It’s been a week since singer and mental wellness advocate Demi Lovato was hospitalized for a suspected drug overdose. People on Twitter are continuing conversations about her addiction and anxiety struggles. Andy Spade, the widower of late designer Kate Spade, posted an Instagram tribute to her, two months after her suicide. But while many openly share their trials with ADHD, anxiety, depression, addiction, PTSD and other conditions, stigma remains. That may be keeping people from seeking the treatment they need.
Americans are talking more than ever about mental health, making it an ideal time for a revolution toward mental wellness and prevention. Americans rank mental health the nation’s top concern over cancer and obesity. Yet, about two-thirds of people in the U.S. never visit a mental health professional themselves.
They’re not alone. Nearly as many people worldwide also say they never see a mental health professional. These are among the results of the Ipsos Global Advisor survey of 23,000 people’s views about healthcare. The comprehensive study covers personal health, technology, information and future expectations.
The numbers are telling given that suicide in the U.S. is at a 30-year high. More than half of the 45,000 people who died by suicide in 2016 did not have a diagnosed mental health condition, according to the Centers for Disease Control and Prevention.
The U.S. falls in the middle globally for people shunning mental health visits. Two-thirds of Canadians say they never go. More than four in five people in Japan don’t go. At least seven in 10 people in Spain, South Korea, Italy and France never see a mental health professional.
“It tells me that there’s obviously still a stigma or at least a perceived stigma for people who receive mental health treatment,” says Katie Joyce, senior vice president-healthcare services at Ipsos. Another factor behind the lower numbers could be that people may be turning to their primary care doctors for mental health treatment, she says.
Other factors hinder mental wellness
Why American society has yet to embrace mental health from a wellness perspective may be due to the separation of primary care versus specialization, says Joyce. She says that at least in American culture there is less focus on preventative than acute care where if someone has a cold or acute illness then they’re going to see a doctor. “Mental health is often called an ‘invisible illness.’ It’s not a runny nose or a cut finger. So, in most cases people aren’t pressing enough to understand that they have something that’s actually an illness,” says Joyce. “But it’s much more insidious in many cases.”
Still, the U.S. is one of a handful of countries that list mental health first among health concerns in their country. Globally, people rank mental health third behind cancer and obesity as the top health problem in their countries.
Barriers exist beyond stigma, Joyce says. One is access to care, which includes ease of scheduling, wait times, quality of care, and whether there are follow-up appointments. “Quality of care is underpinned by community context,” Joyce says. “What are the community factors if you live in a rural versus an urban area or if you are more conservative versus a liberal?” Insurance coverage is also an issue. These factors can affect the prevalence of care in the area.
Millennials lead the shift to wellness
But differences between generations surveyed signal a shift. Millennials are the least likely to avoid a mental health provider. Just half of people under age 35 never go (54%) versus GenX-ers (63%) and Boomers 50 (76%).
Attitudes are beginning to change and stigma is being reduced all the time, agrees Mark Covall, president and CEO of the National Association for Behavioral Healthcare in Washington.
“There’s more in the media about how mental illness is like other illness,” he says. “People are seeing more people speak out about mental disorders from family, friends, neighbors or famous celebrities. That’s making inroads but more needs to happen.”
The biggest shift in the future would be to work from a mental wellness rather than mental illness standpoint. “There’s growing literature and research that suggests that the mind and body are connected and we need to recognize that keeping a healthy mind results in a healthy individual,” he says. “A lot of it is recognizing potential symptoms earlier on.”