Faculty Member Calls for Significant Changes to the U.S. Mental Health Care System

ALBANY, N.Y. (Oct. 26, 2022) – In a recent commentary published in the Annals of Bioethics and Clinical Applications, David Hoffman of the Department of Health Policy, Management, and Behavior calls for collective action to address the shortcomings of the mental health care system in the U.S.

Diagnoses of anxiety and depression have increased by approximately 25 percent since 2020, and most states report shortages of the mental health professionals needed to address this growing demand. According to Hoffman, the U.S. currently has only a fraction of the workforce required to meet the mental health care needs of its population: “This is a significant public health, health care, and social justice issue.”

Hoffman believes that part of the problem is a lack of recognition of the role mental health plays in physical health: “Our mental health is inextricably tied with our physical health. For example, a person with untreated depression may be less likely to exhibit positive health behaviors, like managing other chronic conditions, eating a balanced diet, and getting sufficient exercise.”

The first step, according to Hoffman, is to normalize conversations around mental health. And while there has been some progress in this area already, Hoffman argues that we need to rethink the way we approach the topic.

“We live in a society where for generations mental health symptoms are ascribed only to those with a diagnosable mental illness,” Hoffman explains. “But many of us experience symptoms like anxiety, depression, sleep disturbances, and others that interfere with our health, our relationships, and our wellbeing in every sense of the word. This is not in any way to diminish the need for early identification and treatment of diagnosed mental illness, rather it calls for us to acknowledge just how normal it is to experience some of these symptoms at points in our lives or chronically.”

Acknowledging that mental health is more than just a diagnosis may help to solve other problems as well. For example, the normalization of open conversations about mental health could lead indirectly to more funding for educational opportunities that would grow the mental health workforce, a better payment system for mental health services, and the creation of evaluation programs to ensure the quality and consistency of care.

But for Hoffman, the bottom line is that it’s the right thing to do. “The Principle of Justice calls for us to create systems based in fairness and equity. This is truly a social justice issue in every sense. When we are all better off individually, we are all better off collectively,” Hoffman explains.

The growing mental health crisis may indeed be one of the defining public health challenges of this generation. But in every crisis is an opportunity to build something better. And for that, Hoffman is still hopeful: “For those who would argue that this problem is too big for us to solve, I would challenge them to recall that this country was founded by a group of people who believed deeply that only white male landowners deserved the vote, women had no rights, and slave holding was normal. If we can change this much to where we are today, we can go further.”