Part 2: Pandemic Drivers and The Loneliest Generation

By Brad Baum & Patrick Harmon Lopez

In our Part 1, we dug into a key problem plaguing our country: mental health. As a quick reminder, 1 in 5 people in this country have a diagnosable mental illness. However, the problem is actually more pervasive if we begin to think about mental health as a spectrum on which all of us exist, somewhere between ill and well. The vast majority of us are reactive instead of proactive (as shown below and further discussed in part 3), an approach that has left us ill-equipped to cope with something as stressful as a global pandemic and economic crisis:

So what’s being done to change this? Unfortunately, not much due to the broken way in which the system is currently structured, and the fact that individuals are not getting the treatment they need. Some of the underlying drivers behind our mental health problems:

1. The stigma — 2/3 of people who have received hospital treatment for a mental health condition say they have experienced discrimination at work or when seeking employment. This goes beyond severe conditions and extends to common ailments such as depression: a recent survey found that 21.5% of people would not hire a person with depression, even if qualified, and 77.3% of people would not let a depressed person take care of their children. This is exactly the sort of stigma that keeps people from seeking out therapists, psychologists, and psychiatrists. Men oftentimes struggle with the stigma issue to a greater degree. Unrealistic and flawed male stereotypes (e.g. strong, quiet, stoic) that many males are implicitly and explicitly told to embody lead to shame, insecurity, and a fear of seeking treatment. Consequently, drug use is often a maladaptive coping strategy, which only reinforces the underlying issues. There is some thought provoking research being done on this issue.
2. Access to proper medical practitioners — Companies have been popping up trying to eliminate barriers between practitioners and patients, but the question around who is the right type of professional to turn to, how do you know you’ve found the best potential fit, etc. have not been solved (company building request: Hinge + ‘speed dating’ platform for optimizing the process of finding the right therapists). Similarly, the issue isn’t always around access, but distribution, wherein rural patients have inferior access to care as compared to urban patients.
3. Improper handling — In the US, 80% of psychotropic drugs are prescribed by primary care physicians (PCPs) rather than psychiatrists.
4. Prohibitive cost — A session with a psychotherapist costs $80-$120 on average, which 45% of untreated individuals cite as a barrier. Keep in mind, 40% of Americans don’t have $400 in the bank for emergency expenses.
5. Shortage of therapists — There is a 26% appointment rate in the US (i.e. only 26% of patients seeking care were able to book an appointment), with 25 days on average to book an appointment (again, more on this supply-side issue in Part 3 of this series). Lack of therapist capacity to take on new patients is a key driver here; the Substance Abuse and Mental Health Administration estimates that by 2025, existing capacity will only meet 44% of need, and that this gap is significantly greater in rural areas (as shown below).

Unfortunately for the future mental health of our society, the group suffering disproportionately from the mental health pandemic in the US is the country’s youngest generation: GenZ. This problem has been stewing for a while now, as GenZ is known to be the most prone to depression, anxiety, and stress as compared to older generations. A 2018 APA study revealed that 91% of Gen Zers between ages 18 and 21 experienced at least one physical or emotional symptom because of stress in the past month, compared to 74% of adults overall. It also found that Gen Zers are more likely than other generations to be diagnosed with an anxiety disorder and to report that they have been diagnosed with depression.

Expertly depicted in Netflix’s The Social Dilemma, social media is intentionally orchestrated to exploit your vulnerabilities in order to capture as much of your attention as humanly possible, as it’s the currency which social media companies monetize.

It’s no secret that Gen Z and Millennials tend to be superglued to their social accounts; and while that’s not inherently bad, social feeds tend to depict the 1% of users’ days (e.g. Malibu sunsets, perfect relationships, expensive nights out) rather than the 99% depicting true lived experiences. Social media has become a haven for displaying your ideal self to your followers, rather than a wholesome depiction of how you’re doing. As such, users are forced to compare their world with the digital world of their friends and are left frustrated, unsatisfied, and envious.

Now, jumping back to the current state of affairs — Gen Z has been especially affected by this pandemic with one driver being they’ve been cut off from peer interaction during the most formative social learning years, stunting their personal growth and maturity that comes from key life events like moving into college dorms or trying out new hobbies/extracurriculars. Furthermore, constant online connectivity combined with a proliferation of 24/7 news coverage (primarily focused on negative current events) have increased this inclination towards anxiety: a recent survey found that younger Americans are reporting that the coronavirus pandemic has negatively impacted, or even wrecked, their financial stability at rates almost twice as high as their baby boomer parents. The survey also found about 37% of Gen-Z-ers and about 27% of millennials say Covid-19 say has negatively impacted their mental health, compared to 15% of baby boomers and just 8% of the silent generation.

Another harrowing statistic that demonstrates the magnitude of the problem: the CDC recently published that in June, 2020, one in four Americans ages 18–24 considered suicide within the past month, according to a survey completed by 5,412 adults between June 24 and June 30. So did 16% of respondents ages 25–44.

So if the current system and approach isn’t working, how can it be altered to be more effective? What business models and opportunities need to be created to properly address these issues? Importantly, how do these solutions actually change the way we view mental health in a way that can help us fix this problem at a fundamental level, rather than simply applying a band-aid or augmenting existing processes with technology?

Well, we can start changing the way we think about treatment. In our next installment, we’ll dive into the concept of treating mental health like dental health, as well as hacking the supply-side of mental health treatment.

Part 3: Mental Health like Dental Health