We aim to assemble multidisciplinary teams of investigators to address the hypothesis that changes in the physical and social environment are driving increased rates of mental health problems in the United States.
In building collaborations, funding projects, and mentoring students, we can consider this hypothesis across three domains (etiology, mechanisms, and intervention)
OUR APPROACH
Etiology
We will focus on three areas for etiological identification:
Unprecedented changes in the physical environment through climate change are affecting millions of Americans with increased exposure to extreme heat and weather events. Understanding whether these factors influence mental health, how much, and at what points in the lifecourse is critical to building the scientific evidence base for action. SPIRIT will collaborate with climate scientists across the university to address the role of climate in mental health.
Climate
Technology
A central focal point of explaining increased rates of mental health problems in the US has been the extent to which smart phones, social media, and new digital technologies are responsible. These technologies drive political polarization, decrease face-to-face connection, and fuel negative social comparison and image formation. The evidence base is bifurcated in results and the need for better science is urgent, especially given that policies are already being adopted that focus on reducing access to technologies.
Income and resource inequality is growing in the United States, and those most marginalized are the most affected. Poverty continues to constrain options and opportunities for the most marginalized, deeply impacting mental health. These inequalities are experienced more frequently and intergenerationally by racialized lines in the US, and across axes of sexual and gender minority status reflective of structural stigma. Identifying how growing inequality is implicated in population mental health is critical for etiology as well as policy and intervention relevance.
Inequality
Mechanisms
Mechanisms by which we will assess how physical and social factors impact mental health include:
Brain Development
The developing brain plays a critical role in mental health, and disruptions during crucial developmental stages can lead to enduring mental health challenges. Adverse experiences, such as poverty, trauma and neglect during childhood, can alter brain structure and function, increasing the risk of mood disorders and behavioral problems later in life. This connection underscores the importance of early intervention and support to promote healthy brain development and safeguard against declining mental health.
Biological Stress Response
Biological stress responses can damage the brain and nervous system, making it difficult to regulate emotions, cope with stress, and maintain good mental health. Prolonged exposure to high levels of biological stress markers can impair neural connections in the brain, particularly in regions responsible for emotional regulation and cognition, increasing vulnerability to mental health disorders
Loneliness and Connection
The US Surgeon General has identified loneliness as a public health problem, and loneliness and lack of connection are possibly key social drivers in increased rates of mental health problems in the US. Prolonged isolation and disconnection can lead to increased stress, depression, and anxiety, because human beings are inherently social creatures and the absence of meaningful relationships can disrupt our emotional well-being as well as exacerbate mental health challenges. Understanding the changing landscape of human connection and loneliness is key to identifying the right drivers of intervention.
Intervention
We aim to highlight, assess, and implement the following modes for intervention:
Economic and Social Policy
Leveraging economic and social policy as interventions for the mental health crisis in the US is essential. Indeed, among the most effective suicide prevention policy interventions is increasing the minimum wage in the US. By improving access to affordable healthcare, strengthening social safety nets, and promoting policies that reduce income inequality, we can address many of the social determinants that contribute to mental health issues. A comprehensive approach that combines both economic and social policies is vital to create a supportive environment for mental health in the United States.
School- and Community-Based Primary Prevention
By promoting mental health education in schools, providing access to counseling services, and creating supportive environments, we can identify and intervene early in the development of mental health issues. This is a critical issue for epidemiologists and public health scientists to contribute, because there is increasingly recognition that school-based mental health programs currently being implemented are ineffectual at best, and potentially harmful. Thus, a critical rigor needs to be brought to how mental health is discussed in schools, to not only promote health but prevent harm.
Crisis Support
Establishing accessible crisis helplines, crisis stabilization centers, and mobile crisis teams can provide immediate assistance to individuals in acute distress. Nationally, a three-digit number for mental health crisis supported was launched in 2022 (#988), and there is a critical need to establish the extent to which crisis support is working, for whom, and when. Timely intervention and support during moments of acute mental health challenges are essential for saving lives and connecting individuals with the care they need for long-term recovery.
Stigma Reduction
For too long, psychiatric disorders have been viewed as a personal failing, or an uncurable mark. By challenging stereotypes and discrimination, we can encourage open dialogue, increase awareness, and promote help-seeking behaviors. This shift in social attitudes not only enables individuals to seek treatment without fear of judgment but also contributes to a more compassionate and understanding society, ultimately improving mental health outcomes for everyone. Columbia has been a national leader on mental health stigma research for many decades, and has the institutional leadership and expertise to accelerate advances in this ares.