Healing the Mental Health Crisis:

How Can We Make Mental Healthcare More Effective?

Dante Aguanno, Arcadia Calimano, Maggie Dickinson-Sherry, Shane Donaher, Jennifer Hodsdon,
Oliviah Gearhart, Jake Gothelf, Ryan Marshall, Grace Mu, Shamim Nyakoojo, Prerna Ranganathan 

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 Table of Contents
Overview​………………………………………………………………………………………………………… 3

Approach One: Eliminating Implicit Bias in the Mental Healthcare System​………………………………. 7

Approach Two: Combating Stigma Regarding Mental Health​…………………………………………… 10

Approach Three: Increasing the Accessibility of Mental Healthcare​……………………………………….13

Issue Brief Summary​…………………………………………………………………………………………... 17

Works Cited​……………………………………………………………………………………………………. 18

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 Overview
Statistics show that the quality of life in America has been improving over the last few decades: violent
crime has fallen since the 1990s, unemployment is at the lowest level since 1969, and the average American
lived 9 years longer in 2017 than in 1960 (Koons). Despite this progress, the mental health of the nation has
only declined. The U.S. suicide rate is at the highest level since World War II, and the rate is increasing each
year (Koons). In the last year, 17.3 million American adults reported having at least one major depressive
episode (Koons). In addition to being caused by genetic predispositions, mental illness is impacted greatly by
life circumstances. American citizens struggle with rising health-care costs, pressures from social media,
stagnant wages and few well-paying blue collar jobs, and growth in the opioid epidemic, all of which are
detrimental to their mental health.
Despite the consequences of a mental health crisis on Americans and the U.S. economy—mental illness
costs America $193.2 billion each year—the government has taken little action to alleviate the problem
(NAMI). Allocating money for mental health care is not prioritized, leaving citizens with insufficient access to
mental health services. In addition to low funding, the availability of mental health services is extremely low,
with 50 psychiatrists per 100,000 people in Washington, D.C. and only 5.3 per 100,000 people in Idaho
(Koons). The lack of mental health support meant that 60% of all adults and almost 50% of all youth “with a
mental illness received no mental health services in the previous year” (NAMI). Ultimately, until changes are
made by the government, no progress will be made and the mental health crisis in the United States will
continue to worsen.

Mental Health Crisis on College Campuses

As students transition to college life after high school, they have to adjust to “​being in a new
environment outside of the familiarity of home, combined with the ongoing strenuous nature of academic work,
disheartening political climates and economic uncertainty​” (Maine). All of “the lifestyle changes” contribute to
an increase in feelings of depression, stress and anxiety among college students (Solomon).
According to a survey conducted by the American Psychological Association in 2016, 52.7% of the
students on college campuses “reported feelings of hopelessness and 39.1% of students reported being severely
depressed” (Solomon). Additionally, data in 2018 showed that “​three out of five students experienced
overwhelming anxiety, and two out of five students were too depressed to function​” (Roy). From 2016 to 2018,
there was not a huge difference in the proportion of students that felt severe depression. With about 40% of
students feeling depressed, in addition to other mental health issues, there is a clear need to support students.
Even so, ​only about 10 to 15 percent ​of students in need actually get help from counseling services
(Roy). Others struggle on their own, negatively affecting their everyday lives and academics. Suicide is a major
consequence of deteriorating mental health, as “the suicide rate among young adults, ages 15–24, has tripled
since the 1950s” and it is “the 2nd leading cause of death among college students” according to the Centers for
Disease Control and Prevention’s 2016 Leading Causes of Death Report (Maine). Through the insight of
“approximately 600 universities and college counseling centers,” Penn State’s Center for Collegiate Mental
Health found in their 2019 annual report that self-threat was the highest in the 2018-2019 year and has been
increasing since 2010 (see fig. 1) (13).

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 Fig. 1. 2010-2019 data of self-threat on college campuses (Center for Collegiate Mental Health)
Colleges have implemented certain techniques to attempt to improve the mental health situation. The
University of Pennsylvania has a program called I CARE, which trains students and staff to build a “​caring
community with the skills and resources needed to intervene with student stress, distress, and crisis​” (Roy). A
professor at Santa Clara University, Chan Thai, incorporates creating campaigns related to mental health into
her class in order to teach students about the topic and reduce stigma (Roy). Initiatives like these are popular
across college campuses, but mental health is still a prevalent issue.

