Global Health Blogs with Professor Swahn

    Mental health is very important for every individual. What is mental health? Mental health refers to cognitive, behavioral, and emotional well-being. It is the state of mind of an individual expressing his thoughts, feelings, and behavior. Mental health is very important for every individual. What is mental health? In the present lifestyle, people are becoming more reserved. People have trust issues among themselves. No one wants to show their real personality out. There are various reasons behind this kind of change in nature. If we talk about the older times, people used to trust each other, they felt relieved by discussing their thoughts and feelings with their loved ones and friends. But now in this modern and advanced time, everyone competes with the other person. Earlier we used to say, your grief can be minimized if you share it with your loved one, but now people say it’s better to cry in front of a wall than a person. It’s the sad reality of our lives that we are lacking in trust. 

        The Internet plays a crucial role in our lives. It has made our life very easy, we have access to multiple opportunities. We are doing online studies, remote jobs and doing payments online, and many more. But everything has its pros and cons, social media which was initially a tool of connecting with friends and family living far away. But with time, I realized it’s becoming a hub for mental sickness. Everyone is showing off their fake lifestyle, showing how happy they are, how cool the lifestyle and they are living the best of their life. But it is the opposite, especially for adults. Adults like school kids and adolescents are the prime victims of this social media trap. They are more worried about how many likes and followers they are getting, they feel depressed if they get fewer likes than others. It’s a whole new world now. There is no privacy, where they are going, what they are eating and what they are doing is all over their social profile. This is the main reason that many kids become victims of cybercrime, where they are stalked and blackmailed. They are always thinking about what is next to post, instead of playing or doing some physical activities.

        Where is real interaction? There is no real conversation between people. It’s all texting and sending emojis to each other. These are the emotional language now, sending happy, sad, laughing, and angry emojis. This is the biggest reason that the families are parting apart, earlier in the family dinners like Thanksgiving, friends, and family sit together for dinner, share their feelings and laughter. But now, it’s all about posting pictures of dinner items and waiting for likes and followers. They are sitting at the dinner table and everyone on their cell phones. Kids no longer share their problems with parents, they are in their different worlds. https://www.mcleanhospital.org/essential/it-or-not-social-medias-affecting-your-mental-health 

     Suicide is the outcome of mental illness. In my experience, loneliness kills the person. Cases of suicide have increased exponentially in the past decade. The reason for suicide can be many, people commit suicide because of family abuse, sexual violence especially in those parts of the world, where law and order are always in favor of the rich and powerful party. People feel helpless and depressed, don’t know what to do, where to go. Especially poor girls who were victims of rapes and sexual molestation either by family members or by someone who had powers.https://gulfnews.com/world/asia/india/india-rape-victim-commits-suicide-in-india-after-the-accused-were-let-off-by-the-village-heads-with-five-slaps-each-1.1587983639781

 Feeling of helplessness, physical trauma, and social pressure is a mental illness that resulted in suicides. Since I am talking about social pressure, it’s torture which had named as cultural pressure. There are many cases of honor killing witnessed all over the world. Why do people honor killing? It’s also a kind of mental illness, which has turned into violence and killing. https://www.meforum.org/2646/worldwide-trends-in-honor-killings

     COVID19 pandemic has shaken the world. Millions of people lost their lives and their loved ones. To stop the spread of this disease, the government had put some guidelines like stay at home, lockdown, 6 feet apart social distancing, and quarantine regulations. Although these were meant to control the situation as a result of this, more cases of mental illness were diagnosed during this period. Fear of getting infected from COVID19, fearing losing a loved one has caused anxiety in people. Many people had panic attacks and anxiety episodes, while they were waiting for their results for COVID19. Those who were the frontline workers like health care workers and essential workers like truck drivers, grocery store workers were also going through this fear of getting infected. Kids were also suffering from the same kind of depression, as schools were closed, with no interaction with their teachers and friends. Even for parents, it was hard to keep them engaged all the time. They missed visiting their grandparents and other close relatives due to the lockdown. https://www.psychiatrictimes.com/view/new-findings-children-mental-health-covid-19  

