10 Mental Health Stories to Watch in 2024
The Peace Corps, New Year’s Resolutions, Congress & Campaigns, The Workforce, and more.
Hello,
It’s Sunday, January 7th, and this is Bipolar and Bipartisan.
Earlier this week, I published a piece on ten mental health stories from 2023. Today’s newsletter is a lookahead to the world of mental health in 2024.
Feel free to forward this email to someone you think may appreciate it and encourage them to subscribe. If you have any feedback, reach me at tylerfishergmu@gmail.com. Thank you for reading.
Sincerely,
Tyler
1. Will Americans fulfill their New Year’s Resolutions? A new poll by the American Psychiatric Association (APA) finds that 28% of Americans want to focus on improving their mental health in 2024. The number of young adults (44%) resolving to improve mental health was six times that of seniors (7%). If you’re looking to undertake a similar resolution, take inspiration from some of the ways surveyed Americans say they will improve their mental health this year: exercise more (67% of respondents), meditating (49%), keeping a diary (26%); seeing a therapist (35%) or psychiatrist (21%), finances (34%); diet (26%); social relationships (22%); traveling (21%); hobbies (18%); organizing and decluttering (15%); or volunteering (12%).
2. Will the Peace Corps be found guilty on mental health? The Peace Corps is facing a lawsuit over its mental health practices. A class action lawsuit includes accounts from nine individuals who had their offers to complete the Peace Corps program rescinded because of a mental health record. After the Peace Corps offers applicants a position, they begin a process of medically clearing participants. The Corps has used a low bar to disqualify volunteers, including suicidal ideation years beforehand, undiagnosed anxiety currently being treated in therapy, and taking a drug to mitigate depression. In many instances, the fact that Americans are seeking mental health treatment is what is disqualifying them from this opportunity (and others, assuredly); medical records from psychiatrists and therapists have been used by the Peace Corps to justify their decisions. One applicant who was accepted before being declared not medically fit, was told this in a letter:
“The reason for medical non clearance is that you are currently diagnosed with an unspecified anxiety disorder…You indicated that your anxiety symptoms of increased heart rate and queasiness recur during periods of stress, which is likely to occur during service.”
Further, might disqualifying someone from the opportunity of a lifetime only further risk their mental health? Regardless of how the lawsuit plays out, I hope the Peace Corps is found guilty in the court of public opinion.
3. Will young Americans keep drinking less? Alcohol is a depressant; it has a major impact on the brain and can further complicate mental illnesses. For people with bipolar disorder, and others taking antipsychotics or antidepressants, alcohol can limit the effectiveness of medications — including because the drugs compete for the same brain receptors as medicines. I’ve been sober for nearly a year for this reason.
There is good news, nationally. According to Gallup, younger Americans are drinking less and less; this population is more prone to mental health diagnosis. The number of 18-35 year olds who are habitual drinkers is down six percent since 2001-2003, and the share of this group reporting they drink “more than they think they should” is down from 28% to 22%. The trends have spurred a market opportunity with lots of new non-alcoholic products; Athletic Brewing is my favorite.
4. How will Colorado’s new Mental Health Wellness Exam Program go? A law passed in 2021 in Colorado made the state the first in the nation to require healthcare issuance companies to fully cover an annual mental health wellness exam. The law championed by now State Senator Dafna Michaelson Jenet and passed on a strong bipartisan basis (nearly unanimously), is one of many data points to suggest evidenced-based policymaking on mental health is possible.
2024 is the first year all state-regulated insurance plans covered by the law must cover a mental health checkup, much in the same way that insured patients can get an annual physical. The checkup can be conducted by a physician, registered nurse or physician assistant with a license in mental health, a psychologist, social worker, therapist or marriage counselor. The law promises to be good for patients (early detection can prevent more severe symptoms), good for insurance companies (an ounce of prevention is worth a pound of cure), and good for governments (who are often subsidizing the most acute care).
2024 will be a big year in Colorado to see how insurance companies comply with the mandate, if providers can find time in their schedule to do the assessments, and whether or not a strong public education campaign can make Coloradans aware of their new right. If the program is successful, perhaps other states will follow.