Challenges Involved in Addressing the Crisis

In 2018, the Cohen Veterans Network and the National Council for Behavioral Health released a study
titled “America’s Mental Health 2018,” in which the groups surveyed 5,000 Americans whose age, gender,
household income, and race/ethnicity were representative of the American population as a whole​. ​Surveyors
were able to identify four major barriers in their ability to access mental healthcare: high cost and insufficient
insurance coverage, limited options and long waits, lack of awareness, and social stigma ("New Study
Reveals”).
High cost and insufficient insurance coverage were identified as the top barriers by 42% of Americans,
with 25% admitting they were forced to choose between mental health treatment and paying for everyday
necessities ("New Study Reveals”). In terms of long waits, ninety-six million Americans (38%) have waited
more than a week for treatment due to the limited and inconsistent number of providers available ("New Study
Reveals”)​.​ Again, citing Washington, D.C. as an example, there were 50 psychiatrists per 100,000 people, while
in Idaho, there were 5.3 per 100,000 ​(Koons).​ The lack of awareness of treatment options was evident in the
29% of Americans that wanted to seek treatment, but did not know where to find the service ("New Study
Reveals”). Younger individuals (Gen Z and Millenials) often turned to unreliable sources such as Facebook,
Youtube, and Twitter rather than seeking professional help ("New Study Reveals”)​. The social stigma
surrounding mental health caused 31% of Americans to hesitate before seeking treatment because of a fear of
being judged ​("New Study Reveals”).
At college campuses especially, there is a failure to meet the demand for treatment. A study conducted
by the Center for Collegiate Mental Health analyzed data from 432 institutions and found that smaller colleges
were able to service a larger proportion of the student population than larger colleges (see fig. 2) (6).

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 Fig. 2. Relationship between enrollment at institutions and percent utilization of mental health services
(Center for Collegiate Mental Health)
The report also calculated the Clinical Load Index (CLI) of the counseling centers of the institutions and
used these scores to compare the schools based on multiple factors. The CLI is essentially a measure of the
number of “annual standardized caseloads” per institution (​Center for Collegiate Mental Health 10).​ A higher
CLI was associated with less intensive treatments (fewer appointments with more days in between)​ and less
success in combating depression, anxiety, and distress that the students were experiencing ​ ​(Center for
Collegiate Mental Health 10). These results are depicted in fig. 3 and fig. 4.

Fig. 3. Comparisons of CLI Score to appointment frequency measurements ​(Center for Collegiate Mental
Health)

Fig. 4. Comparison of CLI Score to distress index (​ Center for Collegiate Mental Health)

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 These results indicate a challenge in addressing the on-campus mental health crisis due to insufficient
resources. Many universities are understaffed to manage an increase in annual standardized caseloads. Some
colleges thus establish a limit on the number of counseling sessions that students can receive, and students often
have to wait a long time before they are given an appointment (Solomon).

Framework For Deliberation

This issue guide details three different approaches to tackling the mental health crisis both in general and
specific to college. This deliberation will ensure a discussion on the following possible solutions.

Approach One: Eliminating Implicit Bias in the Mental Healthcare System ​attempts to eliminate the
implicit bias present within the mental healthcare industry.

Approach Two: Combating Stigma Regarding Mental Health ​addresses the stigma that prevents many
people from seeking treatment to begin with.

Approach Three: Increasing the Accessibility of Mental Health care ​proposes making mental healthcare
resources more readily accessible to people.

The goal of our deliberation will be to decide which approach or aspects of the approaches provide the best
solution to the mental health crisis. Although there will be differing opinions, we hope that through our
discussion, we will be able to identify our common values and the reasons for disagreements.

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 Approach One: Eliminating Implicit Bias in the Mental Healthcare System
One way to ensure better mental health for teens and young adults is to eliminate the preconceived
biases mental healthcare professionals and educators may have about a student that could affect the diagnosis or
care that they receive. First, what is an implicit bias? It is in human nature to recognize patterns and categorize
things. Most of the time, the categorizations that people make for one another start to align with stereotypical
viewpoints. This unconscious stereotypicalization can affect the daily interactions shared between people, and
for those suffering with mental health, it can alter the way that they are diagnosed. “A 2017 systematic review
revealed that health care professionals exhibit about the same levels of implicit bias as the general population
does, and evidence indicates that biases are likely to influence diagnosis and treatment decisions in some
circumstances (UPMC).”
Disparities in mental health care services among racial/ethnic minorities remain a chronic problem (see
fig. 5). Most who try to seek healthcare are unable to receive adequate care. Men also receive less than adequate
care when referred to a mental health specialist.

