Jill glances at the reflection before her but recoils not from the actual portrayal of her face by the light, but from the meaning overlaid by life upon her countenance.  The reflection reminds her that others have left her along the road of her long sorrow.  The reflection reminds her that the brokenness of family members’ own struggles strands her on a lonely island in the ongoing buzz of life which then cannot hear her cry in the night nor the day.  The reflection reminds her that nothing has relieved the suffering lying behind that reflection.  No therapy, no medication, no well-intended but misdirected words of friends have lifted that reflection out of darkness.  She knows that she will see that reflection tomorrow and the day after and so on until her eyes open no more.  She does not expect the spirit behind that reflection to remind her of anything different in those future encounters. 

               Jill does not realize that millions of others daily recoil at their own reflections.  They gasp at the reflected darkness of various mental illness shadow. The rest of today’s world continues on unaware of these millions until the news reports that one of them has chosen to put an end to the daily ritual of glancing at their own soul in the mirror.  Should we care? Should we act?  How far must this go and how many must fall before we acknowledge how tangled and knotted are the strings of life woven by today’s misunderstanding of reality as manifested in the mental health crisis presently weighing upon us..

               The specter of Jill’s suffering along with the millions of others rumored by the media deserves an answer.  Addressing such a problem as the multilayered complexity of our current mental health crisis requires understanding where the tangled mess begins and then following through the whole tangle to find the solution.  This stands out rather like a multilayered knot in your child’s shoelace.   Attempting to untangle and solve the knot starting halfway through it will either leave you at best with half a knot or possibly even worse with one and a half knots, i.e. a bigger mess than you started with.  The mental health in which we and millions of our neighbors are presently suffering, likewise, cannot be solved without going to the root of the tangle and working out from there.  The solutions offered by the secular world do not aim at the root of the tangle.  Similarly, the solutions currently present in the broader church are falling short and need revision.  The problem requires a solution that can only come from God’s design for the family and the church as the foundations of society, but which the current broader church is not leading as it is called to do.

               The process for untangling something so complex and so multilayered as the mental health condition of our society obviously requires more time, energy, and steps than untying your child’s knotted shoelaces, but the basic steps are strikingly similar.  First, we must be sure that a problem really exists.  Second, once we realize that the problem is real, we must take a big picture look and understand the depth and breadth of the problem (its nature).  Third, with a big picture understanding, we must find the best starting point from which to begin the disentanglement, or in other words, we must identify the root cause or causes of the tangle. Fourth, our response must be sufficiently powered and correctly focused while minimizing hindrances to have a hope of success.

               Over the coming installments of this series, I will walk through this process as it applies to the state of our society’s mental health crisis.  By answering each of these first three questions we will lead into the most important answer to the fourth question: how the work of the family and the church lie at the root of untangling this tangle mess of a mental health crisis.

Step One of Disentanglement: Confirmation that a Problem Exists

               Before allocating extensive time and resources to this issue, we should confirm the truth of the contemporary claim that a mental health crisis exists.  This applies whether referring to either the setting  of our own community or more broadly to our nation.  Just because your 4-year-old says that they can’t untie their shoe does not mean that it is knotted.  Just because the news media and experts say that we have a mental health crisis does it mean that we need to respond to their alarm bells.  Just because a Jill, as described earlier, looks into her mirror with sadness and despair does not mean we have a societal crisis.  We also don’t want to extrapolate our own mental health struggles of anxiety or depression across everyone assuming that every one of us “feels” the same as we do.  Before we devote much time, effort, or money into untying knotted shoelaces, we should be confident that a knot really exists.

               With these cautions in mind, we consider how we might assess the situation and determine if a problem truly exists or not.  Most of you reading this will not be mental health experts or public health experts with knowledge and extensive access to data sources that you trust.  We will have to find sources upon whom we can trust to provide sufficient and accurate evidence for a problem’s existence.  We must admit that looking to our own family and friends’ current experiences of mental illness does not mean that we have an epidemic or a national crisis.  We or our loved ones may have a crisis, but that is a somewhat different problem and solution than having a societal crisis.  The sources must be realistically free of bias, avoiding unnecessary conflicts of interest.  We don’t need a deceitful mechanic telling us that we need to replace our carburetor and we don’t need government officials telling us that a crisis exists so they can offer their solutions at our tax expense.  On the other hand, our sources will have to be sufficiently involved and knowledgeable in the mental health world for them to know something worth considering as a trusted and reliable/accurate source.

               We then want more than one source so that we can be more confident that even the well-intentioned and unbiased did not make an honest mistake in their assessment.  We might initially look to a governmentally derived report or study, but would also appreciate a study from a private or academic source that we trust.  We might also try to find sources from outside the usual ones which agree with our worldview so that we avoid having our own echo biases from other’s who think like us.  Then we would also consider personal experience whether in our family, our church, or our community.   For those of us in the health care world, we can also look to the experiences of our patients as informal surveys of what is happening in the broader culture.  Then we must evaluate each of these sources for bias, accuracy, breadth, depth and other factors to be sure it is worthy of our including it in our analysis.  Finally, by comparing and combining these sources we can develop a better appreciation for whether a problem exists or not.  This process also prepares us for later steps in our attempts to untangle the mental health knot.

