Mental Health in 2023

Mental health care is a critical aspect of overall healthcare. Mental health care encompasses how individuals think, feel, and behave. Mental illness can affect anyone, and the effects of untreated mental illness extend far beyond the individual. The societal impact of inadequate mental health care is significant. 

Each year, the National Alliance on Mental Illness (NAMI) declares May as Mental Health Awareness Month. According to NAMI, “It’s important to measure how common mental illness is, so we can understand its physical, social, and financial impact – and so we can show that no one is alone.” According to NAMI’s fast facts on mental illness, one in five adults and one in six youths aged six through 17 in the United States experience mental illness annually. One in 20 adults experiences serious mental illness every year. NAMI provides these statistics, noting that “These numbers are also powerful tools for raising public awareness, stigma-busting, and advocating for better health care.” Keep reading to learn more about mental health, barriers to treatment, and how Mental Health Awareness Month can make a difference. 

Mental Illness in America in 2023

The Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health (NIOSH) defines mental health as anything that “includes a person’s psychological, emotional, and social well-being and affects how we feel, think, and act.” Mental Health America conducts an annual study that compiles data regarding how mental health affects the country. Like all reports, there is a delay between data collection and publishing of the results. Mental Health America notes that this year’s study uses data collected in 2020, which includes data accumulated during the COVID-19 pandemic. 

While the pandemic undoubtedly affected physical and mental health, the study results are consistent with mental health studies for the last several years. Statistically, reports of mental health conditions are rising as access to care becomes more limited and difficult. Mental Health America’s 2023 found that:

  • 21% of adults in the United States live with at least one mental illness
  • Of these adults, 55% with a mental illness have not received any treatment
  • 4.8% of adults reported serious suicidal thoughts (roughly 12.1 million adults)

Increased Substance Abuse Disorders

The provider shortage plus barriers with insurance providers have made getting treatment difficult. When adults cannot receive treatment for mental illness, they look for alternative coping mechanisms. Increasingly, adults are turning to drugs and alcohol as coping mechanisms in place of mental health treatment. 

Mental Health America’s 2023 study found that nearly 11% of adults reported abusing alcohol, and nearly 7% reported abusing illegal drugs. Untreated substance abuse disorders have contributed to an increase in overdose risk factors. In 2020, more than 93,000 overdose deaths occurred in the United States. 

With mental health concerns on the rise, access to care is critical. However, access to care is one of the primary reasons people with mental health care do not seek help. The provider shortage plus barriers with insurance providers have made getting treatment difficult. 

Barriers to Treatment

A key factor in reducing the disease burden of mental illness is increasing accessibility to treatment. When people have access to the care they need, they can take a proactive approach to managing their mental health, resulting in a positive impact at both the individual and community levels. 

According to a public policy report from NAMI, almost half of the 60 million Americans with mental health conditions do not receive treatment. Reasons for this vary, but there are significant barriers that prevent people from accessing mental health care, including:

  • Insurance Barriers:  It is often more difficult to find a mental health care provider than other types of health care professionals, especially with the current provider shortage. When coupled with the limitations of finding a provider who is considered in-network on an insurance plan, access to mental health care is difficult at best. 
  • Provider Shortage:  Even before COVID-19 there was a shortage of psychiatrists. Over 150 Americans live in federally designated mental health professional shortage areas already, and the numbers don’t show signs of immediate improvement. According to an article posted by the Association of American Medical Colleges, the country will be short between 14,280 and 31,109 psychiatrists.  
  • Financial Barriers:  With many adults unable to find providers that take their insurance, the cost of treatment is all out-of-pocket. The rising cost of living and stagnant wages have contributed to making it increasingly difficult for many to afford out-of-pocket treatment for mental illness. 

The Impact of Mental Health Awareness Month

According to the NAMI, the number of people seeking help for mental health issues has significantly increased in recent years. In 2019, NAMI reported that more than 44 million adults in the United States had a mental illness, and only about half of those received treatment. However, in 2021, NAMI reported that the number of people seeking help for mental health issues had increased to over 50 million adults. That means that while cases of mental illness continue to rise, so does the number of people receiving treatment. A number of factors contribute to the rise in adults seeking treatment including increased awareness of mental health due to the information provided during National Mental Health Month. 

Increasing awareness is a key factor in people seeking treatment for mental illness, but so is reducing the stigma associated with mental illness. When people feel ashamed or embarrassed about their mental illness, they are less likely to reach out for help and the treatment they need. Initiatives like National Mental Health Month help reduce the stigma surrounding mental illness. Any reduction in barriers to treatment, like access to resources, can help those living with mental illness find treatment. 

In addition to increasing awareness and reducing societal stigma, other factors contribute to people seeking treatment for mental illness. One important factor is parity laws. Parity laws require health insurance to cover mental health services to the same extent that physical health care services are covered. Currently, there are still significant disparities in the way that mental health services are covered. For example, mental health services are still more likely to be charged out-of-network, and in-network provider reimbursement rates are lower for mental health visits than for primary care visits. 