Fig. 5. Table depicting racial and gender healthcare disparities (NIH)

Solutions
Have K-12 teachers undergo consistent implicit bias training and hire college counselors for students
with autistic spectrum disorders (ASDs).
- Although it could be argued that parents are the first line of defense in noticing a change in their child,
when entering the school system, children in the U.S. spend 7.5 hours on average in school each day
(U.S. Department of Education). So, arguably, the adult figures that children most interact with are their
schoolteachers. According to statistics released by the U.S. Education Bureau, out of the 3.8 million
K-12 educators, 80% of them are white and nine out of ten of them are female (U.S. Department of
Education). These demographics illustrate the cultural difference amongst the students and their
teachers. These cultural differences can impact the way in which teachers see mental illness in minority
students. The acting out, that for a white student could be seen as a cry for help, for a black or Hispanic
student might be seen as expected delinquency.
- Bias training will enable teachers to self-reflect on their own biases and teaching methods when
handling minority students. A study completed by Winthrop University showed that
implementing reflective teaching techniques into teacher candidates allowed them to consistently

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 examine their own thoughts, perspectives and biases (Merino). This helped create a more
culturally diverse classroom.
- In recent years, there has been an increase in the amount of students who are entering college with high
levels of ASDs (autistic spectrum disorders). During their time in college, these students face a
multitude of psychological challenges, so it is important that their assigned counselors are
knowledgeable about how to properly aid them. On October 9, 2019, President Trump signed the
Autism Care Act. This act allots 1.8 billion dollars for services for adults aged 18-24, allocating some of
those federal funds to encourage universities to hire counselors with experience working with students
who have ASDs (ASCA). This is in an effort to eliminate the biases that other counselors would have
while working with them.

Diversifying the “front lines” of mental healthcare.

- Studies have shown that students attending schools with more counselors have reported feeling more
supported (ASCA). Although minimal research has been directly conducted on the topic, professionals
in the UK reported that when students belonging to marginalized groups reflected on their experiences,
they had ill-thoughts regarding the aid that their guidance counselors provided (McAlpine). Despite the
fact that this survey was done in the United Kingdom, there are still certain factors that apply to the U.S.
Hiring professionals that reflect the demographic of the students will alleviate discomfort and
preconceived biases; particularly in communities where there is a large Latinx population. Due to the
discrimination that the Latinx community has experienced (especially during this past decade), Latinx
youth experience higher levels of depression, anxiety, and suicide rates than other youth in the country
(Foxen). Employing guidance counselors who are proficient in Spanish or are of Latinx descent would
greatly aid Latinx youth.
- Hiring teachers with diverse backgrounds:​ Diversifying educator staff to replicate the student
body of schools will eliminate initial biases that a teacher could have. This also forces teachers
to interact with co-workers of diverse backgrounds, which can improve the way that they handle
students of similar backgrounds. Creating a more comfortable student environment will make
mental illness signs more noticeable.
- Allotting grants to minorities who are becoming healthcare professionals:​ ​According to data
taken in 2017, 70% of the mental health professionals in the U.S. are white and the majority of
them are also female (Hahm). Allocating money for grants offered to minorities in the mental
healthcare profession will create more opportunities for those of lower socioeconomic status
seeking to obtain their doctorates.

Diagnosing the problem not the patient

- Not disclosing race or gender during a mental health screening:​ ​An initial health screening is
often completed through a survey that doctors review before seeing the patient. Providing
surveys that do not disclose the patient’s race or gender prior to an appointment will ensure that
doctors consider the patient’s symptoms based on their survey responses rather than their
demographic.
- ​Initial evaluation includes a team of psychiatrists:​ ​This idea is based on treating mental illness
similarly to physical illness. Usually, in a hospital setting, a team of doctors and nurses
contribute to the final diagnosis given by the lead doctor. Extending this approach to mental

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 health would mean that a team of doctors would evaluate the initial mental health screening
survey before each meeting with the patient.
- Choosing the best fit from the committee:​ ​The idea of a collaborative team effort also inspires
the idea of choice. Most people do not switch their therapist despite indications of discomfort or
incompatibility. Providing the option of choice of a counselor in the beginning will ensure that
patients receive the care that they believe they need.

