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Understanding Mental Health as a Public Health Issue

January 13, 2021

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A mental health professional works in a group therapy session

Poor mental health can not only affect a person’s ability to live a fulfilling life and carry on with their school, work, or familial responsibilities but also lead to physical and social problems with serious impacts.

A vast majority of Americans (90 percent) believe the U.S. is facing a mental health crisis, according to the 2022 KFF/CNN Mental Health in America Survey. When asked, Americans point to the mental health challenges in children and teenagers, the ongoing opioid epidemic, and severe mental illness as particularly critical issues in the nation.

By advocating for prevention and developing effective interventions, public health professionals help individuals and communities combat mental health issues. Explore the intersections of mental health and public health and how professionals can pursue education to advocate for mental health interventions.

Why Do Experts Consider Mental Health a Public Health Issue?

Public health aims to promote healthy lifestyles and detect, prevent, and respond to diseases. The prevalence of mental health issues that affect individuals’ physical and social well-being makes mental health a public health issue integral to achieving community health goals.

Mental health has a huge impact on how people relate to others, make decisions, and handle stress. People’s ability to live fulfilling lives often depends on their mental health. This makes protecting and restoring mental health of immediate concern to public health professionals.

Mental Health and Social Relationships

Poor mental health influences people’s relationships with their children, spouses, relatives, friends, and co-workers. Often, poor mental health leads to problems such as social isolation, which disrupts a person’s communication and interactions with others. This can have particularly harmful effects on children and adolescents whose development depends on forming bonds with their family members and peers. In adulthood, this social isolation can lead to family breakdown, divorce, or even childhood neglect.

Mental health problems frequently put financial and emotional strain on families. For example, a family trying to address a child’s mental illness may exhaust untold funds in search of treatment. Individual family members may also struggle to cope with their own symptoms that require support, such as depression or sleeping problems.

Children who have family members experiencing mental health problems may blame themselves. This can result in loneliness and feelings of being different. It may also lead to future behavioral or social problems. Additionally, as families address their loved ones’ mental health problems, they may socially isolate themselves out of fear of judgment from others, further disrupting their emotional well-being.

Mental Health and Substance Misuse

A clear relationship exists between mental health issues and substance misuse. Each can lead to the other. In fact, 1 in 4 people with a serious mental illness also has a substance use disorder, according to the National Institute on Drug Abuse (NIDA). Data from the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services shows that people with mental health issues are also at greater risk of using nonprescription opioids.

People with mental illness consume substances that harm their health at higher rates than people without mental health issues, according to the 2022 National Survey on Drug Use and Health. Consider the following statistics: In 2022, adults aged 18 or older with serious mental illness or any mental illness in the previous year were more likely to have used illicit drugs compared with those without any mental illness. Specifically, about 52.9 percent of adults with a serious mental illness and 43.9 percent with any mental illness had used illicit drugs that year, compared with only 20.6 percent with no mental illness.

Additionally, NIDA reports an increased risk for the development of substance use disorders among children and adolescents with mental disorders. The research shows that children develop mental health issues, such as depression and anxiety, before they develop substance use disorders, suggesting mental health issues lead to problems with alcohol and drugs.

Mental Health and School

Evidence suggests that poor mental health affects people’s educational success. Many students experiencing mental health issues struggle to form positive relationships with their teachers. They may also find it difficult to concentrate, feel motivated, or follow school rules. This often results in disciplinary measures that can interrupt their learning process.

According to the Child Mind Institute, the suspension/expulsion rate for students with emotional disturbances, for example, is 64 percent. Additionally, every year, nearly 28,000 students with mental health issues and other health issues drop out of school. These individuals who drop out are 63 times more likely to end up in jail than college graduates. People with no high school diploma also have a lower life expectancy than high school graduates — by 9.2 years.

Public health professionals know that education levels play an important role in many aspects of a person’s wellness and quality of life. In fact, greater levels of health correlate with higher levels of education. The Centers for Disease Control and Prevention (CDC) reports that the mortality rates of people with some college are half of those of people who never attend college. The rates of diabetes and asthma are also lower for people who attain higher levels of education.

Mental Health and Work

Mental health and public health intersect in workplace wellness. Mental health issues often reduce concentration, potentially compromising a person’s productivity. The National Alliance on Mental Illness (NAMI) reports that difficulty focusing often accompanies depression. Reduced productivity can limit the ability to earn promotions, excel, and build successful relationships with supervisors and co-workers, ultimately affecting job satisfaction. Mental health issues can also lead to increased absenteeism at work. This can result in job loss or reduced hours and affect a person’s ability to earn a living.

Job loss can result in the loss of health insurance, and the loss of health insurance reduces people’s access to health care, potentially resulting in untreated health conditions and the inability to receive preventive care. A diminished ability to earn a living can also lead to poverty, which affects people’s ability to find housing and receive a quality education, among other necessities.