               These quotes provide a starting point, offering different perspectives and statistics demonstrating why we should be concerned with our nation’s mental health:

               From Abilene Christian University: “The statistics are startling. Between 2007 and 2019, adolescents reporting a major depressive episode increased 60 percent. Tragically, during a similar time frame, the suicide death rate among 10–24 year olds increased 56 percent. This issue isn’t confined to young people. In 2020, anxiety and depression increased globally by 25 percent. Depression and anxiety rates exploded so rapidly that, at the end of 2021, the U.S. Surgeon General declared a “devastating” national mental health crisis.

               From CNN:  “Nine out of 10 adults said ​they believed that there’s a mental health crisis in the US today. Asked to rate the severity of six specific mental health concerns, Americans put the opioid epidemic near the top, with more than two-thirds of people identifying it as a crisis rather than merely a problem. More than half identified mental health issues among children and teenagers as a crisis, as well as severe mental illness in adults.”

From SAMHSA: 

               “Fact: Mental health issues can affect anyone. In 2020, about:

               One in 5 American adults experienced a mental health condition in a given year

               One in 6 young people have experienced a major depressive episode

               One in 20 Americans have lived with a serious mental illness, such as schizophrenia, bipolar                disorder, or major depression

               Additionally, suicide is a leading cause of death in the United States. In fact, it was the second                leading cause of death for people ages 10-24. Suicide has accounted for the loss of more than                45,979 American lives in 2020, nearly double the number of lives lost to homicide.”

From Pew Research Center:  “Mental health and the pandemic: What U.S. surveys have found:

               1. “At least four-in-ten U.S. adults (41%) have experienced high levels of psychological distress at                some point during the pandemic, …”

               2. “More than a third of high school students have reported mental health challenges during the                pandemic. …”

               3. “Mental health tops the list of worries that U.S. parents express about their kids’ well-being,                according to a fall 2022 Pew Research Center survey of parents with children younger than 18. In                that survey, four-in-ten U.S. parents said they’re extremely or very worried about their children                struggling with anxiety or depression….”

               4. “Among parents of teenagers, roughly three-in-ten (28%) are extremely or very worried that                their teen’s use of social media could lead to problems with anxiety or depression, according to                a Spring 2022 survey of parents with children ages 13 to 17.”

               5. “Looking back, many K-12 parents say the first year of the coronavirus pandemic had a                negative effect on their children’s emotional health.”

               As I find further helpful sources to support the existence of a crisis, I will try to return to this blog and post those sources at the end.  I am open to your sharing of ones you find, even ones that argue against a crisis if you find some.  For now, I have also mentioned a few sources of proof in other blogs and can say that between several studies I have read and my experience in our clinic where we are truly seeing more and more mental health issues in our patients, there is a mental health crisis which seems to be worsening.  Various studies indicate that people are more stressed and experiencing more mental health dysfunction with more diagnoses being made and more meds being prescribed.  Weekly, I receive the same comments from my staff in caring for our patients that we are seeing more and more suffering both physically and mentally in those seeking our help.  Many experts are expressing their concern in news interviews, articles, and books.  Government and media are beating the same drum over and over, proclaiming that we need more mental health workers (I will address this inadequate response soon, but for now, their repetition acknowledges that they see a problem).  The consensus of these sources indicate that we have a problem – that the mental health shoelaces are truly knotted.

               If you doubt this assessment, I applaud your diligence to be more confident before responding to a problem that you are not sure actually exists.  If this describes you, take time to solidify your opinion one way or the other before proceeding to the rest of this series.  On the other hand, if you are in agreement with the knot’s existence in our society as well as its importance, return to read part two describing the nature of the mental health crisis.  As you wait, do a little research on your own and begin formulating your own view of this issue.  This work will prepare you for understanding in the next essay.

Bibliography:

Gramlich, John. “Mental Health and the Pandemic: What U.S. Surveys Have Found.” Pew Research Center, 2 Mar. 2023, www.pewresearch.org/short-reads/2023/03/02/mental-health-and-the-pandemic-what-u-s-surveys-have-found/. Accessed 12 Nov. 2023.

Krause, Chelsi. “The Mental Health Crisis: What’s Going on and What Can We Do.” Abilene Christian University, 9 May 2022, acu.edu/2022/05/09/the-mental-health-crisis-whats-going-on-and-what-we-can-do/#:~:text=In%202020%2C%20anxiety%20and%20depression. Accessed 12 Nov. 2023.

McPhillips, Deidre. “90% of US Adults Say the United States Is Experiencing a Mental Health Crisis, CNN/KFF Poll Finds.” CNN, 5 Oct. 2022, www.cnn.com/2022/10/05/health/cnn-kff-mental-health-poll-wellness/index.html.

SAMHSA. “Mental Health Myths and Facts.” Www.samhsa.gov, SAMHSA, 8 Feb. 2023, www.samhsa.gov/mental-health/myths-and-facts. Accessed 12 Nov. 2023.