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Mental Health Advocacy and Its Importance in Public Health

April 9, 2024

A counselor explains mental health resources to a client

Each year, about 1 in 5 youth between 12 and 17 experience major depression. Meanwhile, nearly a quarter of adults live with some type of mental health issue. This troubling data from the Substance Abuse and Mental Health Administration provokes serious concern, especially when considered alongside data on the abysmally low percentages of those individuals who receive treatment for their conditions.

Of the youth in need of mental health services, only 4 in 10 get care. Less than half of the adults in need of mental health services get care. Studies have consistently shown links between poor mental health, shorter life spans, and diminished physical health.

Cleary, efforts to tackle this issue warrant prioritization. Public health leaders committed to addressing the mental illness stigmas and limited access to care can hone their expertise in mental health advocacy with an Online Doctor of Public Health in Leadership, Advocacy, and Equity.

What Is Mental Health Advocacy?

Individuals deserve access to comprehensive and compassionate mental health care that not only relieves symptoms but also helps prevent and lessen the impact of mental illness. Through education, early intervention, and the development of support systems, people can get the help they need to address their mental health issues and stay well over time.

Providing vital emotional, social, and practical support, along with treatments that identify the underlying factors contributing to mental health issues, can help ensure people have the tools and resources they need to lead healthy and meaningful lives.

This multifaceted approach can also help alleviate some of the fallout that may result from mental health issues such as substance misuse, poverty, unemployment, violence, and isolation.

Mental health advocacy is what addresses the vital need to promote the rights of individuals with mental illness. It focuses on increasing access to mental health services and combating stigma and discrimination. Efforts to change policies and develop effective programs that bolster mental health happen at the local, state, and national levels. Advocacy also happens at the individual level on behalf of patients and their families.

Promoting awareness, education, and policy shifts that improve access to quality mental health services is fundamental to mental health advocacy.

Mental Health, Public Health — How Does One Affect the Other?

Mental health and public health are linked — mental health significantly affects the overall health and well-being of individuals, communities, and society. An abundance of research, including a recent study published in the Journal of the American Heart Association, has found links between depression and higher risks of diseases such as heart disease, diabetes, and stroke.

High levels of stress and anxiety can also lower productivity and increase healthcare expenses, which can depress the local economy and harm the community. Additionally, untreated mental health conditions can lead to higher rates of substance misuse, domestic violence, and other crimes, which can have far-reaching consequences for society as a whole.

Finally, untreated mental health conditions among marginalized communities and individuals with low income status can exacerbate existing health disparities and perpetuate cycles of poverty and inequality.

Prioritizing Mental Health Initiatives

To ensure mental health initiatives receive the attention they need, public health leaders can actively prioritize them within their organizations — both in normal operations and in the aftermath of disasters or acute events like a pandemic, hurricane, or wildfire.

Public health leaders can incorporate mental health considerations into their organizations’ policies, programs, and services. Designers of a nutrition program to promote healthy eating among low-income families, for example, could include mental health education and resources.

While learning about healthier eating habits, participants could also learn how diets can affect one’s mood and that a lack of fiber can actually lead to stress and depression, as per research recently published in the International Journal of Molecular Sciences.

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Why Mental Health Advocacy Matters

Though mental health plays an essential role in overall well-being, people often neglect, misunderstand, and stigmatize mental health issues. In turn, those living with mental illness may struggle to get the care they need.

Effective mental health advocacy can address issues of education and awareness as well as the structural challenges that get in the way of the public’s access to effective mental health care. Mental health advocacy can serve as a powerful tool for change in the following ways:

Raising Awareness and Reducing Stigma

Stigma around mental illness has a long history. To this day, negative attitudes and stereotypes about mental health conditions can block people from getting the care they need. Research has consistently linked mental illness stigmas to lower rates of care-seeking by people with mental health concerns.

Negative self-perceptions, discrimination, and other consequences of stigmas can worsen mental health symptoms and result in fewer people using available mental health services as well. For these reasons, mental health advocacy emphasizes the importance of raising mental health awareness and working to reduce stigmas surrounding the subject.

