Understanding mental health

WHO names individual factors such as emotional skills, substance use and genetics as things that can raise vulnerability.

SAMHSA adds that genes, physical illness or injury, brain chemistry and family history can all play a part. None of these are about being lazy or weak.

Life experiences such as trauma or abuse can affect mental health, sometimes for a long time.

Family can also be a strong source of protection. Warm, steady relationships help people cope with hard times.

WHO lists poverty, violence, inequality and environmental deprivation as social and environmental factors that raise the risk of mental health conditions.

This is why mental health isn’t only a personal matter. Safe housing, fair treatment and access to care help whole communities stay well.

WHO notes that global threats such as economic downturns, disease outbreaks and humanitarian emergencies can affect the mental health of entire populations.

Feeling shaken during a crisis is a normal human reaction. It does not mean something is wrong with you.

Protective factors help build resilience. They work across the same levels as risks: inside us, in our families, in our communities and in society.

Examples many people find helpful

• A sense of belonging and purpose
• Coping and problem-solving skills
• Safe, supportive relationships
• Steady routines for sleep, food and movement
• Trusted places to turn for help

About 23% of U.S. adults live with a mental health condition, according to recent national data. Worldwide, nearly 1 in 7 people were living with a mental health condition in 2023.

Mental health conditions affect people of every age, background, income and culture.

Even young children can show early warning signs. Half of all mental health conditions show first signs before age 14, and three-quarters begin before age 24.

Noticing early and getting support can make a big difference.

Most people with mental health conditions are no more likely to be violent than anyone else. Only about 3%–5% of violent acts can be linked to people living with a serious mental illness.

In fact, people with severe mental illnesses are over 10 times more likely to be victims of violent crime than the general population.

Mental health conditions have nothing to do with being lazy or weak. Many things play a part, including genes, physical illness or injury, brain chemistry, life experiences like trauma or abuse, and family history.

Telling someone to “snap out of it” or “just deal with it” can deepen shame and make them less likely to seek help.

Studies show that people with mental health conditions get better, and many recover fully. Recovery means being able to live, work, learn and take part in community life.

There are more therapies, services and support systems available today than ever before.

People with mental health needs can be just as productive as other employees. Employers who know about an employee’s condition often report attendance, punctuality, motivation and job tenure that is as good as or better than others’.

Loved ones can reach out, listen, help someone find services, share accurate facts, treat them with respect, and use respectful language.

Simple words like “Is there anything I can do to help?” or “People do get better” can mean a lot.

People go to therapy for many reasons: stress, grief, relationships, big life changes, or simply wanting to understand themselves better. The goals include easing symptoms and improving daily life.

Therapy can teach practical skills, like coping and problem-solving, communication, mindfulness and relaxation.

Research involving large numbers of people shows that evidence-based therapies reduce symptoms of depression, anxiety and other conditions.

Therapy is often structured, with goals and skills to practice between sessions, such as cognitive behavioral therapy, which helps you notice and change unhelpful thinking patterns.

There is no single length for therapy. You can ask a therapist whether they recommend a time frame or number of sessions, and how you’ll measure progress together.

If you’ve been in therapy for a reasonable time without feeling better, it’s OK to talk with your therapist about other options.

Trust and comfort with your therapist are important. A short first conversation can help you decide if they’re a good match.

Questions to ask

• What are your training, experience and specialties?
• What approach do you use, and what is the research behind it?
• Have you worked with people my age, or with my concerns?
• How is my privacy protected, and what are its limits?
• What do sessions cost, and do you take insurance or offer lower fees?

Therapy can be one-on-one, in a group, or with family members. Many professionals also offer sessions by phone or video.

Ways to find a therapist

• Directories from professional and advocacy organizations
• Your health insurance provider’s list
• University or medical school training clinics, which may cost less
• State or county health department programs

Counselors and therapists usually have a master’s degree. They are trained to assess mental health and use therapy approaches based on their training. Their job title can change depending on where they work.

Common licenses you may see

• LPC: Licensed Professional Counselor
• LMFT: Licensed Marriage and Family Therapist
• Licensed addiction counselors

Psychologists have a doctoral degree (a PhD or PsyD) and are licensed by their state. They can assess mental health through interviews and psychological testing, make diagnoses, and provide individual and group therapy.