Trade-Offs
Pros Cons
K-12 instructors may not have time to complete such
Providing implicit bias training will help create a
training because of their already demanding job tasks.
more inclusive classroom environment and will help
While bias training is important, should this
teachers identify signs of mental health illness.
responsibility fall solely on educators?
While reflective teaching is effective, it requires
Reflective teaching will allow teachers to reflect on management from administration. Delegating whose
how they are handling situations in the classroom and responsibility it would be to oversee a new program
how to adapt accordingly. when principles and vice-principals are already
overwhelmed could be an issue.
ASDs counselors will improve student life for Using part of the Autism Care Act’s funding for
students with mental disabilities and help them college counselors will detract from funding for group
navigate academic and social difficulties. homes and other services.
While diversifying classrooms is important, a
teacher’s job is to equip students with knowledge, so
hiring well-qualified teachers is more important than
Hiring more teachers of color will create a culturally
hiring a teacher because of their race, gender, or prior
diverse classroom. Teachers with similar backgrounds
socio-economic status. Additionally, there is a small
as students may be able to recognize signs of mental
number of minority teachers to choose from, so it may
illness more readily.
not be possible to change the cultural landscape of a
school staff to reflect a student body if there are not
enough minority teachers to begin with.
Creating grants for minority students to pursue careers
It isn’t clear where the funding will come from, as it
in the mental health profession will provide equal
may originate from mental health bills or from private
opportunity and ensure the employment of more
institutions.
minority therapists.
Not including race or gender while filling out an
Not disclosing information such as race or gender
initial mental health screening will remove the
might leave out information that could affect the
preconceived notions that may come disclosing those
diagnosis received.
demographics.
A team evaluation will ensure more than one This idea would require time and a complete
viewpoint is considered, eliminating the risk of a reconstruction of the mental healthcare industry to
singular biased doctor. Providing the patient with the make it possible.
option to choose a therapist after their first meeting
will make certain they receive satisfactory care.

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 Approach Two: Combating Stigma Regarding Mental Health
Focusing on understanding the stigma behind mental illness, enabling its reduction, is a key step in
alleviating the mental health crisis. Stigma regarding mental health comes in the form of both external stigma
and self-stigma. Stigma from others, often caused by fear or misunderstanding, indicates an individual or a
community is viewing those with mental illness in a negative way due to traits perceived as negative. Such
attitudes and beliefs toward people who have a mental health condition are common, especially in specific
communities (Mayo Clinic Staff). Self-stigma is also very prominent, which causes people to feel shame
regarding something out of their control (Greenstein). Stigma often prevents people from seeking necessary
help, with 40 percent of people with anxiety and depression from getting help ("Addressing Stigma”). Stigma
threatens the improvement of mental healthcare, since when a community stigmatizes, “a person picks up the
message and self-stigmatizes,” then doesn’t pursue treatment and thus “the symptoms and impairments of
mental illness are never tackled” ("Eliminating Stigma”).
Penn State found in its Center for Collegiate Mental Health’s 2019 report that the majority of counseling
service clients are women (see fig. 6) (2). Although women make up a larger portion of the general
demographic, they are only a little over half of the overall population, showing that the ratio of women to men
clients is still relatively high (Center for Collegiate Mental Health 2).

Fig 6. Table showing the portion of clients of each gender (Center for Collegiate Mental Health)
Men have been trained to have masculine ideals of self-reliance, strength, anger, success, etc, which is
toxic for their mental health (“7 Reasons Why”). These societal beliefs lead to men thinking that they should be
self-sufficient, or in other words, that asking for help will be looked down upon. They often do not discuss their
emotions, as they do not want to show any signs of weakness, and self-care is not a priority for them.
Joel Wong, leader of the Indiana University Bloomington research team, pointed out that people “who
conformed strongly to masculine norms tended to have poorer mental health and less favourable attitudes
toward seeking psychological help” (Marsh). The team’s findings were based on research from over 70
US-based studies based on “more than 19,000 men over 11 years” (Marsh). In Marsh’ article, some men were
asked to talk about their own experiences with mental health. One man, Chama Kay, admits that it took him
“three years, two failed relationships and one botched suicide attempt” to finally seek help, and further says
masculine norms “do not lend themselves to emotional vulnerability,” making it more difficult to obtain mental
healthcare (Marsh). Another male, Daniel Briggs, states, “The pressure to be manly stopped me getting help
earlier,” as he waited about a decade to get help before being diagnosed with clinical depression (Marsh).
According to a Psychology Today article, more than ¾ of suicide victims in the United States are men,
“with one man killing himself every 20 minutes” (Whitley). Additionally, the ratio of men to women for
substance abuse is 3 to 1 (Whitley). This is due to the fact that “men are significantly less likely to use mental
health services” as a result of the stigma about men and mental health (Whitley).