Mental Health and Physical Wellness

Mental health issues influence the onset, development, and effects of physical illnesses. Often, high-risk behaviors, such as substance misuse and physical inactivity, correlate with poor mental health.

A 2023 study published in BMJ Mental Health, as reported by ScienceDaily, found that individuals with severe mental illness are nearly twice as likely to experience multiple physical health conditions. This finding underscores the vital need to consider both mental and physical health.

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Mental Health and Marginalized Communities

Marginalized communities consistently experience worse mental health than other communities for preventable reasons. Individuals who belong to racial, gender, and sexual minority groups, as well as individuals from low-income socioeconomic backgrounds, may disproportionately experience mental health issues and face additional barriers to receiving mental health services.

For example, according to research published in 2023 in the Journal of Racial and Ethnic Health Disparities, Black, Hispanic, and Asian individuals experienced the negative mental health effects of the COVID-19 pandemic more severely than white individuals. The research found that people from racial minority groups experienced a “pandemic within the pandemic”: ongoing racism, evidenced by traumatic racist incidents between 2020 and 2021, along with government inaction toward addressing racism and improving conditions for communities of color.

A crucial strategy for recognizing and prioritizing mental health as a public health issue nationwide is the provision of widespread and affordable mental health care. However, the research showed that during the pandemic, individuals from racial/ethnic minority groups with poor mental health had less access to such care than white people.

Also consider the following additional mental health disparities among marginalized communities reported by the American Psychiatric Association:

Up to 75 percent of youth in the juvenile justice system who are disproportionately from racial and ethnic minorities have mental health disorders.
Minority youth who have behavioral problems are more likely to be referred to the juvenile justice system than to healthcare providers, compared with nonminority youth.
Rates of depression, anxiety, and substance misuse are 2.5 times higher for LGBTQIA+ individuals than heterosexual individuals.
Healthcare providers are less likely to offer Black patients evidence-based medication therapy or psychotherapy than other populations.

Factors contributing to mental health disparities among marginalized communities include limitations to healthcare access and negative perceptions about mental health treatment.

Poor Access to Mental Healthcare Services

Marginalized communities face many barriers to receiving needed mental health care. For one, individuals from these communities are overrepresented in jobs that do not provide health insurance. Without health insurance, few can afford any type of mental healthcare service.

Historically, people from marginalized backgrounds with insurance have encountered discrimination when receiving care or disparate treatment. For instance, Black individuals are offered medication and therapy for their mental health issues at lower rates than the general population, according to the American Psychological Association (APA).

A lack of cultural competency among mental healthcare providers can diminish the quality of care that marginalized individuals receive as well. According to APA, 5 percent of psychologists in the U.S. in 2021 were Black, while more than 80 percent were white. This makes it more difficult for Black individuals to receive culturally competent care. Organizations that influence treatment approaches need more representation within their ranks from people in marginalized communities.

Therapeutic relationships depend on understanding and comfort. A lack of diverse representation in the mental health field can limit both and make it harder for mental health professionals to understand their patients’ identities and address them openly.

Finally, language barriers and implicit bias can interfere with access to mental health services, resulting in individuals giving up on treatment or not recovering completely. Additionally, many marginalized people have fewer mental health professionals in their communities; this can pose challenges to accessing care as well.

Cultural Stigmas and Negative Perceptions About Mental Illness

Cultural stigmas and negative perceptions about mental illness can discourage individuals from getting help. Attitudes about mental health issues vary among different communities. Both religious ideas and cultural perceptions can shape how people feel about getting mental health care.

Sometimes these ideas and perceptions stigmatize mental illness, possibly preventing people from seeking treatment for themselves or loved ones. In some cases, communities may discourage men from showing any signs of weakness. This can result in reticence among men to seek needed mental health treatments.

Understanding different cultural perceptions about mental health is key to developing culturally sensitive programs and services accessible to members of all communities.

The Role of Public Health Professionals in Promoting Mental Health

Public health professionals play a key role in tackling the factors that adversely influence mental health. Addressing a community’s well-being requires a comprehensive approach, and public health professionals in many positions can advocate for mental health support and services. These include roles in public health policy, social work, health care, and community health. They may be educated in public health, or hold a related degree, such as a Master of Health Administration (MHA).

To promote mental health, public health professionals find ways to prevent mental disorders; improve access to mental health services; support recovery; and lower the rate of death, disease, and disability among those with mental illnesses. They also work to increase awareness of mental health issues and reduce stigmas, so people can get the treatment they need. Finally, they strive to eliminate health disparities and provide equitable access to health services.

