World Mental Health Day – A Time to Increase Our Understanding

Last week on October 10^th the world celebrated World Mental Health Day which gave everybody an opportunity to re-kindle our efforts to protect and improve mental health. The number of people with a mental health disorder was growing even before the COVID-19 pandemic with an estimated one in eight people affected with some form of mental health disorder. The pandemic exacerbated the problem with some estimating the rise in both anxiety and depressive disorders at more than 25% during the pandemic’s first year. This, coupled with people sequestering themselves which disrupted many of their mental health services, worsened the treatment gap for mental health. These statistics magnify the importance of taking the time to consider how we can make a difference in the understanding and treatment of mental illness.

I think many people my age have had their perspective of mental illness change over the years. When I was young people never talked about their friends or relatives who had mental health disorders. It was not uncommon for people to reject a mental health diagnosis of themselves or a loved one. Often there was a lack of insurance coverage for many mental health disorders.

Things slowly began to change with some of the stigma of mental health disorders yielding to more education and understanding. But for many of us, mental illness was something that happened to other people, so we didn’t pay much attention. I can tell you from experience that it suddenly comes into focus when a loved one begins to suffer.

One of the amazing statistics that came out of the pandemic was the fact that those 65 and older was the age group least affected by increased anxiety and depression. Here we were, the age group that had the most deaths from COVID-19, seemingly not affected by the strain of this worldwide illness. This might be due to the fact that our life experiences had taught us that we could do tough things and also that we knew the importance that a family played in helping us through anxious times. We are certainly not through the woods yet with inflation, the threat of a recession and the war in Ukraine, adding to our anxiety.

So, what can we do to help? First, we can advocate for a broader range of effective mental health services. There has been an understandable reluctance to cover mental health disorders in the past due to the difficulty in diagnosing a specific disorder and the problems with prescribing an effective treatment. Mental health treatments are often long term and can prove to be costly. More and more effective medicines and treatments are being discovered and can be brought to bear. The loss of productivity for the patient and the time and money spent by those who care for the patient are certainly reason enough to justify the cost. We need to advocate for finding a balance in supporting the coverage of mental illnesses. One immediate way is supporting the continuation of Medicare’s payments for telehealth. It has been shown that mental health services via telehealth, meaning all non in-person treatments like video conferencing, phone, on-line forums, and texts of phone apps, have been effective in treating anxiety and depression. We’ve all become more comfortable in these last two years with zooming and webinars. This opens the doors to less costly approaches to mental health treatments and would be a big step in finding the balance between cost and effectiveness.

Another way we can improve the treatment of mental health disorders is by supporting those who are the caregivers for the patients. Employers need to broaden their support of time off for those who care for those with mental illness. The government can also help. For at least 20 years, that I know of, there has been a movement to offer tax relief for those who are caregivers for sick loved ones. It’s always been a battle over how to regulate the benefit but in these days of constant contact and communication there has to be a way for those who give care to rightly claim and be compensated at some level for their service. It has been shown that this uncompensated care saves money in the long run by keeping patients out of costly institutions and expensive long term care situations. A tax break would, in a small way, ease the burden of those unselfish caregivers.

Mental illness is difficult to diagnose and sometimes to understand. Lately I’ve seen a commercial of a young man crossing a street and suddenly confronting a second person who is another him. They fight and wrestle with each other, while people around them go on about their business, with the second person suddenly disappearing and the original guy left by himself, unnoticed and alone. It helped me understand how difficult it is to wrestle with yourself and your mental illness while very few people even notice or understand what you’re going through. We all need to recognize and seek to better understand how debilitating mental illness is and strive to support programs that help treat this growing mental health epidemic.

Best, Thair