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Why is mental health less equitable for some than others?

Exploring mental health inequity in the US for World Mental Health Day.

Although all people are equally deserving of good mental health, not everyone has equal access to the resources needed to make that a reality. Inequities in societies across the globe impact people’s access to wealth, good health, and equal opportunities. These inequities are avoidable, but persist because they are reinforced within societal institutions and systems. To draw awareness to the inequities that prevent all people from having good mental health, World Mental Health day on October 10, 2021 has set the theme of Mental Health in an Unequal World.

World Mental Health Day is a time to bring awareness to the underlying issues preventing mental health equity globally and to inspire people to take action. Below, we outline two major sources of mental health inequity in the United States — stigma and socioeconomic status — then explore some ways we can all make a difference.

Mental health stigma

Stigma refers to widespread misconceptions about mental illness, such as the belief that seeking help for a mental health condition is a sign of weakness. Mental health stigma is harmful in a number of ways: It can make people who are already suffering feel like their mental health struggles are their fault, and can keep people from seeking effective treatment, even those who are struggling with concerns like suicidal thoughts.

Stigma disproportionately impacts people from marginalized communities, such as people of color or LGBTQ+ individuals. Due to historical and ongoing injustices and discrimination, people from marginalized communities often have lower trust in health care systems and providers. People also may feel reluctant to take on an additional marginalized identity such as “mentally ill,” as they may fear experiencing even greater discrimination and alienation from their society and community. For example, among some Black Americans communities in the US, seeing a therapist is discouraged as it would involve “airing dirty laundry,” potentially putting the family or community at risk of judgment, stereotyping, and further oppression.

Socioeconomic inequity

The World Federation for Mental Health notes that in our world, health, economic, and social inequities continue to grow. A person’s socioeconomic status — their combination of education, income, wealth, and occupation — is strongly associated with mental health status. People who are not employed, or are working part time or at multiple jobs, are less likely to have health insurance that allows them to regularly attend to their physical and mental well-being. Without health insurance (and even sometimes with insurance) mental health care can be costly, and impossible for people without disposable income to afford.

Seeking and engaging with mental health care doesn’t just take money; it also requires non-monetary resources like time, transportation, and child care. People who don’t have a car, or whose jobs lack flexibility, often simply can’t find the time to get the care they need.

What can you do to help?

Worldwide inequities affecting the mental health of millions is a heavy topic, and it can leave us wondering what can possibly be done. But every little bit counts, so here are a few suggestions:

1. Take a stand against stigma

Stigma is maintained when people continue to believe and share misconceptions about mental health and help-seeking. You can practice using “person-first” language to break down stigma: For example, saying “a person with schizophrenia” instead of “a schizophrenic.” Or, saying someone has “died by suicide” instead of saying they “committed suicide.” These slight re-framings ensure that the person comes first, and their struggles — while important and valid — do not obscure their identity. However, some communities, such as the autistic community, prefer “identity-first” language, for example, “autistic person” versus “person with autism.” At the end of the day, the key is listening to the voices of those with lived experience and following their lead.

2. Look after your own mental health

Making your mental health a priority not only helps you lead a better life — it can also empower you to show up for the people you love, and set an example for someone who might be struggling. For example, seeking help to deal with anxiety, depression, and insomnia can help you manage symptoms that may be getting in the way of work, socializing, and even parenting. Plus, if you’re open about your personal dedication to mental health, you can also help break down stigma, showing others that it’s a normal and healthy thing to do.

3. Spread awareness

The more we know about mental health inequities, the more we can take action in our everyday lives. Sharing evidence-based information about mental health helps normalize the conversation, break down stigma, and increases access to information for people who may be hesitant to go looking. You can start by sharing this blog post, or World Mental Health Day website with friends, family, or even on your LinkedIn page.

4. Share the wealth

For many people, socioeconomic status is a barrier to mental health care. A lack of disposable income or employment opportunities due to systemic inequities make it difficult or impossible for people to maintain their mental health. People who are in a situation to donate money can make a difference by supporting organizations which strive to rebalance inequities. One example is the Loveland Foundation, which is committed to providing the means and opportunity for Black women and girls to take care of their mental health.

You can address mental health inequities at your company

Systemic inequities impact the mental health of people around the world every day. Here in the US, even people working at your company are facing barriers that prevent them from achieving good mental health. The good news is that business leaders are in a position to influence change within their companies that can reduce inequities. To learn more about how you can do this at your organization, take the Mental Health Equity Assessment, and take the first step towards fostering equitable mental health in your company.

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During the COVID-19 public health emergency, Sleepio and Daylight are being made available as treatments for insomnia disorder and generalized anxiety disorder (GAD), respectively, without a prescription. Sleepio and Daylight have not been cleared by the U.S. Food and Drug Administration (FDA) for the treatment of insomnia disorder and GAD, respectively.

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