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Over the decades, America has struggled with the stigma of mental illness and therapy. Perceptions are slowly changing, aided by a pandemic that expanded our willingness to speak of depression, anxiety, stress, loneliness and other conditions that were previously referenced in often-hushed tones. 

Overall, mental illness has risen in the United States. Dramatically. A number of factors have played a part in this, including the escalation of social media that has now been found to negatively impact children and young adults—confirmed by the Surgeon General's latest advisory—and societal and political developments, economic worries ranging from housing to debt to food insecurity and a lack of familial and community support. It is not an optimistic picture. At the same time, funding support for mental health is woefully lacking throughout the United States.

Mental Health America, one of the country's leading mental health nonprofits, recently released its annual survey, the 2023 State of Mental Health in America*, sharing trends and patterns of mental health conditions. Among the key findings of the report is that 21 percent of American adults are experiencing at least one mental illness, translating into roughly 50 million people; 55 percent of adults with a mental illness have not received any treatment; and 16 percent of youth report suffering from at least one major depressive episode in the past year. 

The survey also provided a robust set of data points for additional conditions related to mental health care. The report's conclusions are disquieting. Statistics show that the state of mental health, amplified by the pandemic, is on the rise for all age groups, while access to care is becoming even more difficult, especially among those groups who are marginalized. 

From the field

Like so many other healthcare professions, mental health counselors are practicing a balancing act to fill gaps in staffing. The same mental health survey referenced above identified that in the United States, there are an estimated 350 individuals for every one mental health provider. Our Bay Path graduates in mental health counseling experience this reality every day, but like many in their field, they couldn't imagine doing anything else. 

"I wear two hats," says Monica Ardolino G'17, an outpatient clinician at Behavioral Health Network Inc. (BHN), based in Springfield. "I work 20 hours a week as a school support counselor for children in kindergarten to fifth grade, and 20 hours as an outpatient clinician, seeing clients at our BHN center. The common thread among all of my clients, young and old, has been COVID. I work with children who seem to be behind academically, socially, and emotionally. And at the outpatient clinic there are higher numbers of clients reporting anxiety and depression while struggling with coping skills that were diminished by our need to be continually adjusting to the pandemic. Seeing clients in person is more beneficial. And when they are feeling positive about themselves and their lives, it is very rewarding!"

Amanda Hichborn '14 G'17

Amanda Hichborn '14 G'17 has a similar busy schedule that takes her to various locations in the region. She works at River Valley Counseling Center as a program director for its outpatient mental health clinic in Westfield; as program director for two certified community health clinics based in Holyoke and Westfield; and she carries a small caseload of clients. "Even today, COVID has had an immense impact on the demand for therapeutic services. We almost cannot keep up," she says. "As a supervisor, I'm faced with many challenges, but one of the main problems is we just don't have enough certified counselors in the pipeline. And there are not enough resources to support clients and clinicians in practice. Yet another reason why the integrative team approach is helpful all around."

As a practitioner who has been in the field for almost a decade, Hichborn sees positive changes happening in mental health. She says, "We have seen great success with our integrative healthcare team, comprised of a mental health counselor, case manager, medical assistant and peer recovery professional. Together, they are able to treat a client's mental and physical needs. It's multi-prong support that really works." 

What is integrated behavioral healthcare (IBH)?

IBH blends care in one setting for medical conditions and related behavioral health factors that affect health and well-being. IBH, a part of "whole-person care," is a rapidly emerging shift in the practice of high-quality health care. 

Approaches to mental health counseling

At Bay Path, our MS in Clinical Mental Health Counseling program prepares students to be clinicians who celebrate and respect diversity and actively work to break down the stigma of mental health. Two years ago, the program was a recipient of a grant from the Behavioral Health Workforce Education and Training (BHWET) totaling $1,432,781 over four years, funded through the American Rescue Plan.

Dr. Kristina Hallett

"The grant has been a game-changer for our program," says Dr. Kristina Hallett, director of the MS in Clinical Mental Health Counseling degree. "With this funding, we are placing our graduate students in IBH settings, and they are learning collaboration and patient-centered care with other practitioners. More importantly, to become a licensed mental health counselor they must put in 600 hours of clinical practice. As many of our graduate students work, this grant allows us to give them a $10,000 stipend, so even if they take a leave from their present job, they will have income to support themselves or their families.

"Our philosophy in the program is that mental health is public health," adds Dr. Hallett. "A growing body of research shows integrated behavioral health improves health and patient experience while reducing unnecessary costs in time, money and delays. With IBH, everyone benefits, particularly the most important person in this dynamic—the client."

*The information presented in the 2023 survey was collected in 2020 and is the first iteration of the report with data cumulated during the COVID-19 pandemic. As a result of limitations on data collection efforts imposed by the pandemic, as well as changes and updates to the DSM-IV, the authors of the survey analysis stress that figures from the 2023 survey cannot accurately be compared to data from previous years.