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Better But Not Well
The past half-century has been marked by major changes in the treatment of mental illness: important advances in understanding mental illnesses, increases in spending on mental health care and support of people with mental illnesses, and the availability of new medications that are easier for the patient to tolerate. Although these changes have made things better for those who have mental illness, they are not quite enough.
In Better But Not Well, Richard G. Frank and Sherry A. Glied examine the well-being of people with mental illness in the United States over the past fifty years, addressing issues such as economics, treatment, standards of living, rights, and stigma. Marshaling a range of new empirical evidence, they first argue that people with mental illness—severe and persistent disorders as well as less serious mental health conditions—are faring better today than in the past. Improvements have come about for unheralded and unexpected reasons. Rather than being a result of more effective mental health treatments, progress has come from the growth of private health insurance and of mainstream social programs—such as Medicaid, Supplemental Security Income, housing vouchers, and food stamps—and the development of new treatments that are easier for patients to tolerate and for physicians to manage.
The authors remind us that, despite the progress that has been made, this disadvantaged group remains worse off than most others in society. The mainstreaming of persons with mental illness has left a policy void, where governmental institutions responsible for meeting the needs of mental health patients lack resources and programmatic authority. To fill this void, Frank and Glied suggest that institutional resources be applied systematically and routinely to examine and address how federal and state programs affect the well-being of people with mental illness.
eBook
Preventing Mental, Emotional, and Behavioral Disorders Among Young People
Mental health and substance use disorders among children, youth, and young adults are major threats to the health and well-being of younger populations which often carryover into adulthood. The costs of treatment for mental health and addictive disorders, which create an enormous burden on the affected individuals, their families, and society, have stimulated increasing interest in prevention practices that can impede the onset or reduce the severity of the disorders.
Prevention practices have emerged in a variety of settings, including programs for selected at-risk populations (such as children and youth in the child welfare system), school-based interventions, interventions in primary care settings, and community services designed to address a broad array of mental health needs and populations.
Preventing Mental, Emotional, and Behavioral Disorders Among Young People updates a 1994 Institute of Medicine book, Reducing Risks for Mental Disorders , focusing special attention on the research base and program experience with younger populations that have emerged since that time.
Researchers, such as those involved in prevention science, mental health, education, substance abuse, juvenile justice, health, child and youth development, as well as policy makers involved in state and local mental health, substance abuse, welfare, education, and justice will depend on this updated information on the status of research and suggested directions for the field of mental health and prevention of disorders.
eBook
Mental health challenges, treatment experiences, and care needs of post-secondary students: a cross-sectional mixed-methods study
Post-secondary students frequently experience high rates of mental health challenges. However, they present meagre rates of treatment-seeking behaviours. This elevated prevalence of mental health problems, particularly after the COVID-19 pandemic, can lead to distress, poor academic performance, and lower job prospects following the completion of education. To address the needs of this population, it is important to understand students' perceptions of mental health and the barriers preventing or limiting their access to care.
A broad-scoping online survey was publicly distributed to post-secondary students, collecting demographic, sociocultural, economic, and educational information while assessing various components of mental health.
In total, 448 students across post-secondary institutions in Ontario, Canada, responded to the survey. Over a third (n = 170; 38.6%) of respondents reported a formal mental health diagnosis. Depression and generalized anxiety disorder were the most commonly reported diagnoses. Most respondents felt that post-secondary students did not have good mental health (n = 253; 60.5%) and had inadequate coping strategies (n = 261; 62.4%). The most frequently reported barriers to care were financial (n = 214; 50.5%), long wait times (n = 202; 47.6%), insufficient resources (n = 165; 38.9%), time constraints (n = 148; 34.9%), stigma (n = 133; 31.4%), cultural barriers (n = 108; 25.5%), and past negative experiences with mental health care (n = 86; 20.3%). The majority of students felt their post-secondary institution needed to increase awareness (n = 231; 56.5%) and mental health resources (n = 306; 73.2%). Most viewed in-person therapy and online care with a therapist as more helpful than self-guided online care. However, there was uncertainty about the helpfulness and accessibility of different forms of treatment, including online interventions. The qualitative findings highlighted the need for personal strategies, mental health education and awareness, and institutional support and services.
Various barriers to care, perceived lack of resources, and low knowledge of available interventions may contribute to compromised mental health in post-secondary students. The survey findings indicate that upstream approaches such as integrating mental health education for students may address the varying needs of this critical population. Therapist-involved online mental health interventions may be a promising solution to address accessibility issues.
Journal Article
Adolescent mental health in crisis
We need to understand the causes to inform prevention
Journal Article
Mental health promotion in schools : cross-cultural narratives and perspectives
The narratives of the children and young people, school teachers and school leaders, parents and carers, policy makers and service managers, and mental health workers and professionals, presented in this book, should provide an invaluable resource for all those involved in mental health promotion in school. The insights drawn from these direct field experiences may help to inform policy and good practice and serve as an inspiration to schools in their efforts to introduce and promote mental health for their communities. Most of the chapters present original research carried out in schools, services, universities and other contexts across different cultures. Through various qualitative studies carried out in different cultural contexts, Mental Health Promotion in Schools provides a platform for children, teachers, school leaders, parents, professionals, policy makers and teacher educators, to express their views on what works and does not work in mental health promotion in school. In our continued quest for evidence based research, we may tend to underestimate the value and significance of capturing the views and experiences of those most directly involved in mental health promotion, such as children and young people, school teachers and parents/carers, in seeking to enhance policy and practice in the area. This book should be of particular interest to those involved in mental health promotion in school at practice, training and research levels and we are sure that among these chapters, they will discover many new and stimulating insights into the promotion of mental health in such complex systems as schools.
Book
It is Time to Realize the Promise of the Digital Mental Health Transformation: Application for Population Mental Health
The past 25 years have seen the explosion of digital health care—from 1s and 0s initially serving most researchers for accomplishing their work, to the creation of smartphones, mHealth, and more recently artificial intelligence. The revolution for digital mental health is no longer in its infancy, as new tools are created to address mental health, sometimes even undergoing evaluation for adoption and efficacy. In fact, a recent study reporting on National Health Interview Survey data (annually conducted by the National Center for Health Statistics) indicated that, in 2024, 40% of adults reporting serious psychological distress used a digital health tool, which has increased from 21% in 2017 and 10% in 2013. Given the widespread access to digital tools and the potential of digital mental health, it is time for a new paradigm of care to address the mental health crisis in the United States. Reactive care, consisting largely of medication and counseling provided to those already experiencing severe or debilitating symptoms of mental anguish, is not adequate to address the needs of 22.8% of the US population (>55 million people) experiencing symptoms of a mental illness, and the larger number of people with preclinical mental health concerns. A population mental health approach is needed that includes early identification, intervention, and prevention, in addition to reactive care.
Journal Article