May is Mental Health Awareness Month, but mental illness is a year-round reality for many Americans. Chances are you know someone or you are someone who has been affected by a mental health or substance use problem.
Over the course of a lifetime, nearly half of us will meet the clinical criteria. In 2020, 60.6 million Americans experienced mental illness. And 32.1% of U.S. adults with mental illness — 17 million people — also experienced a substance use disorder in 2020.
In Delaware, 157,000 adults — more than four times the population of Dover — have a mental health condition, and 66,000 Delaware adults reported having a substance use disorder. But these illnesses don’t just impact adults. Half of lifetime mental illnesses begin by the age of 14, and 75% begin by the age of 24.
Despite its prevalence, half of U.S. adults with mental illness received no treatment last year. For U.S. youth with major depression, more than 60% did not receive treatment. In Delaware, more than 54% of adults with mental illness received no treatment last year. And 11,000 Delaware children experienced major depression, with only 5,000 receiving treatment and 6,000 going without.
In communities of color, even fewer have access care. In Hispanic/Latinx communities, only about 34% of adults with mental illness receive treatment each year. One in 3 Black adults who need mental health care receive it. And only 23.3% of Asian American and Pacific Islanders (AAPI) access treatment.
Reform mental health care
Now, more than ever, we must strengthen our mental health care system to serve all who need help early and comprehensively. Globally, the pandemic generated a 25% increase in the prevalence of anxiety and depression. For youth especially, the impact of COVID-19 on mental health has been devastating.
The pandemic has magnified the need to reform key pieces of our health care system, including early intervention, stronger insurance coverage for mental health, crisis response and workforce shortages, so that everyone has access to the care they need when they need it.
Improvements and investments are needed across the care continuum to address rising mental health needs. For too many, narrow insurance networks make it difficult, if not impossible, to find and afford mental health treatment. Emergency room visits for mental health crises are up 31% nationally among youth ages 12-17. The workforce shortage, the inadequate number of available psychiatric beds and the inadequate treatment and crisis-response systems are all areas in great need of addressing. One integral part of any strategy must be investment in early intervention. When emerging signs of mental illness are identified early, recovery is not only possible, it can be likely. Ensuring health insurance is comprehensive enough to allow patients to access care early can prevent crises, as well as limit the risk of negative outcomes.
Schools offer a unique opportunity for early intervention but only when there is adequate and appropriate staff in place. It is estimated that the First State has one school psychologist for every 825 students, one school social worker for every 2,547 students and one school counselor for every 382 students. Each of these figures fall well short of the nationally recommended ratios.
House Majority Leader Valerie Longhurst, D-Bear, has three bills focused on early intervention to address mental health in Delaware. House Bill 300 will bring student-to-professional ratios to national recommendations for school counselors, school social workers and school psychologists in Delaware’s middle schools. This bill comes on the heels of HB 100, which Gov. John Carney signed in August, addressing the ratios in elementary schools. HB 301 establishes K-12 mental health education in Delaware with developmentally appropriate content tailored to students’ grade level. And HB 303 will require Delaware health insurers to cover a yearly behavioral health wellness check for every insured person.
While some progress is being made here in Delaware, so much still needs to be done to address our rising mental health crisis on a state and federal level. As we continue to rebound from the pandemic, Delaware and our leaders in Washington must prioritize investments in mental health across the care continuum, especially in upstream solutions that focus on early intervention. Let’s pay now, so we don’t pay later.
Annie Slease is the director of advocacy and education for National Alliance on Mental Illness Delaware.
