The Funding Crisis of Mental Health

The history of brain disorders stretches back thousands of years. People have attempted to diagnose and treat mental conditions in various manners many times in written records of the past. Unfortunately, many of these treatments, at best, did next to nothing, and at worst, resulting in death or disfigurement. 

As we embrace the Imagination Age, it’s encouraging to know how far treatment options have come, but we must also remember how far we have yet to go, especially as many governments around the world continue to shortchange and cut funding for mental health issues. It’s a travesty to have such advanced technology and potential new treatments, but to instead decide not to properly fund them.

Treatments Of The Past 

In ancient times, mental disorders were generally attributed to the supernatural. Our ancestors did not have the comforts of modern medicine or technology to guide them, and the treatments (which were usually well-intended) now seem particularly barbaric. 

Skulls dating back to 5000 BCE have shown evidence of a “trephine”, or a hole chipped or bored into the skull. People suffering from sorcery or demonic possession, or what we would call a brain disorder, would undergo this treatment to allow the evil spirits causing the problem to be released, curing the patient.¹

Bloodletting and insane asylums awaited patients in the 1600s, and the early 1900s saw treatments such as insulin coma therapy (using insulin to induce a coma, but this practice was risky) and electroconvulsive therapy (or ECT). ECT fell out of popular use and is now only used in rare cases of major depression.²

A darker side of mental treatment includes lobotomy. The procedure spread around the globe in the early 1940s, “curing” over a thousand patients suffering from depression, schizophrenia and compulsive disorders each year in the UK alone. 

A doctor would insert drill holes into the skull and then insert a leucotome (which resembled a long icepick) into the hole and then sweep the instrument side to side to cut neural connections in the frontal lobe. The practice fell out of misuse as many patients did not actually improve, but were worse off than before.³

The computer age has ushered in breathtaking breakthroughs as we are able to view the brain as never before. By learning from our past mistakes, we can take the next step to find new treatment options for a myriad of brain disorders.

Without making mistakes, there won’t be lessons learned. Without getting hurt, there won’t be knowledge gained. The only way we grow is by learning from the past. 

Kemi Sogunle

Modern Treatment Of Brain Disorders

Instead of defaulting to thinking of mental illness, we should shift our thinking and consider our brain as important as any other part of the body. However, even with our modern technology and imaging and medicine, brain health comes in far behind physical health. 

A study by World Mental Health found that around 10% of people (from 21 different countries) were affected by anxiety. Of these individuals, only around a third received treatment, and only 1 in 10 received the appropriate treatment. Awareness and health literacy should be promoted around the globe so people who suffer from brain disorders can advocate for proper treatment.⁴ 

Misdiagnosing depression is also a problem for medical professionals--and their patients. The symptoms of several conditions can mimic depression, including anxiety disorders, bipolar disorder and even physical conditions like hypothyroidism. Experts recommend people listen to their gut feelings regarding their affliction, and to seek a second opinion if they don’t improve with the prescribed treatment.⁵

While we’ve come a long way from the days of bloodletting and lobotomies, modern treatment options (including psychotherapy, medications and brain stimulation treatments)  are often hit or miss. 

However, clinicians now have a variety of powerful tools thanks to neuroscience to better diagnose brain conditions and mental illnesses. Just as we can scan other parts of the body to determine where illness or disease is located, we can now scan our brains to hopefully tailor treatment options for whatever ails us. Scientists are optimistic that we will soon be able to have a brain check-up in addition to yearly physical check-ups.

For example, neurofeedback devices, which use EEG sensors to collect real-time information from the brain, may also offer insight and treatment options for brain health issues. Just as you might wear a heart monitor for a few nights to ensure heart health, neurofeedback devices might give doctors and health professionals valuable information to help make the correct diagnosis.  

The Conversation Needed For Better Brain Health 

Brain health spending typically lags behind other medical issues. It’s important for doctors, caregivers and patients to keep the conversation about brain health going. Without proper funding, new research will be severely limited, and we might miss out on potential treatments. 