Prevention and Intervention

Public health professionals develop programs that address the factors that contribute to poor mental health or focus on intervention methods known to foster good mental health. Identifying risk factors for mental illness, such as trauma and chronic health conditions, plays an important role in implementing prevention programs. Identifying risk factors also allows for early intervention. Examples of prevention and intervention strategies that can promote mental health are early childhood programs, programs for older adults, and violence prevention initiatives.

Early Childhood Programs

Early childhood intervention programs for at-risk children offer stable, emotionally supportive environments; learning opportunities; and interactions that stimulate development. These efforts help positively shape children’s brains and can improve their chances of experiencing sound mental health throughout their lives.

The Infant and Early Childhood Mental Health Consultation (IECMHC) program, for example, helps families and adults who work with young children strengthen their ability to cultivate healthy environments that support a child’s social and emotional development. The program aims to respond before intervention is required.

IECMHC brings mental health consultants to child care centers, homes, and preschools where they may engage in the following:

Consult with preschool staff, sharing strategies and insights regarding how to handle the mental health needs of families with infants and young children
Provide child care staff with referral information for mental health services appropriate for young children
Consult with administrators regarding policies that support mental health and provide information about the effects of policies, such as expulsion, that affect mental health

Programs for Older Adults

Early childhood intervention programs for at-risk children offer stable, emotionally supportive environments; learning opportunities; and interactions that stimulate development.

Programs that support older populations facing isolation may offer social activities, interactions with the community, and assistance in dealing with other social and emotional issues. Such programs offer vital support to older adults, 20 percent of whom experience some kind of mental health issue, according to the CDC.

The National Council on Aging (NCOA) lists several programs that can improve older adults’ mental well-being:

Healthy IDEAS (Identifying Depression & Empowering Activities for Seniors) aims to detect and mitigate symptoms of depression in seniors with chronic conditions or limited ability to function. The program screens and assesses older adults and provides education and referrals for mental health professionals as appropriate.
The Brief Intervention and Treatment for Elders (BRITE) program provides substance misuse intervention for seniors. The program offers substance misuse screening, identifies nondependent use of substances and prescription medication issues, and offers intervention strategies that prevent those issues from requiring extensive substance misuse treatment.

Violence Prevention Initiatives

The American Public Health Association (APHA) reports that violence significantly harms children’s development and affects communities’ health. In addition to causing physical harm, violence, and associated trauma negatively impact behavioral and mental health. In fact, trauma has been linked to substance misuse and self-injury, as well as depression, anxiety, and post-traumatic stress disorder (PTSD), according to the Substance Abuse and Mental Health Services Administration.

Programs that challenge social norms, reduce risk factors for violence, and cultivate resilience help improve a community’s health. For instance, in some communities, attitudes about a woman’s sexual purity and family honor have led to violent acts. Violence prevention initiatives can take on such ideas and make it harder to justify violent behavior on the basis of a social norm.

Whether addressing intimate partner violence or firearm violence, evidence-based programs can have an impact on this public health issue. The CDC offers recommendations for effective approaches to prevent every type of violence. Proven strategies for addressing intimate partner violence include the following:

Bystander empowerment programs and education
Social-emotional learning (SEL) programs for children and adolescents
Healthy relationship programs for couples

In addition to specialized approaches to the different types of violence, the CDC focuses on strategies that apply to addressing all types of violence:

Starting prevention efforts early and continuing them through life
Identifying the populations at greatest risk for experiencing and perpetrating different types of violence
Building prevention programs that consider the risk and protective factors most likely to influence several types of violence so as to make the broadest impact

Policy Advocacy

Public health professionals can fight for policies that foster mental health in public health and allow people living with mental illness to thrive. A public health advocate might work to reduce houselessness and incarceration rates — factors that exacerbate mental illness and disproportionately affect people with mental illness. Public health advocates work to change systems that perpetuate mental health problems and the undignified treatment of people with mental illnesses.

Mental Health Research

To identify comprehensive prevention strategies and intervention methods, public health professionals need evidence. When professionals conduct research through a public health lens, they uncover the evidence they need to develop the most effective approaches to prevention and treatment. Research also identifies the causes of mental health problems, informing public health professionals’ work in policy advocacy, prevention, and treatment. Research illuminates the public health professional’s understanding of mental health at the individual and community levels. Whether studying suicide using an epidemiological approach or examining social media’s effects on self-image, research offers public health professionals important insights.

Earn a Master of Public Health and Tackle Mental Health Disparities

Mental health issues put people at a disadvantage. Mental health issues not only compromise people’s well-being but also levy social and physical consequences. To help individuals and communities foster their individual strengths, gain access to care, and address disparities related to poor mental health, public health professionals need empathy, as well as expertise in the best intervention and prevention strategies. Explore how Tulane University’s Online Master of Public Health program equips graduates to tackle mental health disparities and build healthier communities.