     People who were exposed and under quarantine, for them it was so devastating. Completely in isolation away from loved ones and family at the risk of their life is another kind of mental trauma for them. Old people living in nursing homes were also subjected to depression as they can not meet with their kids and grandparents as they were in a high-risk category of getting infected. It’s like a pandemic within a pandemic. Many people lost their jobs, financial insecurities have led to so many mental related problems like aggression, depression, and violence in the families especially black households

       In the end, I would like to give some suggestions to improve mental health. During the time of COVID919, there should be tele counseling for patients regarding mental wellbeing for those who are waiting for test results, so that they don’t get panic attacks or anxiety attacks out of fear of getting infected. All the front-line workers and essential workers should be given some compensation in their salaries and proper personal protective equipment should be provided. Parents should monitor the activities of their kids on social media.

REFERENCES – 

McLean Hospital. (2021, February 10). The Social Dilemma: Social Media and Your Mental Health. Retrieved from https://www.mcleanhospital.org/essential/it-or-not-social-medias-affecting-your-mental-health

Evangeline Elsa, D. S. (2020, April 27). India: Rape victim commits suicide in India after the accused were let off by the village heads, with five slaps each. Retrieved from https://gulfnews.com/world/asia/india/india-rape-victim-commits-suicide-in-india-after-the-accused-were-let-off-by-the-village-heads-with-five-slaps-each-1.1587983639781

Chesler, P. (n.d.). Worldwide Trends in Honor Killings. Retrieved from https://www.meforum.org/2646/worldwide-trends-in-honor-killings

New Findings About Children’s Mental Health During COVID-19. (n.d.). Retrieved from https://www.psychiatrictimes.com/view/new-findings-children-mental-health-covid-19

We are coming up on one year of quarantine as a result of the COVID-19 pandemic. In that time, quite a lot has changed for the everyday person. From eating habits, working at home, spending more time with one’s family, growing in one’s health journey or gaining weight, becoming depressed, and struggling with one’s mental health. 

In this blog post, I will be focusing on the impact COVID-19 had on the mental health of people, specifically in the United States. A year is a long time for one’s mental health to change. For example, according to the Commonwealth Fund, Los Angeles has seen an 8000% increase in calls to suicide and mental health hotlines.

Source: Statista

The graphic above gives an insight as to which countries have experienced the most impact from mental health struggles and it shows that the United States is the one to have a 33% increase compared to the rest of the world. What has caused such a rapid increase to occur? 

By exploring the social determinants of health, we may gain some answers. First, employment- many people were let go from their jobs or had lower pay thereby reducing the chances of staying busy or driven and having the added stress of financial maintenance that may not have been there before. With that comes the added insecurity of access to food, housing, and healthcare resources. The stress of the uncertainties that came with the pandemic itself has also caused a rise in mental health struggles. People have gotten sick, gone to hospitals, and even died during the pandemic due to the virus and that added emotional stress has caused a toll on people. 

The pandemic has helped in the growth of telemedicine, especially the availability of mental health counselors, therapists, social workers, and more. Preston Kadleck, a therapist who was written about in National Geographic, stated that there are now enough social workers or people licensed to give counsel in the United States to help everyone. The issue that arises is access to these experts. He brings up a valid point that volunteers are a vital part of hotlines and help people step back from the edge of whatever volatile emotion they may be feeling, but they are not licensed and do not have the right resources to help a person understand what it is they are experiencing, how to cope with it, and build healthier habits to combat negative emotions that could result in negative actions. The link here provides a wonderful graphic that I was unable to add to the blog due to copyright issues. It shows the access to mental health resources by state and how they fare due to the lack of said resources. 

The next question that arises is then how do we increase access to mental health providers to reduce the struggle of mental health? Something like telehealth is a great start. Yet for some people, telehealth coverage is not included in their insurance. Therefore, one solution would be to expand health insurance coverage to include mental health providers. And the coverage should not have outrageous copays, especially during a pandemic. You know, if it is telehealth, why does a provider network matter for certain insurance carriers? By asserting more control over the health of people, it causes more stress, anxiety, depression, and more to increase and start in a vicious cycle. 