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 Stigma regarding mental health is also prominent in minority racial and ethnic groups. According to the
U.S. Department of Health and Human Services Office of Minority Health, “adult Black/African Americans are
20 percent more likely to report serious psychological distress than adult Whites” (​Armstrong 2019). Yet,
African Americans were less likely than Whites to seek treatment and more likely to stop treatment early
(​Armstrong 2019). This can be tied directly to stigma surrounding mental health, as a​ qualitative study found
that African Americans associated feelings of embarrassment and shame with seeking mental health treatment
(DeFreitas, Crone, DeLeon, & Ajayi 2018)​. In the Latinx community, individuals with relatives experiencing
depressive symptoms expressed discomfort with mentioning their affected relatives to others ​(DeFreitas, Crone,
DeLeon, & Ajayi 2018). A separate study ​published in the journal, ​Frontiers of Public Health,​ found that the
stigma beliefs of both African American and Latinx college students was directly correlated to an
underutilization of mental health resources ​(DeFreitas, Crone, DeLeon, & Ajayi 2018)​. Mental health stigma is
also a large issue in the Asian-American and Pacific Islander community, where seeking treatment is looked
upon with unease and shame because of an association with the word “crazy” ​(Tanap 2019). A cultural value of
independence and a respect for the challenges faced by immigrant parents leads many ​Asian-American and
Pacific Islander youth to avoid seeking treatment out of fear of appearing “weak” ​(Tanap 2019).
The effect of stigma on these different racial/ethnic groups is particularly evident in a study of 432
colleges conducted by the Center for Collegiate Mental Health. According to the study, the percentages of
minority students who sought mental health treatment were significantly lower than the percentage of white
students who requested the same treatment (see fig. 7) (Center for Collegiate Mental Health 23).

Fig 7. Table showing the portion of clients of each race/ethnicity (Center for Collegiate Mental Health)

Solutions
Improve education regarding mental illness
- Improve education both for people suffering with mental illness, as well as their families.
- By providing education and information to people diagnosed with mental health conditions and
their family members, participants can learn to challenge self-stigma and misconceptions
(“Psychoeducation”).
- Educating medical professionals and professional trainees
- The UK-based program Education Not Discrimination (END) attempted to create a way to
eliminate mental health stigma by running a study which educated medical students. The study
demonstrated an improvement, “particularly among students with less knowledge and more
stigmatising attitudes” at baseline, in the amount of stigma the professional trainees had
(​Friedrich​).

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Use policy changes to treat mental illness through the lens of neuroscience
- Treating mental illness as a biological condition, rather than just a social issue, will not only reduce
stigma, but allow for policy changes that can improve treatment (​"Eliminating Stigma”)​.

Trade-Offs
Pros Cons
Through improving education for people with mental It will be difficult to enact a widely used program for
illnesses and their families, external and self stigma education, since those with misinformed beliefs may
can be reduced by disproving misconceptions and be unwilling to learn about a topic they don’t believe
providing relevant information. is an actual issue.
By educating medical professionals and professional
Implementing and standardizing a new curriculum for
trainees, individuals who were initially hesitant to
medical education is costly and time-consuming,
seek treatment will have access to informed, credible
making this a difficult solution to execute quickly.
sources who they can consult with.
Treating mental illness as a biological condition
instead of a social issue will allow people to The current stigma is such an ingrained belief, that
understand the seriousness of mental illness, creating a widespread understanding of the biological
nature of mental illness would require education of
eliminating the belief that mental illness is an invalid many generations, which may not be feasible.
health concern.

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 Approach Three: Increasing the Accessibility of Mental Healthcare
From an objective standpoint, there are many people who have no access to mental health care at all.
The majority of people who cannot acquire sufficient health care treatment are people that live in rural areas and
people with low socioeconomic statuses.
Each year the government classifies specific regions as Primary Care Health Professional Shortage
Areas (HPSAs) when they do not meet a government mandated ratio of population to number of health workers.
From these classifications, 80 million Americans live in areas with a lack of mental health care workers (“State
and Federal”). Studies also show that 60% of rural Americans live in mental health shortage areas. Over 90% of
psychologists and psychiatrists and over 80% of all Masters of Social Work within the United States operate
exclusively in urban areas (“Mental Health”). In addition to a lack of accessibility due to location, many people
lack mental health care due to their socioeconomic status. A low financial status has stripped a number of
families of their ability to afford mental health care. As of 2018, 42% of Americans saw cost and insufficient
health insurance as the number one reason why they couldn’t get mental health care, and an astounding 25%
claim that they choose not to get health care because its cost would force them to lose the ability to pay for
necessities (“New Study Reveals”). Lastly, people of the age 18-25 (typically college students) are in the age
range most typically victim of mental illness (see fig. 8) but also have the lowest frequency of getting help for it
(see fig. 9). Thus, finding a way to give this portion of the population access to this necessity has proven itself
important. As a result of these statistics, increasing the accessibility of mental health care will involve giving
access to people in rural communities, people of low socioeconomic status, and people attending universities.

