Experts Make Roadmap of Mental Health Goals for the Future

During the COVID-19 pandemic, the need for mental health care has increased—but that increase in demand meant that many went without the support they needed. Studies pursued during the last year-plus illuminated an emerging mental health crisis across life stages, and pointed to the long-standing needs of neglected populations.

Experts in the U.K. developed specific targets for research around mental health for the 2020s, publishing goals and thoughts on the path forward in the Journal of Mental Health. The research team underlined four specific areas where more data is needed in order to provide appropriate and effective care those who need mental health support.

Using Goals to Develop an Action Plan

Professor Dame Til Wykes of King’s College London says that the pandemic offered an opportunity to talk more openly about mental health struggles. The report highlights that the economic slowdown coupled with quarantines and lockdowns have exacerbated socioeconomic disparities. Access to treatments varied and practitioner availability was diminished, creating long wait-lists and more expensive care.

Wykes says that efforts to destigmatize mental health care during this time were part of a larger movement that has been growing over the past decade. But she underlines that the increase in people seeking support for or experiencing mental health concerns is not solely attributed to this destigmatization, explaining that longitudinal studies have pointed to an increase in reported struggles with mental health.

Wykes and her colleagues noted that one-third of young adults (ages 16 to 39) reported moderate to severe depressive symptoms during the pandemic. She says that data for children and young people shows a jump from 1 in 8 to 1 in 6 scoring high for anxiety or depression symptoms. She adds, "So it is not just a general movement to talk about mental health problems. There is also an increase in mental health difficulties."

This report underlines that experiences during the pandemic coupled with information already gathered demonstrate the gaps in necessary care—but Wykes explains that it can take up to 20 years for research to be translated into tangible health and social services. This is partially because scientists focus on learning about very specific problems without worrying about larger scopes or future implementation of the findings.

The report is part of a project, ROAMER, that began in 2017, which offered high-level goals for Europe's mental health initiatives. Wykes explains that previously there were no clear targets outlining how future research could address emerging gaps, especially concerning the expectations for evaluating success and the time frame for which goals would be pursued.

Wykes says that the Oxford-AstraZeneca vaccine study proved that researchers are capable of developing thoughtful plans for quicker action when they concentrate on end goals. This inspired her to help create a more structured plan.

Selecting Goals to Prioritize

Expediting the time it takes for study findings to influence change in care and practices requires clear pathways for the scope of projects, funding, and evaluation of studies. Researchers highlight that pursuing research goals will be both a joint and multidisciplinary effort that will require cooperation between various medical and mental health professionals and the support of political and financial leaders to be successful.

One way to gain the attention of potential stakeholders is highlighting the economic toll of untreated mental health concerns. They explain that the number of sick days used due to stress, depression, and anxiety is up 24% and that conservative estimates of missed days at work have doubled since 2013. One hope is that leaders will advocate for evidence-based mental health policies and fund studies to seek solutions for workplace struggles, such as burnout.

They expect four primary goals to be measured in intervals—at three, five, and ten years—and note that each goal is a guide rather than a limitation for those studying mental health. Goals were determined according obvious needs based on gaps in data about specific populations—goals that are necessary for offering quality, effective care.

Halve the Number of Children Experiencing Mental Health Concerns

Even before the pandemic, mental health professionals were particularly concerned with youth, who are increasingly reporting problems related to mental health. Researchers note that half of those who report lifelong mental health struggles first experienced these concerns before age 14 and three-quarters before age 24. This speaks to the need for intervention during childhood when possible.

The increasing number of children and youth impacted by mental health concerns will increase the demand for adult services as they age into new life stages, and researchers believe the need for these services could increase quickly. In addition to more immediately improving the lives of children and young people, research that leads to successful interventions will decrease the difficulties this group will experience as adults and lower their need for future services.

This research team has prioritized the need to educate youth and families about the causes of mental health issues, protective factors which could prevent or reduce symptoms, and the progression of specific concerns. They also hope to increase research on promoting mental and emotional well-being, preventing illness, and supporting young people through community and health settings, eventually implementing the most effective strategies for intervention.

Improve Education About Comorbidities and Eliminate the Mortality Gap

The mortality gap, a term that describes the shorter life span of those who live with serious mental health concerns, could reduce life by 10 to 20 years by conservative estimates. This could be due to comorbidities, or additional physical and mental health problems that accompany a primary diagnosis or concern. Wykes and her team cite that 46% of people living with a mental health concern also live with a long-term physical health condition.

People with multiple comorbidities are up to three times more likely to experience that loss of lifespan. The research team notes that there is still much to learn about comorbidities, urging future teams to consider factors for risk and protection, underlying causes for disease progression, and clusters of health problems that present simultaneously.

The research team promotes well-being programs that treat the individual holistically, seeking more information about effective interventions that both prevent mental illness and promote positive physical health outcomes.

Increase the Number of New Interventions Available

Wykes explains that a variety of new methods and tools for research (for example, portable devices for imaging) are now available, which should expand how many people can participate in studies, include more representative demographics, and improve how quickly data can be gathered.

By developing a better understanding of each person's individual needs and the needs of groups they identify with, researchers can develop improved interventions that are tailored to personal needs, making them more effective. Mental health care shifted to primarily online platforms during the pandemic. This report highlights the need to develop and evaluate more digital interventions to complement and supplement in-person care.

The research team highlights the importance of investigating the specific needs and experiences of differing demographic groups—pointing to its importance when developing new treatments, implementing programs, and examining their efficacy. Future researchers considering people's ages, existing health experiences, trauma histories, race and ethnicity, age, environmental factors—such as poverty and geography, and other contextual influences.

Improve Access to Choice in Mental Health Care

There is currently a failure to reach many who need mental health support. Researchers highlight that barriers exist which prevent some from receiving evidence-based treatments or support and timely care. Future research should pursue and promote cultural competencies, affordability and cost-effective strategies, as well as ways to address systemic disparities for marginalized people.

The research team seeks to better understand barriers that prevent people from both seeking and receiving services as well as addressing the stigma, discrimination, and exclusion of marginalized people—including people of color and the queer community. Because access to care is vitally important to promoting mental health, they also hope to accelerate implementation of current best-practices for care and dedicate substantial attention to increasing choice in providers.

What Happens Next

These targets are intended to keep the focus of both funders and researchers on the end goal of developing and implementing effective, evidence-based initiatives. Routinely collecting data about the impact of research is vital to understanding the efficacy of programming and interventions, and will help keep future researchers focused on the goal of developing innovative and necessary services.

Although research goals were gathered specifically with the needs of U.K. residents in mind, Wykes says that researchers and service providers elsewhere—including the United States and Australia—are funding studies and interested in findings. The research will have global implications and can be used to develop programs and interventions in a variety of settings.

Over time, this will hopefully reduce waiting lists, increase choice when considering providers, and improve access to quality care that truly works. Addressing the barriers people face when attempting to seek the care they need is a first step in learning how to improve access.

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