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The Haves and Have Nots of Mental Health

The Haves and Have Nots of Mental Health

by Deborah Jordan Brooks

National Depression Screening Day, which is October 10, provides Americans with the opportunity to take stock of their own mental health, while also encouraging health professionals to be particularly vigilant in assessing depression in their patients. The National Institutes of Health estimate that 9.5% of the U.S. adult population suffers from a depressive disorder at any given point in time, and 22.1% suffer from a diagnosable mental illness in a given year.

A November 2001 Gallup Poll* indicates that 85% of people consider themselves to be in a good or an excellent state of mental health or emotional well-being. The remaining Americans -- those who consider themselves to be in an "only fair" (12%) or "poor" (3%) mental or emotional state -- are probably in the most need of mental health screening, but Gallup data show that they may be the least likely to have access to it.

Does Money Buy Peace of Mind?

They say that money can't buy you love, but it may buy some insulation from emotional distress. While 25% of people with household incomes of less than $30,000 per year report being in fair/poor mental health, the same is true for only 6% of people from households earning $50,000 or more per year.

Similarly, one quarter of the Americans who report that they are in fair or poor financial shape also report low levels of mental/emotional well-being, compared to only 6% of people who say that they are in excellent or good financial shape. And significantly more people who are not employed (21%) report that they are in a fair or poor state of mental health or emotional well-being than do those who are employed (11%).

Whether it is more often the case that concerns about money prevent people from attaining a healthy state of emotional well-being or that poor emotional health hampers the development of earning power, the result is that the allocation of mental health resources skews away from those who may be most likely to need it.

However, lest one think that a higher state of emotional distress is simply the norm among low-income individuals, consider that more than seven out of 10 people in the most challenging financial straits (i.e., those who either have an income of under $30,000, report being in fair or poor financial shape, or say they are unemployed) also say they are in a good or an excellent state of mental or emotional health.

Health Coverage Lacking for Those Who Need It Most

Related to the income differential is the sad irony that emotionally challenged people are disproportionately likely to lack access to any kind of high-quality healthcare resources. Among the people who identify themselves as being in fair or poor emotional health, 41% rate the quality of healthcare they receive as being only fair or poor. Among the emotionally healthy, only 14% say that they receive fair or poor healthcare.

Beyond the quality of healthcare services they do receive, those with minimal healthcare benefits are unlikely to receive coverage for mental health services. Two out of five people who say their emotional health is fair or poor also rate their healthcare insurance coverage as fair or poor, while only 24% of people in better emotional health give their healthcare coverage a fair or poor rating. More than twice as many Americans facing mental and emotional challenges (38%) as people not facing those challenges (16%) have put off medical treatment in the past year because of cost.

Key Points

Nearly three out of four individuals (74%) who say that they are in fair or poor mental/emotional health have not seen a psychiatrist or other mental health professional within the past year (90% of those who rate their mental health as excellent or good have not seen a mental health professional). While some may not need professional help, many may simply not have the financial resources or insurance coverage needed to access it. Still others, particularly those in a lower socioeconomic level, would greatly benefit from mental health intervention but may not be aware that they have a potentially treatable illness, or be aware of the resources that may be available to treat it. It is for those in the latter two groups -- as well as their friends, family and coworkers -- that an increased focus on mental health screening among disadvantaged populations can make life-changing differences.

*Results are based on telephone interviews with 1,005 national adults, aged 18 and older, conducted Nov. 8-11, 2001. For results based on the total sample of national adults, one can say with 95% confidence that the margin of sampling error is ±3%.


Gallup https://news.gallup.com/poll/6892/Haves-Nots-Mental-Health.aspx
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