Research has shown the power of mental health advocacy to reduce stigma and raise mental health awareness. A 2020 study published in Psychiatric Quarterly found that interventions that provided mental health education and challenges to stigmatizing beliefs effectively reduced mental illness stigmas among college students.

Advocacy efforts that encourage open conversations and challenge misperceptions about mental illness, such as the “Make It OK” campaign, led by Iowa’s National Alliance on Mental Illness, can successfully promote mental health awareness. Such programs give people with lived experiences the chance to share their stories and break down the stereotypes others may have about what mental illness is.

In addition, mental health advocacy can play a crucial role in destigmatizing certain mental health conditions. A 2023 study published in Military Medicine found that advocacy efforts related to post-traumatic stress disorder (PTSD) significantly increased service member and veteran understanding of the condition, reduced their sense of stigmatization, and increased the likelihood of them seeking help for it.

Informing people about mental health and helping individuals understand that mental health conditions are treatable not only encourages people to seek help when they need it but also leads to earlier diagnosis and treatment, which can limit the overall impact of mental illness on individuals and society.

Improving Access to Mental Health Services

People in need of mental health services often face barriers to accessing the care they need. Factors such as high healthcare costs, insufficient insurance coverage, and a limited number of mental health care providers can all contribute to the problem.

According to a recent Mental Health of America report:

42 percent of adults living with mental health issues do not receive mental health services because they cannot afford them.
More than 1 in 10 adults with a mental illness have no health insurance.
The mental health provider-to-patient ratio in the U.S. is 1 mental health care provider for every 350 individuals.

Mental health advocacy can help tackle these barriers. Fighting for legislation such as mental health parity laws that require insurance plans to cover mental health services alongside physical health services can increase the probability of people receiving mental health care. A study in the Journal of Health Economics found that such laws increased the chances of individuals receiving mental health care by nearly 10 percent.

Leadership in public health can also lead the charge in promoting the integration of mental health care into primary care to improve access to mental health services. An extensive research review in Medicine shows that this approach increases access to mental health care and delivers more effective and cost-efficient treatment as well.

Promoting Prevention and Early Intervention

Preventing mental illness or identifying mental health issues before they become more serious can significantly limit people’s suffering. Advocacy for preventive measures and programs that encourage people to seek help early on can help reduce the burden of mental illness.

Evidence has repeatedly shown that stress reduction, healthy lifestyle choices, and early treatment can significantly reduce a person’s risk of developing a mental health condition. In fact, a 2022 systematic review and meta-analysis published in the JAMA Network found that even minimal physical activity can substantially lower a person’s risk for depression. Mental health advocacy can help promote programs that champion such life-affecting interventions.

Research has clearly established the effectiveness of preventive measures and early intervention when it comes to mental health. Nevertheless, preventive public health strategies often underutilize mental health models.

A recent study in Frontiers in Psychiatry indicates that using new types of mental healthcare approaches can increase access to preventive care. These include mobile and internet-based interventions, apps, and other online technologies, as well as blended and stepped-care — care models that deliver mental health support based on a patient’s different levels of need.

These novel care models can provide mental health services with less stigma, greater accessibility, and more flexibility.

Additionally, public health leaders can advocate for programs that promote screening for depression, anxiety, substance misuse issues, and other hidden or overlooked mental health issues. Screening helps identify individuals at potential risk for developing mental health conditions or individuals already experiencing early symptoms. Early identification gives healthcare professionals the opportunity to prevent conditions from worsening or stop them altogether.

Prioritizing Mental Health in Disaster Response

Public health leaders can also ensure that their organizations have plans in place for addressing the mental health needs of people affected by disasters. This includes allocating adequate resources for mental health services such as counseling and support groups.

Next, public health leaders can prioritize trauma-informed care. This may involve providing staff training on how to recognize the signs of trauma and use interventions rooted in the principles of trauma-informed care such as individual choice and control in one’s care, empowerment, and safety.

Public health leaders may form partnerships with trauma-informed organizations to learn best practices and share resources. They may also initiate collaborations with community-based organizations and mental health providers to improve the availability and access to trauma-informed care.

