Changes in health care, prevention services help millions who struggle
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Children can’t necessarily explain where it came from but now they can feel it. They might feel numb or ‘I cry myself to sleep every night but I don’t know why’ ... It’s just being able to normalize that it’s OK to not be OK.”
Andrea Magana, Southwest Behavioral & Health Services
If your mental state has made it difficult to do well at work or school, you’re not alone. It is estimated about one in five U.S. adults suffers from a diagnosable disorder in a given year.
In 2021, that meant 57.8 million people lived with a mental illness.
The Centers for Disease Control and Prevention labeled depression as the leading cause of disability for adults aged 18-44 more than 10 years ago, and the illness remains a top disability — a fact that illustrates the prevalence and severity of the state of the mind.
Mental illness includes depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors, and can vary widely in type and severity.
The challenge of mental health as a leading disability is that it’s an invisible ailment. Unlike what may have historically been thought of physical disabilities, mental health is invisible to others and can ebb and flow throughout one’s life.
Dr. Craig Sawchuk, a psychologist with Mayo Clinic, says there’s been a fragmentation between physical health and mental health as being two different things that don’t interact, when they actually do.
“Mental health is just part of health, it’s part of overall health,” Sawchuk said.
Graphic by Independent Newsmedia/Erik Maurer
Changing views
A shift has begun, Sawchuk says, where a clearer picture of the world’s population is emerging as disability and mental health are examined. He says mental health can be completely disabling, and the more those symptoms are hidden or kept private, the more a stigma is reinforced and people feel trapped.
“We’ve seen this across time with both prevalence rates of mental health conditions and disabilities associated with that changing over time. Every time we seem to run a new epidemiological study, the rates of depression, anxiety and other mental health conditions keep rising,” said Sawchuk.
A mental health disability is defined by the U.S. Department of Labor as a mental impairment that substantially limits a major life activity. There is not one agreed upon definition of a mental health impairment, the DOL website states.
“The world actually is a very stressful place,” said Sawchuk. “There’s a lot of unpredictable and uncontrollable stressors that are going on at multiple levels.”
Sawchuk points to the COVID-19 pandemic — unpredictable and uncontrollable — and how it hit the public.
“(The pandemic) has increased the incidents of symptoms and disorders associated with depression and anxiety with isolation, dramatic changes in stability, disruptions in relationships,” Sawchuk said. “We think of some of the socio-political stressors going on too, we’ve seen without a doubt an evolution of that.”
Some positive has come about as well. Sawchuk says people are more comfortable talking about their mental health and how the stigma around that has decreased because of the pandemic.
While more people reporting their mental health struggles will inevitably increase the statistics, it is helping health care professionals better understand the population.
“I think this is actually a good shift. If we think about it looking at a population, people are much more willing to endorse symptoms of anxiety and depression whereas historically, maybe less so,” Sawchuk said.
While the stigma around mental health may be dissolving, Sawchuk says changes within health care facilities could help more people get services. For example, having mental health specialists available at a person’s primary care physician may lead more people to find solutions for their ailments.
“A lot of time when people are struggling, say with anxiety or depression, their first thought is not ‘I need to go see a psychologist.’ No, they’re usually trying to work within primary care,” Sawchuk said. “Being able to work out of the primary care setting, we’re able to catch people earlier in their course of illness, we can collaborate with primary care teams on the overall health of individuals, and it reduces stigmas — they’re being seen for their mental health care right in the same place they see their other health care.”
Graphic by Independent Newsmedia/Erik Maurer
Services to help
Despite more people discussing their mental health, tragedy still strikes often.
In 2019, the Pan American Health Organization stated suicide is the third-leading cause of death for Americans ages 15 to 29. John Hopkins Medicine states most people who die by suicide have a diagnosable mental disorder, most commonly a depressive disorder or a substance use disorder.
At Southwest Behavioral & Health Services, Andrea Magana, a program director for inpatient crisis, helps those in trouble regain stability.
“The members I receive here are members in crisis, they’re members who are in the ICU because they just attempted to kill themselves — so they really are at their worst,” Magana said. “Our job is to help them journey along that recovery phase.”
Magana says crisis stabilization is provided through counseling or medication, as well as a place to be safe. SB&H’s inpatient crisis department has a number of steps for patients to work through to gain independence. When a person is ready to discharge from SB&H, they go through various services first starting at a place with 24-hour support, like a group home, and then slowly moving into places with more independence.
“SB&H covers a huge platform of services for someone to go from the worst of the worst to being the best of their best,” Magana said.
Magana points out depression is a silent disability that we can’t put a finger on at times, especially for youth.
“Children can’t necessarily explain where it came from but now they can feel it,” Magana said of depression. “They might feel numb or ‘I cry myself to sleep every night but I don’t know why’ ... It’s just being able to normalize that it’s OK to not be OK.”
Magana wants youth to know that it’s OK to speak with someone who’s not just your mom and dad. SB&H has partnered with schools to provide services to prevent mental health crisis from happening to students. She says they have professionals who will work with children as young as kindergarten.
“We can teach people if you feel this way, what are some health ways to cope with it so it does not become a disability, it doesn’t become disabling so you can perform at work or taking long absences of leave because they can’t get up from bed?” Magana said.
The entire SB&H organization served more than 28,000 people in 2022, officials there said.
Managing Editor Melissa Rosequist can be reached at mrosequist@iniusa.org. We’d like to invite our readers to submit their civil comments, pro or con, on this issue. Email AZOpinions@iniusa.org.
Melissa Rosequist Managing Editor | East Valley @mrosequist_
I first started my journalism portfolio at the age of 15 while in high school before going on to study at the Walter Cronkite School of Journalism and Mass Communications. Being in the journalism field is the only professional avenue I was ever interested in, and have worked hard covering topics from school boards to hard news while working for the Independent, where I have been awarded for my reporting.
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