The 22nd Winter Olympic Games now underway in Sochi will involve 6,000 athletes from 85 countries competing in 98 events.1
The Olympics, watched by a television audience of nearly 3 billion people, thrives on national pride and a spirit of competition. We will cheer our athletes’ victories and commiserate their defeats.
If these games are like the 2010 Winter Olympics, the U.S. will dominate, winning more medals than any other country. Our stiffest competition will come from three countries—Germany, Canada, and Norway.
But what if, in addition to figure skating, ski jumping, and hockey, fighting mental illness were an Olympic Sport? How would the U.S. fare?
Worldwide, 450 million people suffer from mental disorders, including depression, schizophrenia, and bipolar disorder.2 Mental illnesses are the leading global cause of all non-fatal burden of disease accounting for 22.9% of years lived with disability, significantly higher than the numbers for cardiovascular diseases (2.8%) and cancer (.6%) combined.3
How well does the U.S. do compared with our three chief Winter Olympic competitors in key “Mental Health events?”
Prevalence of Mental Disorders: With a mental illness prevalence rate of 29.1%, the U.S. has the highest overall rate. We also have the highest rates of serious (8.2%) and moderately severe (7.0%) mental disorders, surpassing those in Canada and Germany.4 These rates don’t get Team USA to the podium.
Treatment Rates: Professional treatment rates in the past 12 months varied across the four countries, with Germany having the highest rate (20.3%) and Canada the lowest rate (7.0%). Team USA takes Silver, with a treatment rate of 10.9%.4
Suicide Rates per 100,000 Population: Suicide rates for men (17.7) and women (4.5) in the U.S. are similar to those in Germany, Canada, and Norway.5 No medals here.
Mental Health Outpatient Facilities per 100,000 Population: Germany takes Gold, with 30.32. The U.S. comes in last, with 1.95.5
Psychiatric Beds in General Hospitals per 100,000 Population: Again, Germany takes Gold, with 41.08 while Team USA misses the podium with 14.36.5
Beds in Psychiatric Hospitals per 100,000 Population: Norway takes Gold with 89.1, Germany takes Silver with 47.62, and Canada takes Bronze with 31.38. Team USA again fails to make the podium, with 19.44.5
Psychiatrists per 100,000 Population: Norway takes Gold with 30.77, Germany takes Silver with 15.23, and Canada takes Bronze with 12.61. Again the U.S. is dead last with 7.79.5
In summary, the U.S. has the highest mental illness prevalence rate and the lowest rankings on all but one indicator of treatment.
To be sure, cross-national comparisons are fraught with difficulties, including the reliability and validity of assessment measures, differential reluctance on the part of study participants to disclose information, differences in diagnostic criteria and practices, and cultural factors.
Still, change is needed on multiple fronts if the U.S. is to become a leader in the fight against mental illness. Changes must include:
Reducing stigma. Campaigns to reduce stigma have been launched by NAMI and Bring Change 2 Mind. But what we need is a large, well-coordinated effort led by a major corporation with deep pockets—one that captures the attention of people while they’re watching the Olympics. Although many companies including Chevrolet, 3M, A.C. Moore, Ace Hardware as well as Major League Baseball and the National Football League have rallied around cancer, not a single U.S. corporation has launched a major campaign targeting mental illness. Bell Canada’s Let’s Talk campaign is exemplary. Since 2010, Bell has committed $62 million to mental health initiatives in Canada. Targeting stigma, access to care, workplace health, and research, Bell’s Let’s Talk Day 2010 raised $5,472,585.
Integrating care. Psychiatrists, psychologists, social workers, and nurses will be more effective in providing mental health care when they begin working in harmony with one another—acting more like a curling team and less like a freestyle snowboarder. Inpatient and outpatient care needs to be coordinated. An interdisciplinary team coordinating the care for each person with mental illness would solve many of our problems.
Increasing resources. The U.S. needs to train more psychiatrists and expand the number of mental health outpatient facilities. But we also need to recognize that sometimes, no matter how much support is provided to an individual in the community, outpatient care does not suffice. The number of inpatient psychiatric beds needs to grow too. And, if we are to develop better treatments, we need increased funding for research.
If the 2014 U.S. Olympic Team performs as well in Sochi as it did in Vancouver in 2010, we’ll take home close to 40 medals. But the U.S. needs to start training seriously to become a consistent medal winner in the fight against mental illness by the time the 2018 Winter Olympics in Pyeong Chang, South Korea begins.
- R.V. Bijl et al (2003). The prevalence of treated and untreated mental disorders in five countries. Health Affairs, 22 (3), 122-133.