~Buzz!~ What's that? Oh, your Apple Watch is reminding you to breathe again. Despite potentially appearing a bit condescending on the surface, this is one example of how trends in  mental wellness (and our ability to self-manage it) are making their way into our everyday lives.

According to the World Health Organization, mental wellness is defined as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”

We’d all like to think we fit into this definition, but most of us have had those periods of “fluctuation” -- sometimes lasting much longer than we’d like to admit -- when we can’t cope with the normal stresses of life (am I alone here?... anybody?). As culture, society, the environment, and technologies continue to shift at overwhelming rates,  the topic of mental wellness has become increasingly popular yet is interpreted differently across individuals and organizations. What’s clear, though, is as public conception of mental wellness changes, healthcare’s response will and should change to meet consumers, customers and patients where they’re at.

Landscape

Awareness and seeking treatment
Mental health is everywhere. From mainstream media (the Today show doing meditation segments in-between cooking and weather) to education (currently 9 states mandate mental health education in schools). And every lifestyle magazine covers “stress” management tips a few times a year.

It’s clear that mental wellness is more on our collective mind and more part of the cultural zeitgeist than ever before. From understanding the concept that people need to care for their mental wellbeing to having a sense of what drives mental wellness, we are all more aware. This leads to more people trying to address their mental health whether it be by making lifestyle changes or seeking treatment

  • 1 in 5 U.S. adults experience mental illness
  • 1 in 25 U.S. adults experience serious mental illness
  • There is still an unmet need for mental health treatment among youth and adults. Only 28.2 percent of youth with severe MDE (major depressive episodes) were receiving some consistent treatment, and over 10 million adults still report an unmet need for mental health care.
  • Almost a quarter (22.3%) of all adults with a mental illness reported that they were not able to receive the treatment they needed. This number has not declined since 2011.
–  Mental Health America's 2020 State of Mental Health in America Report

The stats above really only pertain to those aware of their mental health needs.  There still exists a lack of understanding and self-awareness as to what signifies mental health  (see reality television and internet troll wars). For middle aged and younger adults the term “mental health day” has become a widely understood concept (if not a widely embraced one). But, for older generations, there is less normalization of needing to care for your mental health and more stigma for doing so.

Land of 1000 apps
One of the biggest indicators that there is a ground swell of understanding about mental wellness and a growing desire to address one's mental health is the influx of apps centered around mental health (pun intended). There are hundreds of apps of different types to address different aspects of mental health. Heck, your iWatch even comes standard with Breathe, a mindfulness app.

Some of the app trends the National Institute of Health outlines are as follows:

Self-Management Apps - tools for managing stress, anxiety or sleep problems. You can use additional tools to track heart rate, breathing patterns or blood pressure etc.
Apps for Improving Thinking Skills - These  are geared toward people with serious mental illness and help with cognitive remediation (improved thinking skills)
Illness Management, Supported Care - “The app may help the user connect with peer support or may send information to a trained health care provider who can offer guidance and therapy options.
Passive Symptom Tracking and Data Collection - Apps that collect your data without you having to do anything (“movement patterns, social interactions [such as the number of texts and phone calls], behavior at different times of the day, vocal tone and speed, and more”)and aggregate behavior

Drivers

We may generally understand that mental health is important, but we’re still mighty...unwell. A lot of factors are driving that.

We can’t get treatment when we want it
Individuals seeking treatment but still not receiving needed services face the same barriers that contribute to the number of individuals not receiving treatment:

  • No insurance or limited coverage of services
  • Shortfall in psychiatrists, and an overall undersized mental health workforce.
  • Lack of available treatment types (inpatient treatment, individual therapy, intensive community services).
  • Disconnect between primary care systems and behavioral health systems.
  • Insufficient finances to cover costs – including, copays, uncovered treatment types, or when providers do not take insurance.
- Mental Health America's 2020 State of Mental Health in America Report

Social Media is the worst
It’s no wonder, with the pressure to “keep up” and the bullying comments, it seems as the negatives of social media outweigh the positives.

"Numerous studies found that greater daily time spent on social media, increased frequency of SMU, and multiple platform use were associated with both depression and anxiety.Research suggests that increased social media consumption may lead to negative online experiences, fewer in-person social interactions, and decreased ability to sustain attention."
- National Center for Biotechnology information | National Institute of Health

People don’t socialize enough
Turns out we need to socialize. We’re community based creatures. Investing in social time yields some very positive mental wellness results.

"A strong social support system improves overall mental health outcomes and the ability to bounce back from stressful situations."
- Mental Health America
"The number of friendships you have early in your adult life and the closeness of those relationships can influence your well being 30 years later."
- Mental Health America

Unfortunately we make some less stellar choices for our time

During the week, Americans watch an average of 2.5 hours of TV per day, but only spend half an hour per day socializing.
- US Dept. of Labor, 2018 American time use survey

Work is the worst
Adults spend most of their waking time at work and it's taking its toll..

“Poor work-life balance increases your risk for health conditions like sleep problems, digestive disorders, and mental health problems. This is especially true for people who work longer shifts or on nights and weekends."
- MHA National

Even if you like your job, it can be stressful. And while I’m sure you, dear reader, absolutely love your job, (I do, too... hi boss) take a gander at these bummer statistics.