Some have extra training in specific approaches, like cognitive behavioral therapy or dialectical behavior therapy.

Clinical social workers usually have a master’s degree in social work. They assess mental health and provide therapy, and are also trained in case management and advocacy.

They can be especially helpful if you need support with things like housing, work, or paying for care, alongside your mental health.

Licenses you may see

• LCSW
• LICSW
• ACSW

Psychiatrists are medical doctors who have completed extra training in psychiatry. They can diagnose mental health conditions, provide therapy, and look at how physical and mental health affect each other.

Some have further training in areas like child and teen mental health, substance use, or older adults.

Psychiatric nurses can also provide therapy and care. Your family doctor is often a good first stop, and can help rule out physical causes for how you feel.

Peer specialists are people with their own lived experience of mental health challenges, trained to support others on their recovery. A peer specialist or social worker may be a good fit if you need practical help.

For young people, school counselors and school psychologists can be a helpful first person to talk to.

The National Institute of Mental Health (NIMH) explains that the link between substance use and mental health is complex and works in both directions.

Some reasons

• Shared roots: stress, trauma and genes can raise the chance of both
• Coping: some people use substances to numb painful feelings, which can lead to a substance problem over time
• Brain changes: some mental health conditions can make substances feel more rewarding, and substance use can cause brain changes that raise the risk of other mental health conditions

Physical and mental health are linked too. People with a long-term illness have a higher risk of depression, and depression can make physical health harder to manage.

NIMH notes that accurate assessment is key because symptoms can overlap. Professionals with experience in both mental health and substance use can use thorough assessments to lower the chance of something being missed.

Why things get missed

• Overlap: poor sleep, tiredness and trouble concentrating can come from many different causes
• Masking: drinking can hide anxiety for a while, and anxiety can look like a heart or stomach problem
• One thing gets all the attention: a person in treatment for one issue may never be asked about another
• Stigma and shame: people may feel able to talk about stress but not about drinking, or about pain but not about mood
• Separate systems: physical health, mental health and substance use care are often in different places

Integrated care brings mental health and substance use support together, so people get coordinated care in one place. Talking therapies like cognitive behavioral therapy and motivational interviewing can help people build coping skills. Family-focused approaches that improve communication can be especially helpful.

Questions you can ask a provider

• “Can you help with both of these, or can you work with someone who does?”
• “How will my different providers share information?”
• “What should I watch for to tell which issue is flaring up?”

SAMHSA suggests choosing a time and place where the person feels safe and comfortable, speaking plainly, and slowing down if they seem confused or upset.

Openers you can try

• “I’ve been worried about you. Can we talk about what you are experiencing?”
• “It seems like you are going through a difficult time. How can I help you find help?”
• “I’m concerned about your safety. Have you thought about harming yourself or others?”

Comparing it to physical health can help. Just as someone with a bad chest infection may need a doctor, someone with a mental health problem may need professional care too.

• “I’m here for you.”
• “Thank you for trusting me with this.”
• “That sounds really hard. Do you want to talk, or do you want company?”
• “Would it help if I came with you to an appointment?”

• “Everyone gets sad sometimes, you’ll be fine.”
• “Just think positive.”
• “I saw a video, you definitely have…” (leave assessment to professionals)
• “Are you sure you need therapy for that?”
• “Don’t tell anyone.”

Stigma, even subtle, can make people delay getting help or stop care. Small changes in what we say can make it easier for someone to keep reaching out.

It’s okay to have limits. You can care deeply about someone and still need rest, time with others and support of your own. Family members of people with mental health conditions can feel stigma too, and may need a place to talk.

• Share the load with others
• Keep up your own routines and friendships
• Join a family or friends support group
• Talk to a counselor if you feel worn out

A family doctor can listen, check for physical causes of how you feel, and help you find the next step.

School counselors, school psychologists and campus counseling centers can listen, support and point students toward more help if needed.

Licensed professionals are trained to listen, assess and support you. See “Who’s who in mental health care” above for the differences.

Find A Helpline (findahelpline.com) lists free, confidential helplines in more than 175 countries.