World Mental Health Day 2021: Addressing Inequities in Care

Across the world, October 10 is hailed as World Mental Health Day. A program of the World Federation for Mental Health (WFMH), World Mental Health Day has been observed since 1992. WFMH’s mission is to promote the advancement of mental health awareness, prevention of mental disorders, advocacy and best practices, and recovery-focused interventions worldwide. World Mental Health Day is one way WFMH seeks to recognize the goals of this mission.

Each year, WFMH outlines a special theme for World Mental Health Day. Over the past two years, the coronavirus pandemic has not only revealed enormous health inequities across the world, it has also exacerbated existing mental health inequities. That’s why WFMH has chosen for its 2021 theme, “Mental Health in an Unequal World.”

Mental Health Inequities Across the U.S.

In 2018, the National Council for Behavioral Health and Cohen Veterans Network published a comprehensive study of access to mental health care in the United States. The study found what was described as a “mental health crisis in America,” with a much larger demand for mental health services than there are current providers and services available. An overview of the results found:

• 56% of Americans are seeking or wanting to seek mental health services for themselves or a loved one.
• 74% of Americans do not believe mental health services are accessible for everyone.
• 46% of Americans have had to or know someone who has had to drive more than an hour roundtrip to seek treatment.
• 31% of Americans have worried about others judging them for seeking mental health services.
• 25% of Americans reported having to choose between getting mental health treatment and paying for daily necessities.

The study highlighted issues of access between rural and urban areas, as well as how income affects the ability to access services. 53% of individuals who did not seek mental health treatment were living in low-income households.

The high cost of mental health treatment, including insufficient insurance coverage, was also highlighted in the study. 42% of the study participants saw cost and poor coverage as the top barriers for accessing mental health care.

The Impact of COVID-19 on Mental Health

The onset of the pandemic placed additional strain on an already under-resourced mental health system. In a 2020 Kaiser Family Foundation (KFF) poll, 53% of adults in the U.S. reported that their mental health had been negatively impacted due to worry and stress caused by the coronavirus pandemic. Even more worrisome, a June 2020 CDC report found large increases in substance use and suicidal ideation as a result of the pandemic.

However, since the proliferation of effective COVID-19 vacations in 2021, the number of those reporting mental health impacts related to the pandemic have plateaued. In March 2021, KFF found that 47% of adults are still reporting negative impacts on their mental health due to the pandemic. While this slight drop in the numbers of people reporting mental health impacts is encouraging, there are still a lot of people in need of help.

These reports and studies point to a larger trend in mental health care: many mental health providers and advocates warn that a pandemic of mental illness will be the next large public health crisis in America. The incredible impact of COVID-19 on individuals’ mental health in addition to the inequities in mental healthcare access is what has prompted the WFMH to address access and mental health equity as its 2021 theme for World Mental Health Day.

Increasing Access to Mental Health Care

The WFMH and many advocates consider mental health care as a human right. Accessible mental health care is a foundation for health care in general, and it is urgently needed as the world continues to grapple with the pandemic.

There have been some improvements to mental health access since the beginning of the pandemic. Expansion of reimbursement of telehealth services, for example, has opened up services to many individuals who would otherwise not have been able to safely see a mental health provider.

However, the struggle for full access and equity continues. According to a report by KFF, one quarter of US adults who have experienced mental health issues during the pandemic have not received care because they could not afford it. Historically marginalized groups, including women, BIPOC communities, and LGBT individuals, have been hit particularly hard. According to KFF, women with children were more likely to present symptoms of anxiety and depression than men with children (49% vs. 40%, respectively). Additionally, 48% of Black adults and 46% of Latinx adults have reported symptoms of anxiety and/or depression during the pandemic, opposed to 41% of white adults.

Addressing these inequalities across the mental health care system is why the WFMH made it’s 2021 theme “Mental Health in an Unequal World.” If the systematic inequalities in healthcare are not addressed, these disparities will continue to widen. In the words of Professor Gabriel Ivbijaro, WFMH Secretary General:

“The 2021 World Mental Health Day campaign provides an opportunity for us to come together and act together to highlight how inequality can be addressed to ensure people are able to enjoy good mental health.”