Mental health

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About

Mental health encompasses emotional, psychological and social well-being and includes the misuse of substances such as alcohol and drugs. It affects our ability to learn, work, respond to stress, navigate, interact with and participate in our communities. Mental health influences and is influenced by our physical health.

Relationship to health and equity

About one in five people in the U.S. experience mental health conditions each year. Mental health conditions include depression, anxiety, personality and psychotic disorders and substance use disorders. Suicide rates have increased by 37% since 2000 and adolescent mental health issues are at an all-time high.

Groups of people who have been historically marginalized by society are more likely to experience certain mental health conditions. For example, American Indians, Alaska Natives and veterans are more likely to experience post-traumatic stress disorder and LGBTQ+ individuals and gender and sexual minorities are more likely to experience depression, anxiety and substance misuse, in part due to the widespread experience of stigma and discrimination.

Less than half of Americans with mental health conditions receive treatment, and those numbers are even lower for marginalized groups. For example, 25% of individuals who are Black seek treatment, versus 40% of those who are white. Less than one in four people needing substance use treatment get the help they need due to lack of treatment facilities, cost, distance and stigma.

Relationship to systems and structures

Mental health conditions, including substance misuse, have long been stigmatized by society, viewed as moral or spiritual failings and seen as a source of shame for both the individuals who suffer from these conditions and their families. People with mental health conditions were intentionally excluded from society or isolated in homes or asylums. Those living in institutions were often subject to ineffective, cruel and exploitative treatments.

While attitudes have shifted and mental health care has become more widely available, stigma remains, along with mistrust of the system to provide care without exploitation or harm. Inadequate insurance for mental health care and a lack of providers reduce access to mental health care for populations that have been under resourced and disenfranchised, including racially and ethnically minoritized groups, individuals with low incomes, sexual and gender minorities, and other disadvantaged populations. The criminalization of drugs starting in the 1980s and the closing of psychiatric hospitals in the 1950s without adequate community-based facilities for people with mental illness resulted in jails being the largest mental health facilities in the country. However, jails are neither designed nor staffed to provide these services.

However, when we organize together we can change systems. The National Alliance on Mental Illness (NAMI) started with two mothers who were frustrated by the lack of services for people with mental illness and is now the largest grassroots mental health organization. NAMI has contributed to expanding access to mental health services through the Affordable Care Act and creation of the 988 Suicide and Crisis Line.

Additional Readings

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Measures