This bar graph comparison shows a clear increase in anxiety and/or depression in 2019 compared to 2021. 

This article by the KFF does a great job of breaking down the percentages and changes of anxiety and depressive disorder development in the United States before the pandemic and during the pandemic. The article does well to address the people that already had mental health issues in their life before the pandemic and how their situations were exasperated during the pandemic. It specifies per section an age group that has been impacted. For example, it focuses on young adults who are ages 18-24 who have experienced pandemic-related stress which has increased mental health struggles. Some of that stress is from schools closing and transitioning to 100% online education. Other stress includes losing one’s job or reduced hours as well as the risk of working during the pandemic and being distrustful of people who may not be taking protective measures properly. 

The stress of wearing a mask and covering one’s face is another huge factor that is not discussed often. Our society functions on interactions with one another which includes facial expressions and socializing in close circles or going out. By wearing masks, we have closed ourselves off to a major source of interaction which is reading one another’s facial expressions and interacting based on the reactions one has with the other. Something so small was not even realized until the pandemic and makes one question if we, as a society, took it for granted previously. The isolation that comes with putting a mask on and feeling alone along with the literal isolation during the pandemic really caused the rise in anxiety or depressive disorders to increase substantially. Will we go back to being “normal” after the pandemic? 

East Asian countries such as China, Korea, and Japan include masks as part of their daily lives. Some of it is due to air pollution, fashion, being respectful of people around them if they are sick, and for some, it’s to be a bit more protected against smoking. Therefore, would people be completely opposed to keeping the masks even after the mandates subside? Personally, I don’t think so. An element of that has to do with being worried or nervous about what germs or illnesses someone else may have. While that may make our society less trusting of one another at the beginning (which is another mental health concern), it would provide a sense of security to everyone in knowing that they are looking out for their own health and the health of others. 

It’s clear to say that the mental health status of Americans has steadily deteriorated over the last year, but it makes Americans that much more determined to persevere in the face of difficulties. I look forward to the positive changes this pandemic may possibly bring, even if it takes a while. Until then, if you need someone to talk to, hotlines are great for a conversation, but please reach out to someone who is able to give you professional guidance without any judgement; someone who wants the best for you. 

What comes to mind when you hear the words “mental health?”  Suicide? Abnormalities? People who have too many feelings or do not know how to handle the world? According to mentalhealth.gov, Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is as important to our bodies and minds as physical health. In fact, I think that without good mental health, you will never obtain good physical health. Mental health issues vary from eating disorders, to anxiety and depression, to phobias and addictions. While some of these issues are rooted in our genetics, the environment and social atmosphere we surround ourselves in also play a crucial part in our mental health. 

In her TedTalk video, Heather Young Sarkis explains why it is important to discuss mental health. 43.8 million adults experience mental illness each year. This number is actually four million less than the 2019 population of the entire state of California. AN ENTIRE STATE OF PEOPLE, and the third largest state at that, all diagnosed with mental illness and there is still a large stigma around ‘mental health.’ She brings up a very good point; we have specific months and fundraisers for other health related topics but we are still scared to promote mental health. The entire month of October is dedicated to Breast Cancer awareness. You can sign up to run 5k’s for specific diseases, like pulmonary fibrosis, but what about supporting mental health, or even bringing awareness to it? Especially when it effects so many people.

I did a Google search for mental health awareness and was introduced to a new name; NAMI aka the National Alliance on Mental Illness. According to their website, NAMI joins the national movement to raise awareness about mental health every May. While many people are familiar with breast cancer awareness in October, the Susan G Komen foundation, is anyone aware that May is dedicated to mental illness? As someone who suffers from mental illness myself, this is news to me. The AHA, or American Hospital Association, also advertises May as Mental Health Awareness month. The National Council also shares this information, yet this is still the first time I am hearing about this. 