In Australia, mental health was given around 5.25% of the health budget, but brain issues represent 12% of the overall burden of disease. The 2017 budget increase only allocated $115 million (split over four years) to care for the brain. For comparison, the 2006 budget added over $5 billion, while the 2011-12 budget provided over $2 billion.⁶ 

These shortages aren’t limited to only Australia. A proposal in the United Kingdom (which is dependent upon a Brexit deal), devotes £2 billion extra for mental health, but this is only half of what would be needed to bring brain spending up to the levels spend on physical health, according to the Institute for Public Policy Research.⁷   

Overall health expenditures in Australia in 2014 topped over $4000 per person (per year), but only a fraction of this (less than 10%) was devoted to mental health.⁸ 

It is quite disappointing that in a developed country like Australia, we had around $373 per person (in a year) of funding for mental health treatments⁹, when a single therapy session usually costs between $100 - $250…it doesn’t really add up, does it? 

In the United States, a country with no socialised medicine, the federal government plays a role in health care, but many patients are at the mercy of the state they live in. For instance, Maine spends 5.6% of total state expenditures on mental health compared to 1.2% in Texas and 0.7% in Arkansas.¹⁰

Treatments can be expensive and long, and in most cases, it's not a 'one size fits all' scenario. This means a lot of people end up trying different methods and techniques, which creates financial stress for families. Even worse, those who do not have the ability to pay may not get any treatment at all!

All this, coupled with the stigma associated with mental health and the increasing statistics on depression and anxiety - puts everyone in a very precarious position.

Taking Action Is The Only Solution

So where does this leave us? Governments need to change. There needs to be better care and more funding. While we wait for this to happen, we need to take action! The only way to do this is to speak up, vote for the correct policies, support local mental health groups and lobbyists. Everyone needs to do their part.

Leaders in the Imagination Age NEED to support brain/mental health in their organisations and be part of this dialogue. We spend most of our day in the workplace, so organisations should be responsible for increasing staff wellbeing which will help in preventing further mental health disorders from happening due to work-related stress. This will, in turn, create greater employee productivity, engagement and satisfaction. 

The question about ROI is obsolete! Who wants to go to work depressed or stressed? Happy and healthy employees means less mistakes, more efficiency and happier customers, increasing the value/brand of the company.   

At the About my Brain Institute, we provide education and give guidance on effective strategies to navigate brain/mental health. We have developed leading edge public programs and corporate training and even a documentary that has given many people hope to make long lasting changes in their lives.

Stay tuned for my next article, as we explore how brain imaging can help provide relief for people suffering from mood and anxiety disorders. Subscribe to our blog here to receive updates.

Check out my article on “How Dancing Changed My Mental And Physical Health”

Citations:

1. Stanley T. A Beautiful Mind: The History of the Treatment of Mental Illness. History Cooperative. 2015. 
2. Shorter E. The History of ECT: Unsolved Mysteries. Psychiatric Times. 2004;21(2).
3. Levinson H. The strange and curious history of lobotomy. BBC News. 2011.
4. IMIN. Only 1 in 10 patients with anxiety disorders receives the right treatment, study suggests. Medical Xpress. 2018.
5. Stewart K. Could You Have Been Misdiagnosed With Depression? Ziff Davis, LLC. 2011.
6. Rosenberg S. Mental health funding in the 2017 budget is too little, unfair and lacks a coherent strategy. The Conversation US, Inc. 2017.
7. Sparrow A. Mental health services to get £2bn funding boost in budget. Guardian News & Media Limited. 2018.  
8. WHO. Australia. World Health Organization.2019. 
9. AIHW Media Releases. Mental health spending hits $9 billion, but retains steady proportion of government health spending. Australian Institute of Health and Welfare. 2018. 
10. Jaffe DJ & Torrey EF. Funds for Treating Individuals with Mental Illness: Is Your State Generous or Stingy? Mental Illness Policy Org. 2017.