  • More than half of people who responded to MHA’s Work Health Survey say that they do unhealthy things (e.g. drinking, drug use, lashing out at others) to cope with workplace stress.
  • More than two-thirds of people have had their sleep negatively affected by workplace issues.
  • Over 75% of people are afraid of getting punished for taking a day off to attend to their mental health.                
- MHA National Work-Life Balance

On top of all this we are overwhelmed, have toxic people in our lives and are currently in a worldwide pandemic.

Future of Mental Wellness Predictions

What does the future hold? Well I believe we’re going get better at creating boundaries for our time, expressing our emotions and healthfully asking for what we need. Why do I think this? I have a daughter who is being taught these skills in school. She knows to hug herself and breathe deeply into her belly when she’s really upset. She asks for alone time for cooling off and recharging. And, although the allure of television and screens loom large she knows that running around, climbing and jumping outside makes her feel good and sleep better. She is FOUR YEARS OLD. I didn’t know these things until my 30s and still have a hard time incorporating them into my life. My parents have not yet approached this level of self-awareness.

Knowledge of what elements constitute mental health is spreading and will continue to spread. There’s an acronym that has been popularized that outlines all the facets of mental health; SEEDS - Sleep, Exercise, Education, Diet, Socialization.  People will start to understand their own needs in these categories and become more vigilant in tracking and implementing these not just for their own sake, but for the purpose of mental health. Learning new skills or expanding your mind, getting enough z’s, time with friends, and eating nutrient rich foods will also be the criteria by which we start to judge others. I can imagine a world where the dating population starts to use metrics across mental health categories (in addition to the timeless mating and dating criteria currently in use).

Of course there will be more technology to address these issues, but ultimately I think the prevailing wisdom will be that you can’t shortcut these behaviors. For instance, there are wearable devices being developed that vibrate in frequencies that cause the body to produce stress reducing hormones. While this may become popular for a short time, people will understand that (if able) they can get the same or better results from a jog and a hug.

Healthcare Opportunities

So how might healthcare participate in mental wellness trends and ideals of the future?

Healthcare Networks
In addition to expanding mental health diagnostics and treatment access, healthcare provider networks can start to differentiate by creating dedicated programs and spaces to engage behaviors that benefit mental health. Health systems already provide support groups for people with specific diseases and conditions, what about guidance or peer support for what to do about work burnout, or programs/content that help model and normalize healthy relationships. Perhaps they can even provide addiction help for those who have a hard time putting down their phones.  Health networks can also play a large part in destigmatizing talking to professionals about what you’re going through, absent a diagnosable mental health disorder.

Healthcare will also have the opportunity to differentiate by addressing the mental health component of physical conditions. Currently, in order to help deal with the depression and anxiety that comes from a cancer diagnosis and ensuing treatment, some networks offer therapists and licensed clinical social workers as part of their oncology programs.  Imagine that awareness amplified and routinely offering mental health help for things like the anxiety that can commonly plague people who have eczema, certain cardiac conditions, and many others.

There’s also the wonderful cuddly world of pet therapy. Some hospitals use pet therapy to help improve mood and healing of patients. Pets, as any animal lover will tell you, can drastically improve your quality of life and studies have shown the positive effect of  having an emotional support pet or pet therapy.…

“ Improve cardiovascular health and physical activity; Decrease stress and lower blood pressure;  and for people receiving treatment for mental illnesses, animal-assisted interventions reduce anger, anxiety, depression, and general distress, while improving the ability to socialize."
-Mental Health America, Animal Companionship

Health Network campuses can start to offer drop in pet therapy (or music therapy or art therapy) clinics on their campuses for existing members or patients.

Health Insurance
Of course, a big differentiator will be to offer comprehensive mental health benefits and encourage your customers to seek treatment. Making it easier to find a mental health provider is key. Today a lot of those lists aren’t up to date, and even if they are, there aren’t enough providers on them. Beyond that, health Insurance has the opportunity to educate their customers about the correlation between mental health and physical health and work to boost both.

"When it comes to diet, sleep and exercise, having good, strong routines is linked to improved mental and physical health."
-Mental Health America, Creating Healthy Routines

Health insurance companies can only benefit if their covered population can create those healthy habits. Build platforms and include educational content that helps illustrate what it takes to be mentally healthy. Create and offer incentives for programs that build positive mental health habits.

Loneliness is perhaps hardest on the elderly. One of the opportunities for Health Insurance is to help people to understand and reduce loneliness, which, according to Mental Health America, “increases risk of many chronic health conditions.”

Health insurance would do well to create platforms and programs where aging people can connect and perhaps become re-imbued with purpose, sharing some of their talent or experience.  

Medical devices and technology products
Telehealth access to mental health providers is huge today and will continue to be important. Allowing these sessions to be as robust as possible with potential interactive exercises as well as the ability to create notes, share content and parse out the “advice” given by providers in a way that allows that advice to become more actionable and surfaced more easily.

In addition to the slate of mindfulness and reminder apps, it would be helpful to have different digital tools that allow people to normalize their feelings and experiences and understand whether their symptoms warrant professional treatment. Create platforms that help people understand what behaviors or treatments might be helpful for their current situation or at least a good starting place. Create devices or platforms that can track behavior and build awareness of feeling, mood, and unhealthy thinking patterns as well as platforms that can build habits.

Thanks for reading. We didn’t talk much here about diet and nutrition's effect on mental wellness but I’ll be covering that in an upcoming Future of Wellness in Healthcare article for Lux @Propane.

Kim-Minh Huberwald
Director of Strategy, Propane