Is America more comfortable with vulnerability? A soon-to-be-released study says that more Americans than ever are reporting feeling depressed and anxious along with a host of other emotional health issues. If we are ready to acknowledge our mental health struggles, then why aren’t health care professionals seeing more Americans in their offices? A doctor from the Johns Hopkins Bloomberg School of Public Health has recently submitted findings from his 10-year study for publication in the November issue of the American Journal of Public Health. The study examined responses given by 300,000 Americans ages 18 to 64. Respondents took part in annual surveys conducted for each of the 10 years during the life of the study. A Growing Mental Health Crisis The study reveals an increase in the number of Americans who feel unable to perform daily tasks or engage in social interactions due to their mental health. The number self-reporting mental health disability in 1999 was 2 percent, which rose to 2.7 percent by 2009. That increase represents close to 2 million people who feel limited by their lack of emotional well-being. The study’s findings in terms of numbers and percentages are quite clear. What is less certain is how to properly interpret those numbers. There is a nuance in the results which leaves even its author wondering if Americans are experiencing more psychological distress or simply are more willing to admit it when they do. One would be cause for concern and the other cause for gratitude. With more information available and more public discussions occurring, are Americans simply more aware of mental health issues? Or does the study give expression to a cumulative mental health toll being experienced by the country due to factors such as escalating unemployment, economic uncertainty and a growing feeling of isolation? Are people feeling more psychologically distressed or is it only having more impact on day-to-day living? The study does not definitively answer these questions. Fewer People Seeking Mental Health Treatment Although the results reveal that more Americans express psychological distress, they also show that fewer people are seeking treatment for those issues. According to the report, 3.2 percent of those polled in 1999 said they sought the help of a mental health professional in dealing with their emotional hardships, but only 2 percent reported doing so by 2009. Sadly, the people who revealed the greatest amount of psychological distress were also the ones who had no contact with mental health care providers. One explanation for the drop in utilization of mental health services could be that people are turning to their primary care physician for support. A 2010 report from the American Medical Association said that 33 percent of primary care patients were receiving help for psychological problems from their general care doctor. This supposition appears to be confirmed by a 30 percent increase in the number of antidepressants being prescribed without a clear psychiatric diagnosis attached. Contributing to the trend is the growing number of people who say they simply cannot afford mental health services. The study saw a clear rise in this statistic. In a worsening economy people feel they do not have the funds to make another co-payment. Combined with the fact that patients may have longstanding relationships with a trusted general practitioner, the migration to primary care treatment for mental health issues could well be explained as a matter of economy. Whatever the reason, an improvement in the integration of primary care and mental health services seems appropriate. Americans seem to be more aware of their mental and emotional health issues and more comfortable talking about them, according to this study. What isn’t as clear is why people still hesitate to seek out help from a mental health professional and what can be done to change that.