Additional ways public health organizations can prioritize mental health include:

Screening for and responding to post-traumatic stress disorder (PTSD), a common condition that can appear after traumatic events
Implementing shift rotations for healthcare providers during surges to ensure they have enough rest to deliver high-quality care during and after disasters

The Challenges of Integrating Mental Health into Health Services

Integrating mental health into health services is instrumental to comprehensive care. However, the task comes with its challenges. Common barriers range from a lack of resources to fragmented service delivery systems.

For example, insufficient coordination and communication between various healthcare providers and facilities can often lead to a lack of continuity in care. Separate facilities and practitioners who provide mental health services frequently don’t communicate with primary care providers.

Fragmentation can also occur because of siloed funding for mental health services. This can result in limited support for patients along with delays in diagnosis and treatment.

Public health leaders can begin to address these challenges and advocate for mental health services by concentrating on coordination efforts that improve communication and collaboration among healthcare providers and promote integrated care models.

Additional barriers to integrating mental health into health services include:

Limited Funding

Mental health research receives only a small fraction of the total funding for biomedical research. In 2021, the National Institute of Mental Health (NIMH) had a budget of approximately $1.86 billion. This represents a mere 4.3 percent of the National Institutes of Health’s (NIH) total budget of $42.9 billion.

Over time, these funding disparities have hindered the development of new mental health treatments and interventions, as well as the integration of mental health into general health services.

For additional perspective on this issue of limited funding, it’s useful to examine some statistics provided in a recent International Alliance of Mental Health Research Funders report. According to the findings:

Cancer and infectious disease research receive more than double the money of mental health research.
More than half of mental health research focuses on basic discovery science as opposed to clinical and applied research that explores mental health prevention, diagnosis, and treatment.

Increasing funding for mental health services can significantly reduce costs in other areas, such as expenses related to emergency room visits and hospitalizations.

Shortage of Mental Health Professionals

As mentioned earlier, the U.S. faces a mental healthcare professional shortage. Today, fewer than 1 in 3 people in the U.S. live in a place with enough mental healthcare professionals to meet the population’s needs, according to Kaiser Family Foundation research.

This lack of providers means that millions of people, particularly those in rural areas, lack meaningful access to mental health services. Addressing the shortage, however, can both improve access to mental health services for underserved populations and help facilitate the integration of mental health into health services.

While the benefits of addressing the shortage of mental health professionals are clear, the path to achieving this requires significant political will.

With robust mental health advocacy, public health leaders can push governments to adopt policies that better support mental health professionals and improve their distribution. Such policies could include:

Incentives for mental health professionals working in underserved communities
Investment in recruiting and training programs for mental health professionals
Higher reimbursement rates to encourage mental health providers to accept insurance

Cultural and Language Barriers

Public health leaders may confront cultural and language barriers that can complicate their efforts to integrate mental health care into health services. To begin, they can face challenges recruiting and retaining mental health providers who have the necessary cultural and linguistic competencies to deliver effective care to individuals from minority and underserved communities.

While data from the U.S. Census Bureau indicates that people of color make up about 40 percent of the population, less than 20 percent of psychologists come from diverse backgrounds. Additionally, public health organizations often lack the resources and infrastructure needed to provide language services to their non-English speaking clients.

Limited cultural competency can make it especially challenging for public health leaders to promote mental health services in culturally sensitive ways that resonate with diverse communities.

Mental Health Advocacy Examples

There are numerous examples of mental health advocacy initiatives that strive to increase awareness, reduce stigma, and expand access to mental health services.

Knowledge of relevant organizations and initiatives empowers public health leaders to better support the mental health needs of their communities and develop effective mental health policies and programs.

Mental health advocacy organizations and initiatives often play a crucial role in raising awareness about mental health and reducing stigma. Public health leaders can partner with these organizations and initiatives to promote mental health awareness and reduce barriers to care.

Additionally, familiarity with the services and resources offered by these organizations and initiatives enables public health leaders to connect individuals and families with the support they need.

Mental Health Advocacy Organizations

The following mental health advocacy organizations and initiatives serve as a great place to start for public health leaders exploring the resources that can support their advocacy efforts.

