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Comment by mfer | Hacker News Reader

> And while suicides, drug overdoses and alcoholism were the main causes

It looks like there is increasing mental health issues that aren't being addressed. This seems to get blown past too quickly.

We tend to look at the medical side of things and the way the healthcare system works. But, somethings have changed that caused the mental heath of many to go down. Will changing the US to single payer or medicare for all change the mental health problems? Given the research I've read it's highly unlikely.

Can we please put more time into understanding and addressing the increasing mental health problems? This is important for forums like this because studies have repeatedly found we have a hand in it.

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Don't you think these things are directly related?

A friend of mine had some minor mental health issues going into their 20s. Lack of meaningful opportunity paired with obscenely expensive and inaccessible healthcare helped drive those to become major health issues, including drug addiction, due to intoxicating themselves to "help" distract from their grim reality.

Absolutely I think it would have been different had they had access to general preventative healthcare from the start so they could get routine dental, physical, etc. Would they be cured of their mental health problems? Probably not. Would the effects have been less destructive? Yeah, I would bet on it.

> Don't you think these things are directly related?

From what I've read there isn't a strong relation between them. Some of it is obvious. The system has been roughly the same for many years but the change happened to mental health anyway.

As I start to read studies on it I learn there are other factors affecting mental health.

The people who study these things are predominantly saying it's related. Why should we think it is?

The universal health care proposals by Bernie Sanders and Pramila Jayapal include mental health and substance abuse treatment services.

https://www.congress.gov/bill/116th-congress/senate-bill/112... https://www.congress.gov/bill/116th-congress/house-bill/1384...

Why does everyone think this will help? Don't we already have more mental healthcare than ever before? Why is the assumption that even more would help?

What was mental healthcare like 30, 50, 100 years ago? Was there a lot more of it back then? Why do people attribute the suicide and drug use to lack of care? It seems like the most extreme dodge of actual issues to paper over it with yet-more-healthcare. For all we know, none of what we have already is really helping, and more won't help more.

We have more food on this planet than ever before, yet people still die of starvation. All of the advancements in mental healthcare in the world are meaningless if the people who need it cannot access it, which, in our current system (at least in the US) of employer-provided healthcare, is generally the case.

In the past 10 years there has been a 2.5x increase in teen girl suicide rates. Those kids can either get healthcare through their parents employers or though other means if their parents can't provide it.

Those kids have access to health care.

How many of the parents know how to spot the problems? Do they know when to get their kids into a professional?

Researchers have documented many of the causes yet we rarely talk about them or do anything about them. For example, smart phones and social media are a major factor. This was first correlation and then researches later figured out the causation.

How come we don't even talk about what's causing this?

Looking just at the means by which we get healthcare isn't going to fix all the things. We need to talk about the other elements and do something about them if we want change.

I'm contesting that access to healthcare is the problem at all. I don't think it is. I think all available evidence we have, including historical OD rates and the like, point to "other things" being the problem.

Maybe access to more healthcare would help, though the US already uses more healthcare than almost any other nation, but I suspect, like the rest of health, the real gains are to be found elsewhere, and this is a huge canard so people can feel like their pet political policy will solve something real.

We have other developed countries we can compare to. Also, you can consider the lack of care as a smaller part of the general economic anxiety that plagues the areas described in the article.

Stress and mental heath are strongly linked. So, the current system with it’s high costs and uncertainty is actively making things worse.

On it’s own it might not make a huge change, but in aggregate this is a significant effect.

These are diseases of despair. The financial inequality in this country is literally killing us. Sure there are other mental illness issues, there always are, and always will be. But this inequality is the root of the issues causing the . declining life expectancy. If the average person can't feel somewhat secure in their life, like they aren't completely struggling and beat down just making ends meet, if we are living one paycheck away from homelessness or bankruptcy, buried in debt from student loans, medical bills, credit card debt, mortgage etc... Most people can barely stay afloat, let along save for retirement, and have time to actually feel relaxed and able to enjoy their lives. What do we expect from this situation? A healthy society?

They are diseases of despair, and that is key. (have an upvote)

But casting this as primarily an issue of financial inequality seems misleading. I wouldn't feel one whit less awful if everyone in the country was poorer than me.

It's absolute want that matters. If you can't afford medical care for your kid, it doesn't matter whether or not anyone or everyone else can--you're still going to be devastated.

> Given the research I've read it's highly unlikely.

Can you expand on this? I see a pretty direct line through an unpayable medical expense, inability to afford housing, and declining mental health from all of the associated stress. Add in the unpredictable nature of health scares and that seems like a terrible mixture for mental health.

I'll start with one example. The rising suicide rate. Since 2010 there has been a large increase in teen girl suicide rate. A significant cause of this is social media and smart phones. This has to do with bullying, comparisons, and other things. [3]

Now take a place like Texas where the homeless population has decreased [2] in the same window the suicide rate has gone up [1]. This is just an example.

I know there is a lot of political talk on some of this. I would suggest taking some time to read the data which is prevalent. You can easily find it with search engines.

> I see a pretty direct line through an unpayable medical expense, inability to afford housing, and declining mental health from all of the associated stress. Add in the unpredictable nature of health scares and that seems like a terrible mixture for mental health.

Can you point me to some research on this? Data researchers have observed? I've not seen this.

[1] https://www.utsystem.edu/sites/default/files/news/assets/Sui... [2] https://www.thn.org/wp-content/uploads/2017/05/2016-Infograp... [3] http://www.jeantwenge.com/research/

Your original comment claimed that research suggests that improving access to healthcare is "highly unlikely" to change the state of American mental health.

I'm not following how this second comment makes that case. It looks like you are extrapolating from "social media use causes poorer mental health" to "access to healthcare and housing are less important to mental health than social media use". The statistics and studies cited don't make this claim, so I don't understand where you're getting it from.

I have no studies in mind that connect mental health and access to healthcare and housing. I was curious if you had studies suggesting the opposite, since the connection appears almost tautologically true to me.

To use an analogy... when people were smoking a lot of people got lung cancer. Doctors can try to treat that and many people died. Access to health care did not mean that everyone who got care was cured of their lung cancer. Instead, people had to go to the root of the problem. Smoking causing lung cancer. They worked to reduce the rate of smoking to reduce the rate of cancer. This was not related to someone's access to medical treatments because access to medical treatment wasn't a silver bullet fix.

The same idea applies here. We talk a lot about healthcare access (and I'm not suggesting that should stop). We don't talk enough about going after what's causing the mental illness and fixing that.

> A significant cause of this is social media and smart phones.

We don't know this, and your comment is not supported by your link. Suicide is a complex phenomena and to distil it down to only social media feels a bit reductive.

One interesting rabbit hole is that children who live with and are raised by both parents have very low levels of mental health issues.

Currently, less than half of the children in the U.S. being born will experience this.

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