For years, there’s been an elephant in the room we’ve almost never talked about in this country. Even as nearly one in five U.S. adults experienced mental illness, even as rates of opioid addiction and suicide have skyrocketed in New Hampshire and across the country, even as that mental illness has doubled our risk for heart disease and diabetes, we swept it under the rug and tried not to talk about it. For too long, we’ve been too ashamed to talk about the real public health crisis in this country, even as we obsess over sensationalized ones like Ebola and coronavirus.
But as Granite Staters head to the polls on Tuesday, there is finally cause to be optimistic about the prospects for improving mental health in America. For the first time I can remember, every Democratic candidate on the ballot has proposed some form of mental health and addiction policy. From increasing insurance reimbursement for mental healthcare to more mental health training and worksite wellness programs, these ideas represent real progress and begin to bridge the divide between the way we think about mental and physical health care.
Still, this conversation hasn’t come far enough. What most people don’t understand is that America doesn’t just have a mental health problem — it’s an epidemic. A recent study suggested that up to half of millennials, and nearly three-fourths of Gen Z have dropped out of the workforce at least once due to a mental health issue. As many as 45% of chronically homeless people have some form of mental illness, and those with serious, untreated mental illness are up to 16 times as likely to die in a law enforcement encounter than others. We need candidates to go beyond having a section on their website, to actually begin really talking about this problem on the campaign trail, as former Mayor Pete Buttigieg did on February 6 in a CNN town hall from New Hampshire. It means having a real plan to move people from mental health crises to lasting recovery. And it means investing in real social infrastructure within communities, where people experiencing mental illness can come together and reduce the debilitating effects of social isolation that, ultimately, are the underlying reason lives are shortened due to mental illness. Loneliness kills, and no group faces loneliness and social isolation more profoundly than people living with mental illness.
Almost nowhere is that more clear than in New Hampshire. The state has been ravaged by an opioid addiction epidemic which has roots in mental health issues caused by a “perfect storm” of pockets of economic disadvantage, combined with an ethos of individualism that might reject community and social support while being fueled by poor access to substance use and behavioral healthcare, and ready access to cheap opioids. New Hampshire’s suicide rate is well above the national average, and many Granite Staters report feeling socially isolated. Yet despite these statistics, half of Granite Staters living with mental illness report being unable to access basic mental health services. That’s a real crisis, and if left unchecked, will continue to lead to increases in “deaths of despair” that have been widely reported, and have affected New Hampshire dramatically.
The Democratic candidates for President should be applauded for making mental health part of this election’s conversation, and we must acknowledge the real progress our society has undergone since the New Hampshire primary four years ago. But voters should demand more — a better conversation that brings this issue out of the shadows for once and for all.
Ashwin Vasan, MD, PhD
President and CEO, Fountain House
Fountain House is an internationally recognized nonprofit dedicated to successfully addressing the devastating impact of mental illness through a pioneering treatment model that applies community-based, social solutions and has inspired the creation of hundreds of similar programs in 34 countries that serve more than 100,000 people annually.