The first thing that comes with mental health awareness is simply an understanding for what it actually is, an illness out of someone’s control. From the perspective of a 20 something year old female who has been diagnosed with mental illness and sought treatment for almost 10 years, it still irks me to hear people say mental illness is in my control. That I can control my feelings, my moods, emotions, and the way the world makes me feel. That I can “let go,” or “move on,” or “stop letting it bother me.”  The simple truth of the matter is simply this; I cannot. I may seek help through a therapist or psychiatrist, I may take medication to even the chemicals in my brain, but it is still an ongoing issue I deal with everyday. Mental illness is an illness that follows you for life. Changing surroundings and the way our brain thinks can only do so much for certain people.  This article outlines six things NOT to say to a depressed person, and gives alternative ways of communicating.

Just like with anything else in life, it takes a specialized professional to diagnose mental health disorders and an even bigger professional to treat or cure them. Speaking from experience, it takes a lot of courage to open up to someone about how you are feeling. Now make that person a licensed professional in a closed room — speaking about your problems becomes almost impossible. When I say it takes a specialized professional, I do not mean someone who went to medical school and interned at different psychiatry offices. Often times it takes an empathetic individual to truly understands where we are coming from to make us feel comfortable. As mental illnesses continue to grow and occur, the need for mental health professionals is also growing. This article takes a closer look at what might be a shortage of mental health professionals in our country. With the ongoing pandemic, I can only imagine these numbers will steadily increase.

In 2017, a rapper known as Logic released a song titled with The National Suicide Prevention Lifeline, 1-800-273-8255. The song has over 1 billion streams on Spotify at the time of writing this (February 2021). For the first time in maybe forever, suicide and mental illness were trending in music charts. This song not only helped people suffering with mental illness and thoughts of suicide, but also brought awareness to the issue. While mental illness does not stop at suicide or depression, the song still made headlines and woke many people up, especially young adults and teenagers. I strongly encourage you to watch this video, where Logic explains the meaning behind his lyrics and the truth behind the song.  After the praise he received from the songs release, and all the fans who wrote to him saying he saved their life, he specifically states “I wasn’t even trying to save your life, now what could happen if I actually did?” He then went onto preform the song at the 2017 Video Music Awards (VMAs). After the performance, which included attempted suicide survivors, calls to the National Suicide Prevention Lifeline increased by 50%.

I hope more artists and people in the spotlight can continue to bring awareness to these issues. Mental illness does not stop at suicide and depression. We must also advocate and support those suffering from OCD, ADHD, schizophrenia, bulimia, and everything else included in mental health. Mental health should be prioritized over everything else, and maybe once it is, the rest of our health and social behaviors will change as well. When you break your leg, you have a cast. When you have cancer, you might get chemo and experience hair loss. When you’re sad and your mind is racing, there is nothing to show. That does not mean there is nothing to see, it just means mental illness shows itself in different ways than other diseases, illnesses, or injuries. 

               There has been a dramatic increase in the use of technology over the past decade. I occasionally witness, or even find myself involved in, discussions about the social and environmental changes youth today find themselves obliviously engaging in. In the 2000’s and early 2010’s, my peers and I were much more engaging with our physical environments. We enjoyed playing outdoors, having playdates at one another’s house, and using our imagination to create fun activities for ourselves. There was even a “Worldwide Day of Play” on one of the popular television networks (Nickelodeon) that encouraged children to go outside and play by halting their regular programming for a majority of the day.

Unfortunately, times are very different for today’s youth. With technological devices being overly accessible, children and adolescents indulge in “screen time” at unhealthy and alarming rates.

According to a 2018 study on Screen Time and Psychological Well-being, adolescent’s psychological well-being decreased after 2012. I distinctly remember this time period as there was an emphasized shift to using social media platforms among my peers, more specifically Instagram. There were social media apps and sites (Facebook, Myspace, Tumblr etc.) that previously existed before this year, however Instagram was in a lane of its own. I witnessed, and was a part of, the steadily growing dependence on smartphones. Retrospectively speaking, this was also the time I began to experience significant disruptions in my mood which affirms this study’s findings. According to the authors, adolescents that spend more time on electronic communication and screens (social media, the internet, texting, television, and gaming) and less time on non-screen activities (in-person social interactions, extracurricular activities, sports, and homework) have a lower psychological well-being. In contrast, adolescents that spend a small amount of time on electronic communication and screens were more content and happier. The rapid uptake of smartphones significantly contributed to the shift in adolescent’s use of time on non-screen activities to the extreme amounts of screen time we witness today.

