Like many of you, I was stunned when Prince Harry opened up in his new docuseries, “The Me You Can’t See,” co-created and produced with none other than Oprah herself. He speaks passionately and with authority about his own trauma and the treatments that have made a significant difference in his life. He also talks about mental health as a journey – an ongoing process similar to maintaining our physical health. His work and that of others continues to elevate mental health as a national priority. With Mental Health Awareness Month coming to a close, it is important to chart how far we have come and how the social sector can take important steps to create a “ripple effect” that touches many lives.
What is the problem?
First, let’s share the problem. According to the National Alliance on Mental Health Illness, 1 in 5 adults and 1 in 6 children ages 6-17 are experiencing some form of mental illness. In the United States, almost half of adults (46.4 percent) will experience a mental illness during their lifetime, and many of those individuals will suffer in silence. Because half of all mental health conditions begin by age 14 and 75% by age 24, it is important to address mental health issues early.
Mental health has always been important, but as a society, we are just beginning to understand and address the many barriers that prevent people from getting care. In 2020, more than 50% of adults needing help with a mental health issue during the pandemic did not receive services. To unpack why, the Bipartisan Policy Center just released a fascinating new poll of Americans. The good news – only 36% stated that not seeking treatment was associated with the stigma behind mental health, which means we have made some progress. The bad news – for those who want treatment, other major barriers exist, including affordability (51%) and availability of providers taking new patients (41%). These issues don’t just affect the United States. Other countries, such as Australia, are facing similar challenges. Based on the results, the Bipartisan Policy Council concluded that we can overcome these obstacles by “advancing integration of primary care and mental health and substance abuse services.”
Furthermore, mental health issues have far-reaching impact on our social systems. For example:
- 21% of people experiencing homelessness also have a serious mental illness.
- 37% of people incarcerated in state and federal prison have a diagnosed mental condition – with a staggering 70% of juveniles with at least one mental health condition.
- 41% of veterans have a diagnosed mental illness or substance use disorder.
- Depression is the leading cause of disability worldwide. Beyond the personal impact, depression and anxiety alone cost the global economy $1 trillion each year in lost productivity.
What can the social sector do to help?
1) Reduce the stigma through education and connection
False beliefs about mental illness are at the center of stigma and the resulting discrimination. It also impedes our public policy. Anti-stigma efforts fall into three categories: 1) education (replacing myths with knowledge, such as Time to Change’s 5-year campaign primarily for men called Be In Your Mate’s Corner, 2) contact (challenging prejudice through personal interaction or connection, such as Instagram’s #HereForYou project), and 3) protest (system strategies to suppress stigma, such as The Power of Okay by See Me Scotland). Taken together, they can provide a guide to correct misinformation and combat negative attitudes and discrimination toward those experiencing mental illness. In response to COVID-19 stress and related mental issues, Centers for Disease Control and Prevention (CDC) and the Ad Council has put together an integrated platform – COPING-19 – to share tools and resources.
2) Advocate for integrated care
If one good thing has come out of the COVID-19 pandemic, it’s that it has helped us recognize the importance of mental health and redouble our efforts to help those who need assistance. During this challenging time, many noted how intertwined physical health and mental health had become in our collective bubbles. This moment created an opportunity for Bill Smith, a former politico, to found Inseparable, a growing bipartisan coalition that recognizes and advocates for policies surrounding “mental health care as health care, period,” after his own family’s issues with mental health. The coalition has three goals: 1) increasing access; 2) investing in prevention and early intervention; and 3) ending criminalization of mental illness. Similar to other movements, Inseparable hopes to ignite a nationwide movement of support and action on mental health in the next few years.
3) Increase access to integrated care
In addition to reducing stigma and increasing support, we must change our system of care. In 2020, the Bipartisan Policy Center (BPC) convened a Task Force, co-chaired by former U.S. Senator John Sununu and former U.S. Representative Patrick J. Kennedy, to break down the barriers and develop policy solutions to integrate physical health, substance use and mental health services. The task force agreed upon 10 core recommendations for standards of care as well as policy recommendations for financing and tools and training to support providers. Based on initial studies, these recommendations would benefit more than 1 million Americans and cost the federal government a net of $2.2 billion over 10 years, including $6.9 billion in direct costs and $4.7 billion in direct savings. These calculations do not take into consideration the inevitable social return on investment of enhanced mental health diagnosis and treatment. Some of the recommendations include: 1) establishing core service standards to improve accountability for care integration; 2) providing financial incentives to build integrated care delivery; 3) creating a national technical assistance program for primary care practices to receive training; and 4) expanding Medicare coverage, including telehealth. In our recent blog post to the president and Republican leadership, we called out mental health as a missing link for pandemic relief. We firmly believe this report provides a path forward for properly treating mental health holistically and stemming the tide of the impact of mental health issues in the social sector.
4) Improve mental health and well-being at your nonprofit
Many people are attracted to the social sector because they have witnessed or experienced adversity. They want to fight within the system to make a difference. But with long hours, wages that don’t match the private sector, leadership challenges and highly stressful work environments (especially during COVID-19), nonprofit work may actually be contributing to mental illness. The CDC has a guide for workplaces with helpful tips. Some of our favorites include:
- Get trained in mental health – everyone on your team should have basic knowledge of mental health and how to create an environment supportive of mental health and other life challenges.
- Be clear about sick leave, including mental health treatment, and provide employees space for positive mental health practices, including quiet rooms, yoga and meditation areas.
- Provide comprehensive and integrated physical, mental and behavioral health insurance coverage, including round-the-clock access to employee assistance program (EAP) services. If possible, extend EAP access to anyone living in an employee’s home with dedicated programming for those who are caring for children or elderly parents.
- Require (not just encourage) resiliency training to reduce burnout and increase skills in empathy and compassion for staff members, especially those in caregiver roles.
- Reduce stigma by using pro-health, strength-based language. Review your marketing communications and grants for sensitive terms. For example, change “committed suicide” to “died by suicide.” Instead of “alcoholic,” use “person in recovery.” This guide provides many great word shifts.
After working in and around mental health for more than two decades, I can sense a transformation coming. As with any movement shift, it is subtle but continuous and is happening in unexpected places. Even if mental health is not your organization’s primary focus, we encourage you to conduct an audit to see how you can better address mental health for your clients, employees and volunteers. It is only when we talk about mental health that it becomes normalized. And, the social sector continues to be large part of the solution. We would love to hear your reaction to this post. Please feel free to share what has worked in your organization for the benefit of others.