IEEE Technology and Society Magazine - March 2023 - 26

Feature
and growing need for accessible and equitable mental
health services, calling on readers to integrate
these questions into future research agendas.
Mental health crisis and limited access
to services
The COVID-19 pandemic brought into focus the
immense need for mental health services around
the world [2], [4]. But even prior to the pandemic,
the occurrence of mental health issues was on the
rise in the United States [5] and elsewhere, most
notably among young people [6], [7]. For example,
studies show that both suicidal ideation and
suicide rates have been increasing steadily for
decades in the United States [4], [8], and a 2005
study showed a pronounced worldwide increase
in suicide among young people aged 15-19 years
old [5], [6]. Overall, in 2019, the Institute for Health
Metrics and Evaluation's Global Burden of Disease
study estimated that more than 13% of the global
population, or 970 million people, live with a mental
health condition [9]. In the United States, that
rate is more than 17% [4], [8], [10].
Mental health status has wide-ranging impacts,
affecting a person's physical, social, and economic
states. According to the National Alliance on Mental
Illness (NAMI), in 2018, only 43.3% of those in the
United States with mental illness received treatment.
Various barriers prevent more of those in need from
accessing care. For example, in 2020, 10.3% of those
living with mental illness in the United States had
no insurance coverage [11]. Additional barriers
include structural problems-such as lack of availability
of appropriate services, transportation, and
cost-and attitudinal barriers, including perceived
ineffectiveness of care [12]. Recipients of mental
health services may also face discrimination, stigma,
and dehumanization both in their communities and
in the mental health system itself, especially if they
belong to other marginalized groups, which may
also contribute to the significant " treatment gap "
[13], [14].
At this time of increased need, there have also
been shortages of mental health professionals and
services [15]. At the 2015 Law and Society Association
Annual Meeting in Seattle, WA, USA, for
example, statistics were presented showing that
the rising numbers of mental health patients had
resulted in U.K. psychiatrists, psychologists, and
general practitioners shortening patient session
26
times to barely 10 minutes [16]. One typical preCOVID
headline read: " GPs like me can't help
mental health patients in 10 minutes - it's cruel "
[17]. In a U.K.-based GP mental health training survey
from 2018 conducted by Mind.org [18], one
doctor wrote: " We are often working towards the
limit of what is appropriate/safe in a primary care
setting, especially when dealing with complex/
specialist psychiatric medication and when looking
after patients who pose a risk to themselves. "
Doctors responding to this same survey by Mind.
org [18] in England and Wales noted that longer
appointments for people with mental health conditions
would be a big help and that " 10-minute
appts are simply not long enough to do anything
other than prescribe antidepressants... " Another
doctor reflected: " 10-minute slots barely give time
to establish a proper agenda let alone deal with
the physical, social and psychological stuff that
arises, " while yet another wrote: " There is a limit to
what can be achieved in 10-minute slots in patients
with mental health issues, and patients frequently
burst into tears or hyperventilate during the consultation,
especially on initial presentation " [18].
Still, other patients cannot access mental health
services in their local area, due to high demand and
limited numbers of healthcare professionals some
of whom are also living with mental health conditions
[19]. One medical doctor in the same survey
wrote
[18]:
" Unfortunately,
patients
are
having
to wait up to 18 months for psychological therapy
in my region. " Since early 2020, staffing cutbacks
in numbers of available professionals during the
COVID-19 pandemic have further exacerbated the
gaps between supply and demand for therapists,
psychologists, psychotherapists, and psychiatrists
[20]. In some regional areas in Australia, for example,
in the South Coast of New South Wales, booking
an appointment with a psychiatrist has meant being
placed on a waiting list for three months for a mere
initial telephone consultation and much longer for
an in-person consultation. In desperation, some people
have chosen to drive long distances to a capital
city to see therapists who were willing to meet during
the pandemic but charged substantial upfront
fees (e.g., $820 AUD) with significant out-of-pocket
expenses to patients and their families [21].
Inadequate or nonexistent treatment services
can lead to an array of negative outcomes for people
living with mental health conditions. These
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IEEE Technology and Society Magazine - March 2023

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