5. Will Congress do anything on mental health? 2023 was the least productive legislative session in a long time: Congress only passed 20 pieces of legislation this year. Just a year before, though, Congress passed the historical Bipartisan Safer Communities Act, which provided a historical amount of mental healthcare funding. In the U.S. House of Representatives, the Bipartisan Mental Health and Substance Use Disorder Task Force now has 130 members; the group has 53 pieces of legislation they are working on. It’s unlikely many (or even any) of these legislative priorities will pass on their own, but with at least two “must pass” pieces of legislation in Congress coming in January and February, many could stand to be added as amendments to budget bills.
6. How will mental health be talked about on the campaign trail? A recent USA Today headline read: “Republican candidates are talking about mental health. Is there room for bipartisanship?” I firmly believe that mental health can and should remain a bipartisan issue. People with mental illnesses do not live in red or blue districts, they live in all districts. And all of these people are experiencing a broken mental health system which is largely attributable to public policy. I’ll be watching what local, state, congressional, and presidential candidates have to say about our crisis, and hopefully campaigns will generate principles and policies for tackling our crisis.
7. What will workplaces be doing on mental health? 92% of Americans say it is important to them to work at an organization that values their emotional and psychological well being, while 95% say employers respecting their boundaries related to work/life balance are important. Employers are more likely than ever before to initiate wellness initiatives, and are using a wide range of tools: reimbursement for mental healthcare; slack channels to celebrate prioritizing self care; meditation at work; employee peer to peer affinity groups; and more. The United Nations just announced their “2024 and beyond” initiative, a particularly exciting opportunity to see how a global nonprofit can set an example for others to follow.
8. How will we address our growing mental health workforce problem? For every 350 Americans, there is only one mental health provider in our country — including psychologists, psychiatrists, licensed clinical social workers, counselors, marriage and family therapists, and advanced practice nurses specializing in mental health care. One result is that more than 150 million Americans live in an area with a mental health worker shortage.
Our mental health system is not serving patients in part because we do not have a workforce prepared to take care of them. We need more workers; we need additional training for the workers we have; and, we need to expand the types of professions we entrust to deliver mental health care.
An April 2023 survey of mental health providers shined light on some of the problems:
Absent public policy changes, 83% of the nation’s behavioral health workforce do not believe current providers will be able to meet growing demand for mental health and substance abuse services.
Caseload and severity is up post-Covid. 65% of the workforce reports an increased caseload, and 72% say the severity of illnesses has increased since the onset of the pandemic.
We may lose the workers we have. 48% of the workforce says they have considered other career opportunities because of the workforce shortage.
9. Will the lines on mental health coaches get clearer or murkier? One way the market is responding to the lack of therapists available to patients (wait times are often months long), is increased growth in personal “coaches.” The difference is important: therapists are licensed professionals who can treat people with mental illnesses through personalized care and planning, and their conversations with patients tend to span the past and the future. Coaches are certified professionals with a forward-looking orientation to one’s career, educational aspirations, personal goals, and more. Despite the distinction, lines between coaches and therapists are often blurry, leaving some patients confused on what they need and some experts raising alarm bells about the rise of non-licensed workers dabbling in the mental health space.
10. How will Artificial Intelligence impact mental healthcare? Given the workforce shortage, some see the development of Artificial Intelligence (AI) as a major opportunity for those with mental illnesses. Bernard Marr, a futurist, lays out some of his thinking in Forbes:
Some people may be more comfortable getting advice and therapy from an AI powered interface.
AI can detect patterns in mental health data, and potentially help providers come to accurate diagnoses. For bipolar patients, this could be especially helpful, as the disorder is very often misdiagnosed as depression (especially for women) or schizophrenia (especially for men).
Non-adherence to medications is a major problem. AI chat bots may be able to help providers predict, detect, and course correct when patients are not complying with prescriptions.
AI might be able to deliver personalized treatment plans. In mental health, rarely does one size fit all. A promising frontier at the University of California Davis is exploring whether AI can use brain image analysis to develop treatment plans for children with schizophrenia.