Mental Health Issues in the 21rst Century

I wrote a chapter in my book about mental health issues, which are close to home for me. I consider the term, “mental illness” in and of itself, a disservice to those of us who occasionally struggle with our mental health issue.  A mental health diagnosis is like any other diagnosed condition: Defined by criteria and when appropriately treated, a state of wellness is achievable with treatment. Mental health issues need not constitute a continuation of a state of “illness”. In the physical, medical world, if one is “ill”, one is actively sick. Properly treated, persons with mental health diagnoses are no different than persons with an appropriately treated chronic medical illness, like hypothyroidism, or glaucoma, or diabetes, or Crohn’s disease, or rheumatoid arthritis, or…. I could go on. For most of us, if we did not reveal we had a mental health diagnosis, one would never suspect it.

Here are some statistics on mental health diagnoses:

Key Findings

  • Over 44 million American adults have a mental health condition. Since the release of the first State of Mental Health in America report (2015), there has only been a slight decrease in the number of adults who have a mental health condition (from 18.19% to 18.07%)
  • Rate of youth experiencing a mental health condition continues to rise. Therate of youth with Major Depressive Episode (MDE) increased from 11.93% to 12.63%. There was only a 1.5% decrease in the rate of youth with MDE who did receive treatment. Data showed that 62% of youth with MDE received no treatment.
  • More Americans are insured and accessing care. We can continue to see the effects of healthcare reform on the rate of Adults who are uninsured. This year there was a 2.5% reduction in the number of Adults with a mental health condition who were uninsured.  
  • …But many Americans experiencing a mental health condition still report having an unmet need. 1 in 5, or 9 million adults reported having an unmet need.
  • Mental health workforce shortage remains. Many states saw some improvement in their individual to mental health provider ratio. But in states with the lowest workforce there was almost 4 times the number individuals to only 1 mental health provider. (Mental Health America, 2019)

From this same website, Mental Health America, statistics for my home state, North Carolina, show a rate of 18.98% of adults have some type of mental health issue. Substance abuse affects 7.03% of our population. Those adults in North Carolina who have serious thoughts of suicide are 4.23% and persons in North Carolina who have any mental health issue and do not get treatment constitute 50.7% of the population. (Mental Health America, 2019)

From the National Alliance on Mental Illness, (who I have contacted regarding the use of the word “Illness”), the site states:

“A mental health condition isn’t the result of one event. Research suggests multiple, linking causes. Genetics, environment and lifestyle influence whether someone develops a mental health condition. A stressful job or home life makes some people more susceptible, as do traumatic life events like being the victim of a crime. Biochemical processes and circuits and basic brain structure may play a role, too.” (National Alliance on Mental Illness, 2019, para. 3)

In addition, on the National Alliance on Mental Illness, (NAMI), it also relays:

“If you have a mental health condition, you’re not alone. One in 5 American adults experiences some form of mental illness in any given year. And across the population, 1 in every 25 adults is living with a serious mental health condition such as schizophrenia, bipolar disorder or long-term recurring major depression.

As with other serious illnesses, mental illness is not your fault or that of the people around you, but widespread misunderstandings about mental illness remain. Many people don’t seek treatment or remain unaware that their symptoms could be connected to a mental health condition. People may expect a person with serious mental illness to look visibly different from others, and they may tell someone who doesn’t “look ill” to “get over it” through willpower. These misperceptions add to the challenges of living with a mental health condition.” (NAMI, 2019, paras. 1-2)

I also noted even the NAMI site does not give a description or note bipolar II disorder, which I have. Bipolar II disorder does not have severe mania. It does have a specific type of depression and antidepressants either are not effective or make the person worse. In bipolar II disorder instead of mania, there may be a period-or more-of hypomanic episodes. Bipolar II disorder leaves the person able to often recognize this trend and seek additional treatment to short circuit the episode. The two disorders are similar to a point, and then branch off into their unique specifics. (I emailed NAMI to ask them to please include bipolar II disorder and its description on their website.)

There have been many public persons who have struggled with mental health conditions, some of which came forward to bring awareness to the conditions. Per Web MD. persons such as, Mariah Carey, Demi Lovato, Brian Wilson, Russel Brand, Kurt Cobain, Jimi Hendrix, Ernest Hemmingway, Mel Gibson, Catherine Zeta-Jones, Vivian Leigh, Frank Sinatra, Jane Pauley, Carrie Fisher, and Winston Churchill all have or had bipolar disorders. (Reviewed by Arefa Cassoobhoy, MD, MPH in October 2017, 2017)

Depression as a diagnosis is, I think, one of the less stigmatized, although much of the public vary with the attitude depression is a state of mind that indicates one is not appreciative of their life on this earth or they could will the depression away if they so choose.  And, there are those who think the diagnosis of depression means someone will inevitably commit suicide. Neither is true, of course. If one thinks about mental health conditions, many require medications to reset the person’s brain chemistry. If mental health conditions were just a state of mind, why would medications resolve the issue? Makes no sense, does it?

Because mental health conditions are so stigmatized-even by the medical community-many persons just don’t want to know or do not wish to take medications, so they avoid treatment. It would be akin to a diabetic refusing to diet or, if needed, take medication for his/her high blood sugar. Or someone with a thyroid condition refusing to replace his/her thyroid hormone. If the public would stop considering anyone with a mental health diagnosis as dangerous or weak, it would go a long way to preventing persons with mental health issues using drugs or alcohol to self-treat their symptoms, (Ernest Hemmingway, Carrie Fisher, Demi Lovato, Winston Churchill, and Jimi Hendrix for examples). Just because I have bipolar II disorder does not indicate I am less than one without a mental health diagnosis. And, if one in five Americans have some type of mental health issue in their lifetime, chances are you are somehow associated with someone-whether you know it or not-who has a mental health condition. I am on medication and have been stable for over 15 years since I finally broke down and sought help for my very severe depressive episodes. It took a lot to admit the psychiatrist was right and that I did not just have depression, but my past showed I had bipolar II disorder. It was a hard pill to swallow because prior to diagnosis, I knew how the public viewed mental health conditions. Yet, look at those persons above noted in the article by Web MD. Did they not and, the ones living, still, make significant contributions to our society. Of course, they did. Wake up, grow up America. Recognize we are not to be feared or shunned or stigmatized just because you have not taken the time to educate yourselves on mental health issues. Come into the 21rst century. If you can spend time learning technology, you can educate yourselves on this subject. One in five, people, one in five.

Works Cited

Mental Health America. (2019). Mental Health America. Retrieved April 10, 2019, from The State of Mental Health in America:

NAMI. (2019, paras. 1-2). Living With A Mental Health Condition. Retrieved from National Alliance on Mental Illness:

National Alliance on Mental Illness. (2019, para. 3). Mental Health Conditions. Retrieved from National Alliance on Mental Illness:

Reviewed by Arefa Cassoobhoy, MD, MPH in October 2017. (2017, October). Celebrities With Bipolar Disorder. Retrieved from Web MD:

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