Fig. 8 Graph showing the distribution of mental illness between sex, age, and race/ethnicity (Mental Illness)

Fig. 9 Graph showing the distribution of people that received mental health services between sex, age, and
race/ethnicity (Mental Illness)

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Solutions
Increase the availability of mental health care to people that live in rural areas.
- Establish an online network in which people can communicate with therapists through video chatting
and other forms of communication by making any facility that can afford to provide this form of
treatment.
- This is a relatively new concept that has given people in rural communities the ability to receive
needed help even if they live very far away from any mental health facility, or even people in
urban areas who have trouble making the time to travel to a therapist outside of work hours
(“What You Need”).
- Mental health facilities can also be cheaper depending on an individual’s situation, however,
insurance companies rarely help pay for the costs of online therapy. An established online
network, that includes most of the larger mental health facilities may encourage more insurance
companies to get involved (“What You Need”).
- Pass legislation to provide tax incentives to healthcare workers in regions considered to be HPSAs.
- People have a misconception of rural areas, and frequently don’t understand that they face a
number of difficulties present in urban communities such as mental health struggles (“Mental
Health”).
- To show the severity of this issue: all of South Dakota has 4 child psychiatrists (“Mental
Health”). Other rural areas likely have a similar problem and this transportation could effectively
eliminate this inequality in distribution.

Make mental healthcare more affordable.

- Force mental health care facilities to be transparent about costs through legislation.
- If all facilities were up-front about the price of their services as well as their prescription
medication, patients could make more informed decisions about the appropriate course of action
for them (“Make Health Care”).
- As a result of the transparency, there would be a higher pressure for facilities to lower their price
to compete with rival companies (“Make Health Care”).
- Pass legislation to require hospitals and care providers to accept equal insurance policies for mental and
physical healthcare
- Currently, 28% of mental health therapists and 21% of mental health prescribers do not accept
insurance while only 3% of primary health care providers do not (see fig. 10)
(“Out-of-Network”).
- The corresponding increase in price, as a result of mental health therapists refusing to accept
various types of health insurance, creates a barrier blocking people from getting the help they
need (“Out-of-Network”).

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 Fig. 10 Graphs showing the percentage of people that have to pay for various mental health services without
getting supported by health insurance (“Out-of-Network”)

Increase accessibility to mental health care within colleges.

- Increase the number of mental health care workers in schools as well as their funding and resources
- The price of health care is certainly an issue for many students, especially if they feel
uncomfortable getting their parents greatly invested in their issues (Simon).
- Ideally the student-to-counselor ratio is between 1,000 to 1 and 1,500 to 1. Although this is
feasible at some schools, at larger schools such as Penn State it is incredibly difficult to maintain
this ratio.
- Train teachers to recognize and assist students that struggle with mental health.
- The University of Michigan, Georgia Technological Institute, and The University of Colorado
Boulder for example, release information to its faculty about mental health issue scenarios and
what to do to handle them (“New Study Reveals”)
- The classroom is the one location where a student is most likely to enter, so that may be the best
place to help those who are struggling (“New Study Reveal”)

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Trade-Offs
Pros Cons
Online health care makes healthcare professionals
Mental healthcare from an online source is not as
accessible to nearly everyone without forcing people
effective as face-to-face treatment.
to relocate or travel long distances.

Providing incentives for healthcare workers in

Incentives would lead to mental health professionals
non-HPSA areas would have a positive effect on the
leaving their urban areas, removing people from a
number of healthcare professionals in rural areas, and
mental health professional that they have established a
effectively encourage more people to become mental
connection with.
health professionals in general.

Government intervention through regarding insurance This may result in hospitals increasing the cost
acceptance in hospitals would enact immediate and requirements for physical healthcare to account for the
definite change to the mental healthcare system and decrease of the cost requirements for mental
the costs associated with it. healthcare.

The corresponding forcing of companies to decrease

Forcing mental health facilities to make prices
the cost of their services would likely decrease the
transparent would cause facilities to compete with one
quality of their service to some extent due to a
another, thus lowering the price everywhere.
decrease in funding.

Increasing the number of mental healthcare workers in

The corresponding funding would likely cause an
universities, as well as their funding and resources,
increase in the already-high tuition its students have to
would expose sufficient mental health care to the
pay, even if they don’t need the service.
portion of the population that needs it most.

Training teachers to recognize and assist students that

Some professors may not feel any inclination to get
struggle with mental health would greatly increase the
involved in their students’ lives as it would change the
frequency in which kids can receive the mental health
desired atmosphere of their courses.
care they need.