While there is still much work to be done, awareness campaigns like NAMI’s National Mental Health Month have a positive impact on mental health care.

Vendor Management and its Potential to Improve Mental Healthcare in Correctional Facilities

Vendor Management and its Potential to Improve Mental Healthcare in Correctional Facilities

mental health in correctional facilities

According to the National Alliance on Mental Health (NAMI), “about two in five people who are incarcerated have a history of mental illness. This is twice the prevalence of mental illness within the overall adult population.” Mental illness disproportionately affects women inmates, with nearly 66% of women reporting a history of mental illness, which is nearly double the percentage of men.

With a constitutional obligation to provide both mental and physical healthcare to those housed in correctional facilities, the burden of providing treatment is something many facilities struggle with. Due to increasingly tightening budgets, larger populations, and an overall shortage of psychiatric and mental healthcare providers, adequate mental healthcare in correctional facilities is challenging.

Prevalence of Mental Illness in Correctional Facilities

According to an article in The Guardian on the role of mental health care in correctional facilities, “correctional facilities are struggling with the reality that they have become the nation’s de facto mental healthcare providers.” While the number of psychiatric hospitals and residential treatment centers has continued to decline over the last few decades, the prevalence of mental illness among the population has continued to climb. 

Currently, the country’s largest providers of psychiatric care are not hospitals, but correctional facilities. Without adequate access to mental healthcare, it is arguably too common for someone dealing with a mental illness to end up in a correctional facility. In fact, in a report from the National Institute of Corrections, “the number of individuals with serious mental illness in prisons and jails now exceeds the number in state psychiatric hospitals tenfold.” This places the burden of treatment on the jails and prisons, many of which are unequipped to handle the mental health needs of inmates.

With the right to treatment affirmed by the United States Supreme Court, correctional facilities must provide care to those with mental illness. As budgets continue to tighten and correctional facilities are forced to stretch resources further than ever before, providing adequate psychiatric care is challenging. The National Alliance on Mental Health affirms that incarcerated people have constitutional rights to both medical and mental health care yet “nearly two-thirds of people with mental illness in jails and prisons do not receive mental health treatment.”

In addition to providing basic treatment and medications, incarcerated people could benefit greatly from supportive programs and therapies. With the ultimate goal being to rehabilitate incarcerated people and move them back into their communities, proper treatment of mental illness is crucial. 

Prevalence of Mental Illness in Correctional Facilities
Correctional facilities struggling with the reality that they become mental healthcare providers.
The country’s largest providers of psychiatric care are not hospitals, but correctional facilities.




Vendor Management in Correctional Facilities

Without significant regulatory changes, the burden placed on correctional facilities to provide mental health care at the level needed is immense. One way that correctional facilities can provide psychiatric care with limited resources is through the use of vendor management. 

Vendor management and a contingency workforce can be invaluable in terms of providing immediate care to those housed in correctional facilities. An important need regarding mental health care is a diagnosis, particularly in correctional facilities. With people living in such close quarters, identifying cases of mental illness where a person may pose a threat to themselves or others is of immediate concern. Some correctional facilities are large enough to warrant designated mental health units, specifically for housing those who may pose a threat to themselves or others. However, while some facilities have mental health units, they often struggle with being able to afford permanent full-time providers who can identify and diagnose cases at the onset of incarceration.

In this instance, temporary help can be a cost-effective method of ensuring the safety of those living and working in correctional facilities.  A locum mental health care provider could review cases before or during the intake process, before placement to identify instances in which an inmate may pose a threat to themselves or others without immediate intervention. While this is important in any facility, it can be especially beneficial in areas where the population of both the correctional facility and the local community does not have access to full-time psychiatric services.

Alternative Mental Health Treatment 

Like most healthcare providers, correctional facilities face tight budgets and increasing demand for services. The healthcare landscape is constantly evolving as providers struggle to meet demand with the resources they have available. With the COVID-19 pandemic, innovative telehealth became a more mainstream medical and mental healthcare tool. 

The use of technology through telepsychiatry can broaden access to mental healthcare in correctional facilities. Solutions that utilize healthcare technology, like telepsychiatry, are more than convenient, they can also help mitigate cost barriers to treatment. Transportation, of both inmates and providers, can affect access to treatment and telepsychiatry can virtually eliminate those costs. 

In addition to mitigating costs, telepsychiatry can be a safer method of treatment for providers. Feeling safe is imperative for providers to offer effective treatment, and telepsychiatry can increase the level of comfort of both the inmate and healthcare providers.  

When considering mental healthcare and correctional facilities, it is clear that significant regulatory changes must happen. However, until regulations and guidelines broaden access to and budget for mental healthcare, using vendor management systems can be an efficient and affordable way to provide mental health services in correctional facilities.