National Alliance on Mental Illness (NAMI)

A grassroots mental health advocacy organization, NAMI focuses on improving the lives of individuals and families affected by mental illness. They offer education programs, support groups, and advocacy initiatives to increase access to quality mental health care, including:

Mental Health Advocate Program trains volunteers to advocate for individuals and families affected by mental illness and help them navigate the mental healthcare system.
NAMI Basics provides a free six-week education program for parents and caregivers of children and adolescents with mental illness. The program provides information on mental illness, treatment options, communication strategies, and advocacy.

Mental Health America (MHA)

A leading mental health advocacy organization in the U.S., Mental Health America promotes mental health and wellness, mental illness prevention, and improved access to mental health services. Mental Health America offers resources, tools, and information to support individuals and communities in their mental health journeys. Two MHA initiatives include:

B4Stage4 strives to change how people think about mental health by promoting early identification and intervention for mental health conditions and emphasizing that, like other chronic illnesses, mental health conditions are easier to manage when identified and treated early. The initiative provides tools for individuals and organizations that support early intervention efforts.
Screening to Supports (S2S) offers free, confidential mental health screenings to individuals online. The initiative aims to make it easy and accessible for individuals to assess their mental health and find support and resources. S2S also provides referral resources for individuals seeking treatment.

Active Minds

The nonprofit Active Minds aims to reduce the stigma surrounding mental health and to promote help-seeking behaviors among young adults. They offer peer-to-peer mental health education and advocacy programs on college campuses and in high schools. Their initiatives include:

Send Silence Packing features an exhibit of 1,100 backpacks, representing the number of college students who die by suicide each year. The exhibit travels to college campuses across the country and serves as a starting point for conversations about mental health and stigma.
Active Minds @Work focuses on mental health and support in the workplace. The program provides employers with resources including webinars, tool kits, and workshops designed to help organizations develop policies and practices that prioritize employee mental health and well-being. It also offers training to create a mental health-friendly workplace culture and to support employees in managing their mental health.

American Foundation for Suicide Prevention (AFSP)

AFSP aims to save lives and bring hope to those affected by suicide. They offer education, support groups, and resources for individuals and families affected by suicide. The organization also lobbies for suicide prevention legislation and policies that prioritize mental health and suicide prevention at the local, state, and federal levels. Their initiatives include:

Out of the Darkness Walks serve as fundraising events in hundreds of communities across the U.S. each year. The walks raise awareness about suicide prevention and support AFSP’s research and advocacy initiatives.
Interactive Screening Program is a web-based mental health screening tool used at many organizations including universities, hospitals, and law enforcement agencies. It allows individuals to complete a self-assessment and receive personalized feedback, as well as referrals to resources if needed.

Black Mental Health Alliance (BMHA)

BMHA focuses on developing and supporting culturally-relevant education, trainings, and referral services that support the health and well-being of Black individuals and other underserved communities. The organization aims to increase awareness and access to mental health services, promoting the development of social and emotional intelligence, as well as the health and well-being of Black communities. BMHA initiatives include:

Black Mental Health Provider Directory helps people locate Black therapists, psychologists, psychiatrists, and other mental health providers. The directory includes professionals trained in cultural competency and with experience working with Black communities. The initiative works to address the underrepresentation of Black mental health providers and the unique challenges faced by Black individuals seeking mental health care.
Emotional Emancipation Circles, created by the Community Healing Network, are community healing circles that BMHA sponsors. The program involves group discussions and activities designed to help participants understand the various forms of racism and their impact on mental health, including racial stress and historical trauma. The groups also focus on internalized racism — ways in which individuals may internalize negative messages and beliefs about their own racial identity.

Champion Mental Health Advocacy as a Public Health Leader

By supporting mental health initiatives, public health leaders can work toward reducing the stigma surrounding mental illness and increasing access to quality mental health care for all individuals. Mental health advocacy helps create healthier and more resilient communities.

Explore how Tulane University’s Online Doctor of Public Health in Leadership, Advocacy, and Equity prepares graduates to develop meaningful mental health initiatives and understand the role of mental health in public health.