Screen time and use is of significant importance today due to our current circumstances. The Covid-19 pandemic has caused laws and policies to be created (school closures, shelter-in-place orders, and social distancing implementation measures) to best promote citizen’s well-being and reduce the spread of the virus. However, the global lockdown orders have incited an increase in screen times and usage. In addition to the physical health risks (obesity, high blood pressure, and diabetes) this may cause, there may also be some mental health risks such as an increase in depression, anxiety and even suicide within youth and young adults. Having to socially isolate and be unable to physically connect with friends and family members could result in negative mental health outcomes. There are free mental health educational resources and support services individuals can utilize to combat any of these issues, which is a positive screen time benefit. Georgia State University actually offers some of these resources at the counseling and testing center. Fifteen free counseling and therapy sessions are offered to students but only via telehealth, which is a contributing factor to screen time.

Virtual mental health support services are a great example of all screen time not being negative or yielding the same outcomes. Due to there being various types of screens (televisions, computers, tablets, cellphones) that can be used in a variety of different ways (watching films, playing games, reading books, using social media) the effects of screen time and screen use can be a bit conflicting. Each of these screens can have a different, unique impact on children and young adults. For example, using screens to communicate and connect with friends and family members can have a positive effect on one’s mental health. Though social media use has been reported to cause unhealthy comparisons, enable bullying, and increase exposure to negative content it can also have positive influences on youth. Some children have stated that it is a significant help to them in keeping in contact with their loved ones, strengthening their friendships, and allowing them the opportunity to explore new information, opinions, and perspectives.

However, numerous studies have reported that if used excessively screen time has been associated with negative mental health outcomes. In their 2018 article, Twenge and Campbell found that after 1 hour a day of screen time, any additional hours were associated with lower psychological well-being (less curiosity, lower self-control, increased distractibility, more difficulty making friends, less emotional stability, decreased ability to finish tasks). For adolescents aged 14-17 years old, users that had a screen time of more than 7 hours of day were more than twice as likely to receive a diagnosis of depression, anxiety, receive treatment from a mental health professional, or have taken medication for a psychological or behavioral issue in comparison to those adolescents that had a screen time of 1 hour or less a day. They also reported that adolescents that even had a moderate screen time of 4 hours a day also displayed an association with lower psychological well-being.

There are also age and gender differences in the effects that screen time have on mental health. For example, the associations between screen time and lower psychological well-being are more salient among adolescents than younger children. In a recent (2020) article Jean M. Twenge conducted with Eric Farley, it was reported that girls demonstrated stronger associations between screen media time and mental health indicators than boys. This finding validates Barthorpe’s article that also reported a greater amount of time spent on social media was associated with an increased risk of self-harm, depression, and lower levels of self-esteem in females.

Due to the significant negative mental health effects screen time has on youth, there are a few suggested ways to limit screen time to promote a healthy mental well-being.

For children:

• For children under 18 months old, no screen time.
• For children 18 to 24 months old, parents should choose only high-quality media and watch it with their child.
• For children 2 to 5 years old, less than one hour per day of high-quality programming is recommended, with parents watching along.
• No screens 1 hour before bedtime, and remove devices from bedrooms before bed.

For adults:

• Use phone apps to remind you when it’s time to stop using the phone
• Turn off the majority of your notifications
• Delete your social media apps

Future guidelines and screen time plans could include virtual activities that promote physical activity, education, and socialization while still setting time limits to decrease the risks of mental distress. Credible, trusted organizations should implement policies that guide individuals and families on the optimal amounts of screen time to indulge in daily.