U.S. health care system can shoulder the burden of skyrocketing mental health needs evident today. If we are ever going to reverse these ominous trends, it will take all of us to take steps to improve our own mental health for ourselves and our loved ones. It will take communities to be places of welcome, support and positive relationships. It will take businesses and industry to be mindful of the full scope of the health of each person involved in their enterprise.
Perhaps the old proverb rings true: “If you want to go fast,” it instructs, “go alone. If you want to go far, go together.”