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Freitag '14: The broken mental health system

Mental health disorders remain one of the most widely stigmatized and misunderstood issues of our day. At Brown, nearly one in five students suffers from anxiety or depression. Brown provides official support through Psychological Services and other community groups, but whether the University provides adequate support to the mentally ill is up for debate. And the same can be said for society at large.

A study conducted between 2001 and 2003 by the World Health Organization found that the United States has the highest prevalence of mental disorders in the world, with 26.4 percent of the population suffering from some form of mental illness. That number far exceeded the other 14 countries that participated, including Lebanon at 16.9 percent, Germany at 9.1 percent and Japan at 8.8 percent.

Though cultures vary — in terms of employment structure, relationship norms, family values and other factors — some of the differences in prevalence of mental health disorders can only be explained by how individuals are diagnosed. The cultural differences in acceptance and the treatment infrastructure available prevent people from seeking treatment and doctors from diagnosing patients.

Whether the United States over- or underdiagnoses remains ambiguous. But our failure to efficiently allocate funding toward treatment has led to a bloated psycho-pharmaceutical market. Drugs are an integral part of treating mental disorders. But the unprecedented rise in prescribing psychotropic drugs is largely due to the rising power of drug companies.

In the United States, antipsychotic drugs bring in almost $15 billion per year in revenue, making them the most lucrative of all classes of medicine. The pharmaceutical lobby spent more than any other lobby from 1998 to 2012, giving over $2.7 billion in donations. Through political contributions, corporate control over the health care industry has moved the United States to become a nation bent on mass medication.

A study in the American Journal of Psychiatry found that the number of Americans who participated in psychotherapy remained constant from 1998 to 2007. But the proportion of individuals prescribed psychotropic drugs increased from 44 percent to 57 percent during that time. In addition, the number of individuals who sought treatment through psychotherapy without prescription drugs decreased significantly.

Mental health care is evolving as science develops and awareness expands. But as more people seek care, it is important to make sure the most effective treatment is the one delivered.

The marketing of psychiatric drugs has led to a common perception that medication is the best approach to care. Often, patients believe drugs are a substitute for therapy, requiring less time and less effort. But studies on depression and other mental disorders have shown that a combination of psychotherapy and medicine are most effective in the treatment of patients.

In order to improve our national mental health, we must eliminate the stigma attached to psychological illness by continuing to increase awareness. Designing a mental health system that allocates treatment resources more efficiently and overcomes barriers associated with insurance coverage and differences in perceived need is essential.

Increasing government spending on program-based therapy, expanding mental health insurance and spreading awareness through a reformed health-education system can help reduce the deleterious effects of mental health problems. It is imperative that politicians increase funding for mental treatment clinics, while resisting the financial temptation of the pharmaceutical lobby.

Our duty as Brown students is to work toward creating a more inclusive, tolerant and healthy society.  About one in three students who visit Psychological Services at Brown have been referred by a friend. Increasing that number for those who need help — both here at Brown and outside of school — is the best way we can help the 26 percent of Americans and 20 percent of Brown students currently living with mental illness.



Scott Freitag ’14 specializes in economic issues and can be reached at


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