Our world is in the midst of a massive mental health epidemic that shows few signs of abating. 800 million people globally struggle with their mental health, dealing with challenges ranging from anxiety to depression, PTSD to suicidality. Suicides are peaking globally across every demographic — having increased 25 percent since 1999 in the United States alone; and the opioid epidemic now claims 200 lives each day.
In the wake of COVID-19, the New York Times recently noted that: "a third of Americans were showing signs of clinical anxiety or depression at the end of April...In early May, half of those surveys said they felt, 'down, depressed or hopeless,' double the number who responded that way in a 2014 national survey."
Mental health struggles represent the largest cause of disability in the world, adversely impacting families, workplaces, and communities and costing the US over $60 billion annually. Half of those who might benefit from treatment will never seek it. The remainder will struggle to connect with their mental health provider or find appointments impossible to obtain. The nearly ubiquitous focus on so-called evidence-based treatments is a large part of the challenge, as reflected in a great article by psychologist Dr. Jonathan Shedler: Where is the Evidence for Evidence-Based Therapy.
Our mental health system — focused on symptom management and mitigation — has proven ineffective for the vast majority of those who struggle, and most concerning, may in fact be preventing them from living well. This was reflected in the recent words of Dr. Thomas Insel, the former director of the National Institute for Mental Health: “Are we somehow causing increased morbidity and mortality with our interventions?”
We have spent the past six years exploring every facet of the mental health system to understand why the current approach and treatments are not working for so many. We have concluded that there are three root causes:
1) Philosophy: our mental health system has codified the problematic notion that times of trauma and struggle are permanently diminishing. Those struggling are taught they should learn to live with their “new normal” and rely on pharmaceuticals to feel less bad. This in anathema to what we understand about successful approaches, and the importance of a growth mindset, as noted in a May 2017 Journal of the American Medical Association editorial: “...what is clear is that instilling a growth mindset in patients about their belief in the capacity to change is an important precursor to health and healing.”
2) Connection: in an attempt to rapidly meet growing mental health needs, new professionals have been trained in what to do rather than how to do it. The result is protocol-driven approaches that make patients feel like broken things needing to be fixed, and a profound lack of connection between patient and provider. This also results in impairment, where professionals who are not practicing they way they know they should struggle; adversely impacting their ability to meaningfully support their clients. A self-reported American Psychological Association survey found that 50 percent of providers reported being impaired by burnout, anxiety, or depression.
3) Innovation: despite all of these challenges, mental health providers remain averse to innovation.
The result is a system that can perpetuate a mindset of brokenness and hopelessness, where the cure is often worse than the disease — an idea captured in a quote by Moliere: “Most men die of their remedies, and not of their illnesses.”
It is imperative that we transform our mental health system from one of pathology to progress, trauma to thriving, struggle to strength. Boulder Crest Foundation is the leader in that effort.