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 Issue Brief Summary
Today, more and more progress is being made to ensure a higher quality of life and longer life
expectancy. However, mental health in America continues to deteriorate, proving that there is indisputably a
mental health crisis in the United States. Despite this understanding that there is a crisis, views remain split on
regarding solutions and how communities should approach mental health. It is essential to come to an accepted
conclusion to ensure mental wellbeing for citizens across the United States and make the mental health care
system more effective. Three distinct approaches have been viewed, each with their own sets of pros and cons.
The first of these approaches focuses on eliminating implicit biases in regards to mental health. This includes
implementing bias training for teachers, and encouraging patients to talk with their health care provider to
refocus medical care on the hippocratic oath instead of race, sexuality, and other identities that often experience
biases. The second approach assesses the need to remove stigmas surrounding mental health. This includes
educating the common public about mental illness warning signs and promoting open conversations between all
people in regards to their mental health. Our third and final approach to making mental health care more
effective is to make resources more readily available by reducing the cost of care through new legislation and
methods of meeting with professionals and providing more mental health care in rural areas and schools. In
proposing these approaches, we hope to increase the effectiveness of mental healthcare and create a more
open-minded community.

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 Works Cited

Overview:

Center for Collegiate Mental Health. ​2019 Annual Report.​ 2020,

https://ccmh.psu.edu/files/2020/01/2019-CCMH-Annual-Report.pdf. Accessed 16 Feb 2020.

Koons, Cynthia. "Latest Suicide Data Show the Depth of U.S. Mental Health Crisis." ​Bloomberg Businessweek​,

20 June 2019,

www.bloomberg.com/news/articles/2019-06-20/latest-suicide-data-show-the-depth-of-u-s-mental-health

-crisis.

Maine, Dineo. "The Kids Are Not Alright: The Mental Health Crisis On College Campuses". ​Edsurge

Independent​, 14 July 2018,

https://edsurgeindependent.com/the-kids-are-not-alright-the-mental-health-crisis-on-college-campuses-d

ee6cf1b2190. Accessed 16 Feb 2020.

"New Study Reveals Lack Of Access As Root Cause For Mental Health Crisis In America". ​National Council

For Behavioral Health​, 10 Oct. 2018,

https://www.thenationalcouncil.org/press-releases/new-study-reveals-lack-of-access-as-root-cause-for-m

ental-health-crisis-in-america/. Accessed 15 Feb 2020.

Roy, Nance. "The Rise Of Mental Health On College Campuses: Protecting The Emotional Health Of Our

Nation’S College Students". ​Higher Education Today,​ 17 Dec. 2018,

https://www.higheredtoday.org/2018/12/17/rise-mental-health-college-campuses-protecting-emotional-h

ealth-nations-college-students/. Accessed 16 Feb 2020.

Solomon, Samantha. "Facing The College Mental Health Crisis: The Need For More Faculty Training". ​Best

Colleges,​ 12 July 2019, https://www.bestcolleges.com/blog/facing-the-college-mental-health-crisis/.

Accessed 16 Feb 2020.

18
Approach 1:

“Counselors.” Data USA, 2018, datausa.io/profile/soc/counselors.

Eunice C. Wong, Collins, R., Cerully, J., Roth, E., Marks, J., & Jennifer Yu. (2015). Effects of Stigma and

Discrimination Reduction Trainings Conducted Under the California Mental Health Services Authority:

An Evaluation of the National Alliance on Mental Illness Adult Programs. In Effects of Stigma and

Discrimination Reduction Trainings Conducted Under the California Mental Health Services Authority:

An Evaluation of the National Alliance on Mental Illness Adult Programs (pp. 1-29). RAND

Corporation. Retrieved February 19, 2020, from www.jstor.org/stable/10.7249/j.ctt19w7364.1

Hahm, Hyeouk Chris et al. “Intersection of race-ethnicity and gender in depression care: screening, access, and

minimally adequate treatment.” Psychiatric services (Washington, D.C.) vol. 66,3 (2015): 258-64.

doi:10.1176/appi.ps.201400116

McAlpine, D D, and D Mechanic. “Utilization of specialty mental health care among persons with severe

mental illness: the roles of demographics, need, insurance, and risk.” ​Health services research​ vol. 35,1

Pt 2 (2000): 277-92.

Merino, Yesenia, et al. “Implicit Bias and Mental Health Professionals: Priorities and Directions for Research.”

Psychiatric Services, vol. 69, no. 6, 2018, pp. 723–725., doi:10.1176/appi.ps.201700294.

Sejal Parikh Foxx, Stephen D. Kennedy, Merry Leigh Dameron, Amber Bryant. (2018) A Phenomenological

Exploration of Diversity in Counselor Education. Journal of Professional Counseling: Practice, Theory

& Research 45:1, pages 17-32

U.S. Department of Education. “Data & Statistics.” ​ED.gov,​ www2.ed.gov/rschstat/landing.jhtml?src=ft.

19
Approach 2:

"7 Reasons Why Masculinity Is Causing A Crisis In Men’s Mental Health". ​Thrivetalk​, 29 Oct. 2018,

https://www.thrivetalk.com/mens-mental-health-crisis/. Accessed 23 Feb 2020.

