What would you define as the most significant mental health issue in the United
States, and why (use 2-3 references from the scholarly literature to support your
position)? What services and solutions do you propose to offer for this issue? How
does this issue serve as an indicator for society's overall health?
Mental health issues are common in the United States, with an estimated 26.2% of
Americans 18 years of age or older suffering from a diagnosable mental disorder in a
given year, which translated to about one in four adults (Kessler et al., 2005). Although
mental health issues are widespread in the population, the burden of illness is
concentrated in a smaller proportion of individuals who suffer from a serious mental
illness. Mental health issues are also a leading cause of disability in the United States
(WHO, 2008). Many people suffer from more than one mental illness at a given time and
close to half of those with any mental disorder meet criteria for two or more disorders
(Kessler et al., 2005).
One of the most significant mental health issues in the United States is depression,
which is classified as a mood disorder. Mood disorders affect approximately 20.9 million
American adults, or about 9.5 percent of the United States population 18 years of age or
older in a given year, according to Kessler et al. and the U.S. Census Bureau (2005;
2005). According to the National Institutes of Health, depression may be caused by a
combination of genetic, biological, environmental, and psychological factors (n.d.).
Depression interferes with daily life and causes pain for both the individual and their
loved ones, and although depression is common, it is serious. Kessler et al. (2005) cited
that depressive disorders often co-occur with anxiety and substance abuse and many
people with depressive illness never seek treatment (NIMH, n.d.). There are several
forms of depressive disorders: major depressive disorders/major depression, dysthymic
disorder (dysthymia), minor depression, and manic-depressive illness.
Major depressive disorder is the leading cause of disability in the United States
from individuals ages 15-44 (WHO, 2008) and affects approximately 14.8 million
American adults 18 years of age and older in a given year (Kessler et al., 2005; U.S.
Census Bureau, 2005). Major depression, according to the NIMH (n.d.), may be
characterized by a combination of symptoms that interfere with a person’s ability to
work, sleep, study, eat, and enjoy activities that were once pleasurable. It is also disabling
and often prevents a person form functioning normally (NIMH, n.d.). A nationally
representative face-to-face household survey determined that 6.7% of adults in the United
States experienced a major depressive episode in the past 12 months (CDC, 2011). The
CDC also reports significantly greater percentages of lifetime major depression among
women than men, 11.7% versus 5.6%, respectively (2011; Kessler et al., 2003). Ethnic
differences for depression are also evident with a reported “6.52% among whites, 4.57%
among blacks, and 5.17% among Hispanics” (CDC, 2011). Put in other words, women
are 70% more likely than men to experience depression during their lifetime and nonHispanic blacks are 40% less likely than non-Hispanic whites to experience depression
during their lifetime (NIMH, n.d.).
Dysthymic disorder, also known as dysthymia, is characterized by long-term
symptoms that are not necessarily severe enough to disable a person but can prevent
normal functioning or feeling well (NIMH, n.d.). Minor depression is characterized by
having symptoms for 2 weeks or longer that do not meet full criteria for major
depression, states the NIMH (n.d.). People with this type of depression are at high risk for
developing major depressive disorder without proper treatment (NIMH, n.d.). Manicdepressive disorder, also known as bipolar disorder, is not as common as major
depression or dysthymia and is characterized by cycling mood changes from extreme
highs (such as mania) to extreme lows (such as depression), according to the NIMH
(n.d.).
The USPSTF recommends screening adults for depression when staff-assisted
depression care supports are in place to assure accurate diagnosis, effective treatment,
and follow-up (2009). On the other hand, the USPTF recommends against routinely
screening adults for depression when staff-assisted depression care supports are NOT in
place but there may be considerations that support screening for depression in an
individual patient (2009). The American Psychological Association states that depression
can be successfully treated when he or she receives competent care (2014). It is critical
for individuals who suspect that they or someone they know may be suffering from
depression seek care from a licensed mental health professional who is both trained and
experienced in helping people cope with and recover from depression. Unexpressed
feelings and concerns accompanied by a sense of isolation can worsen a depression;
therefore, the importance of getting appropriate help cannot be overemphasized (APA,
2014).
Several approaches to psychotherapy, including cognitive-behavioral,
interpersonal, and psychodynamic, help depressed people recover. Psychotherapy offers
people the opportunity to identify the factors that contribute to their depression and to
deal effectively with the psychological, behavioral, interpersonal and situational causes.
Working with individuals who are suffering from depression can help by identifying life
problems that contribute to their depression and help them understand what aspects of
those particular problems can be solved or improved; identify negative or distorted
thinking that contributes to feelings of hopelessness and helplessness that often
accompany depression; explore learned thoughts and behaviors that create problems and
contribute to depression; and help these individuals regain control and pleasure in their
lives (APA, 2014). Moreover, the support and involvement of family and friends, along
with the guidance of a specialized therapist, can play a crucial role in helping someone
who is depressed. Individuals in the support system can help by encouraging a depressed
loved one to stick with treatment and practice the coping techniques and problem-solving
skills he or she is learning through psychotherapy (APA, 2014). Therapy and counseling
may be beneficial in learning effectives ways in which the individual can work with
his/her therapist and family/friends to cope with and find support for their depression.
References
American Psychological Association, (2014). Depression. Retrieved from website:
http://www.apa.org/topics/depress/index.aspx
Centers for Disease Control and Prevention. National Center for Chronic Disease
Prevention and Health Promotion, Division of Population Health. (2011). Burden
of mental illness. Retrieved from website:
http://www.cdc.gov/mentalhealth/basics/burden.htm
Kessler, R. C., Berglund, R., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., Rush, A.
J., & Walters, E. E. (2003). The epidemiology of major depressive disorder:
results from the national comorbidity survey replication (NCS-R). The Journal of
the American American Association, 289(23), 3095-3105. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/12813115
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity,
and comorbidity of twelve-month DSM-IV disorders in the national comorbidity
survey replication (NCS-R). Arch Gen Psychiatry, 62(6), 617-627. doi:
10.1001/archpsyc.62.6.617
U.S. Census Bureau, Population Division. (2005). U.S. census bureau population
estimates by demographic characteristics. Table 2: Annual estimates of the
population by selected age groups and sex for the United States. Retrieved from
website: http://www.census.gov/popest/national/asrh/
U.S. Preventive Services Task Force. (2009). Screening for depression in adults: U.S.
preventive services task force recommendation statement. Annals of Internal
Medicine, 151(11), 784-792. doi: 10.7326/0003-4819-151-11-200912010-00006
The World Health Organization, (2008). The global burden of disease: 2004 update,
table a2. Retrieved from WHO website:
http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_
AnnexA.pdf