In certain sectors of society, saying "most Americans don't understand mental health" might be be met with howls of protest. For instance, if you're a millennial, that statement might be genuinely untrue for you. You're part of a generation which has, by and large, become increasingly comfortable with discussing mental health and seeing it depicted realistically around you; a 2015 report by the Anxiety and Depression Association of American found that 60 percent of college-aged Americans viewed seeking professional mental health treatment as a sign of strength, not weakness — a marked break with the stigma found in past generations.
But mental health literacy in most segments of the population — and even among many young people themselves — simply isn't that common. Though the National Alliance on Mental Illness notes that 18.5 percent of U.S. adults experience mental illness in a given year, a 2013 poll by the Henry J. Kaiser Family Foundation found that 47 percent of respondents would be uncomfortable living next door to someone who had a serious mental illness, and 41 percent would be uncomfortable working with someone who had a serious mental illness; similarly, a 2016 Harris poll found that 53 percent of respondents didn't know that people with anxiety disorders are at risk for self-harm. Sifting through all these facts, some questions are clear: why don't people know enough, and why does it matter so much?
It's Mental Health Awareness Month, so it's prime time to look at our own levels of knowledge about mental health disorders and see what's lacking. In a perfect world, we'd all be able to reel off all the diagnostic criteria for bipolar II disorder or automatically be able to compare different treatment options for generalized anxiety disorder; but, alas, our world is far from perfect. But while perfection may be a long way off, we can take steps to become more knowledgeable — which is important, because mental health illiteracy can have far more serious consequences than just looking uninformed after you accidentally make some uneducated remarks. Community attitudes about mental health can encourage or discourage people from seeking treatment — and that can impact the course of someone's life.
Bustle talked to Michigan State University's Dr. Courtney Cuthbertson, one of the scientists behind a new mental health survey that's provoking old questions anew, to find out how little Americans know about mental health — and why that matters.
Ignorance About Mental Illness Increases Stigma
The latest findings to support the desperate need for more widespread understanding of mental health issues come from researchers at Michigan State University, who just released a study that points to a problem with mental health awareness in the U.S. The study surveyed 4,600 people via the internet about their awareness of various issues, from anxiety and depression to prescription drug abuse. The results were, well, not great. Dr. Courtney Cuthbertson, who worked on the survey under leader Dr Mark Skidmore, explained how it worked to Bustle:
32 percent of the people who took the survey couldn't identify the signs of prescription drug abuse, 80 percent didn't think it was a treatable issue, less than 50 percent could recognize the signs of anxiety, and the vast majority of the respondents had no idea about how depression is treated. The multi-branch approach of the survey — targeting not only what people thought mental disorders "look like," but whether they understand how they're actually meant to be treated — gave a big-picture look at just where more information needed to be targeted. Unfortunately, the answer seems to be "everywhere."
The study results aren't a one-off, either. The problem of mental health literacy, as it's called, has been reiterated in studies across the world; a 2003 survey in England, for instance, found that 63 percent of the population appears to believe that fewer than 10 percent of all people will experience a mental illness. The problem? The number is actually one in four. That's a huge difference, and creates the false impression of rarity — which can lead to stigma, which can in turn discourage people from seeking help. So what's causing this, and why is it so important?
Why Are So Many Of Us So Confused By Mental Health?
There is, according to experts, a kind of cycle effect when it comes to ignorance of mental health issues and stigma surrounding them. The less people know about mental disorders, according to the British Journal of Psychiatry, the more likely they are to be afraid or confused by them, or to hold beliefs that penalize or misunderstand the mentally ill. Stigma both stems from and creates more ignorance; when something's seen as socially taboo, people are less inclined to learn more about it; and when we don't learn about mental illness, we're less able to identify a mental health concern emerging among a friend, family member or ourselves, or understand what treatment options are available.
The Michigan State study also added new understandings about factors that seem to interfere with understanding of mental illness. You are less likely to recognize depression in others, for example, if you're from a higher-income background, live in an urban area or are young, and the same factors are in play for recognizing anxiety.
Personal experience is the swiftest way to learn about mental illness; people with their own difficulties or those with family members or close friends and partners who have disorders tend to score the highest on literacy tests. Similarly, a 2007 study in the Medical Journal of Australia noted that women tend to test better on mental health literacy than men. Some mental health problems are indeed more common among women, but by and large the issue affects both genders equally; women's advantage may simply be through societal "caring" roles, which mean they're more exposed to the realities of mental illness and mood disorders.
But part of mental health ignorance is also cultural, shaped by messages from media and the prevailing climate of beliefs. A 2016 study of Japanese adults, for instance, found that if they believed depression and schizophrenia were caused by certain "personality characteristics", they were more likely to believe that mentally ill people were dangerous and unpredictable. Ignorance doesn't necessarily come from nowhere — and it can cause more harm than you might think.
What's The Real Cost Of Ignorance About Mental Health?
1/ "There’s evidence to show that a lack of mental health literacy in the workplace discourages help seeking." https://t.co/lCUkLva6YH— Black Teacher (@BlackTeacherPro) March 14, 2017
There are a couple of obvious downsides to people's lack of education about mental health problems. The big issue, of course, is that not knowing what a mental disorder looks like, or how to treat one when it appears, stands in the way of effective diagnosis and treatment, not only for oneself but for others — and stigma provides additional obstacles, because it makes the disorder not only invisible but something to be concealed or deliberately avoided.
The reality is that 25 percent of all adults will experience mental health issues in their lifetime, 10 percent of all children will, and while many of those disorders will not be so problematic as to require hospitalization or significantly disrupt their lives, they do require treatment and understanding. The undertreatment problem in mental health is pretty spectacular; it was estimated in 2008 that 67 percent of the entire US population with mental health issues gets no help whatsoever, and that over two-thirds of mentally ill people globally aren't being treated at all.
And the problem is exponentially worse in countries that don't have a high GDP or developed infrastructure; in those countries, noted a 2015 study, "the majority of people with mental, neurological, and substance use (MNS) disorders [are] receiving no or inadequate care".
In the face of this sort of problem, understanding how to get around ignorance and stigma becomes incredibly important. But not all kinds of ignorance provoke the same reactions. A fascinating study from the EU in 2010 found that a community's specific misinformation about mental health impacted how community members dealing with mental health issues reacted.
In places where people tended to believe that the mentally ill were to blame for their own problems, those who were concerned about themselves or others weren't very likely to seek help. But in groups where the prevailing belief in the community was that mentally ill people were dangerous or unable to live healthy lives, people were actually motivated to go find treatment. Obviously, neither of those attitudes are ideal — but they point to the fact that different strategies need to be applied for different situations when dealing with ignorance or confusion about mental illnesses.
On a very basic level, ignorance about mental health issues costs lives and a significant amount of human happiness. Understanding what disorders look like, how they work, and how they can be treated is a big public good. It's a large effort, but we can take our own steps. If you feel comfortable with talking to a coworker or acquaintance about mental illness, give it a try this month. It might not change the whole world, but it could change at least one person's mind.