"Addressing Stigma." ​CAMH,​ www.camh.ca/en/driving-change/addressing-stigma.

Armstrong, Victor. “Stigma Regarding Mental Illness among People of Color.” ​National Council for

Behavioral Health​, 8 July 2019,

www.thenationalcouncil.org/BH365/2019/07/08/stigma-regarding-menta

l-illness-among-people-of-color/.

Center for Collegiate Mental Health. ​2019 Annual Report.​ 2020,

https://ccmh.psu.edu/files/2020/01/2019-CCMH-Annual-Report.pdf. Accessed 16 Feb 2020.

DeFreitas, Stacie Craft, et al. “Perceived and Personal Mental Health Stigma in Latino and African American

College Students.” ​Frontiers in Public Health​, Frontiers Media S.A., 26 Feb. 2018,

www.ncbi.nlm.nih.gov/pmc/articles/PMC5834514/.

"Eliminating Stigma is Key to Effectively Treating Mental Illness." ​UCSF Department of

Psychiatry,​ 9 Aug. 2016, psych.ucsf.edu/news/eliminating-stigma-key-

Effectively-treating-mental-illness.

Friedrich, Bettina, et al. "Anti-stigma training for medical students: the Education Not Discrimination project."

The British Journal of Psychiatry 202.s55 (2013): s89-s94.

Greenstein, Luna. "9 Ways to Fight Mental Health Stigma." ​NAMI: National Alliance on Mental

Illness​, 11 Oct. 2017, www.nami.org/blogs/nami-blog/october-2017/9-ways-to-fight-

mental-health-stigma.

Marsh, Sarah, and Guardian readers. "'As Boys, We Are Told To Be Brave': Men On Masculinity And Mental

Health". ​The Guardian,​ 24 Nov. 2016,

https://www.theguardian.com/commentisfree/2016/nov/24/as-boys-we-are-told-to-be-brave-men-on-mas

20
 culinity-and-mental-health. Accessed 23 Feb 2020.

Mayo Clinic Staff. ​Mental Health: Overcoming the Stigma of Mental Illness.​ 24 May 2017.

www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/mental-health/art-20046

477.

“Psychoeducation.” ​GoodTherapy.org Therapy Blog,​ 9 Sept. 2016,

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nami.org/Blogs/NAMI-Blog/July-2018/Why-Asian-Americans-and-Pacific-Islanders-Don-t-go.

Whitley, Rob. "Men's Mental Health: A Silent Crisis". ​Psychology Today,​ 6 Feb. 2017,

https://www.psychologytoday.com/us/blog/talking-about-men/201702/mens-mental-health-silent-crisis.

Accessed 23 Feb 2020.

Approach 3:

Gallimore, Alec D., et al. “A Friend at the Front of the Room.” ​Inside Higher Ed​, Inside Higher Ed, 2 Dec.

2019,

www.insidehighered.com/views/2019/12/02/professors-should-be-more-involved-helping-students-mental

-health-challenges.

“Make Health Care Work Better For America.” ​U.S. PIRG,​

uspirg.org/issues/usp/make-health-care-work-better-america.

“Mental Health and Rural America: Challenges and Opportunities.” ​National Institute of Mental Health,​ U.S.

Department of Health and Human Services,

www.nimh.nih.gov/news/media/2018/mental-health-and-rural-america-challenges-and-opportunities.shtm

l.

“Mental Illness.” ​National Institute of Mental Health,​ U.S. Department of Health and Human Services,

www.nimh.nih.gov/health/statistics/mental-illness.shtml.

21
“New Study Reveals Lack of Access as Root Cause for Mental Health Crisis in America.” ​National Council,​

National Council for Behavioral Health,

www.thenationalcouncil.org/press-releases/new-study-reveals-lack-of-access-as-root-cause-for-mental-he

alth-crisis-in-america/.

“Out-Of-Network, Out-Of-Pocket, Out-Of-Options: The Unfulfilled Promise Of Parity.” ​NAMI​, NAMI,

www.nami.org/about-nami/publications-reports/public-policy-reports/out-of-network-out-of-pocket-out-o

f-options-the

Simon, Caroline. “More and More Students Need Mental Health Services. But Colleges Struggle to Keep Up.”

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olleges-struggle-to-keep-up/37431099/.

“State and Federal Efforts to Enhance Access to Basic Health Care.” ​Commonwealth Fund,​ 2009,

www.commonwealthfund.org/publications/newsletter-article/state-and-federal-efforts-enhance-access-bas

ic-health-care.

“What You Need to Know before Choosing Online Therapy.” ​American Psychological Association,​ American

Psychological Association, www.apa.org/helpcenter/online-therapy.

22