Mental health for many folks extends beyond diagnoses; mental health is often talked about in the context of diagnosable disorders with specific criteria that must be met for diagnosis, such as generalized anxiety disorder, clinical depression, schizophrenia, PTSD, depersonalization, etc., but this is limiting for a number of reasons (Cohen, 2016).
Many folks experience mental health in a much more complex way, with subclinical or sub-threshold presentations (e.g. depression symptoms that don't meet enough of the diagnostic criteria to be considered clinical depression as defined by the DSM), comorbidities, or experiencing more than one mental illness at a time (the average person in the U.S. struggling with their mental health experiences 2.1 disorders), and highly contextualized causal and perpetuating factors that are often dismissed (e.g. trauma from institutionalized biases or discrimination, etc.) (Boorsboom, 2017; Cohen, 2016).
Diagnoses are important for some reasons, including ensuring that psychiatrists are administering medications appropriately and that psychologists and therapists are utilizing evidence based treatments in the correct manner and dosage. Additionally, diagnoses are one of the only ways for many folks to insure that their insurance covers their therapy sessions in our current healthcare system. At the same time, a transdiagnostic model and understanding that accounts for subclinical presentations, comorbidities, and multiple causal and perpetuating factors may be more informative (Boorsboom, 2017).
"Mental illnesses" and their related symptoms are often not abnormal, pathological, or some kind of inherently faulty biology, but are often rather normal responses to distressing or disturbing circumstances. These normal responses to distressing or disturbing circumstances may have biological correlates (e.g. measurable markers of stress in the blood like heightened levels of pro-inflammatory cytokines such as interleukin-6), physiological responses (e.g. sweating, heavy breathing, heightened heart rate), and mental or emotional states and experiences (e.g. anxiety, fear, anger, etc.), and these normal responses may be unwanted or no longer serving folks in a helpful manner. This might help explain why folks in marginalized communities face higher incidence of mental illness; there's no inherent aggregate difference in their genetics with respect to mental health, but rather these folks might have responses to trauma, bias, and discrimination that manifest as anxiety, depression, or some other mental illness.
Access to mental healthcare, particularly in the United States, can be difficult to obtain. There are many barriers to mental healthcare accessibility, which can include:
Additionally, for folks belonging to marginalized or minority groups, these accessibility concerns may be especially likely to represent their experiences, and they may have other addednaccessibility concerns that white, wealthy, cisgender, heterosexual, able-bodied folks don't have to worry about, such as:
Thus, addressing accessibility in mental healthcare is crucial, and many structural changes clearly need to be implemented to fix many of these issues and barriers. At the same time, if you are struggling with any of the accessibility concerns above and want to seek mental healthcare, here are some resources that might be helpful:
Following therapists via social media. There is a huge movement amongst therapists to make their knowledge more accessible through social media platforms such as Instagram. Of course, this is not therapy, but many of these therapists are providing free resources and tools to their followers that may be useful. Thus, here's a list of Instagram usernames of just some of the many therapists on Instagram: @nedratawwab, @lisaoliveratherapy, @lizlistens, @alyssamariewellness, @therapyforlatinx, @therapyforblackgirls, @drlaurenfogelmersy, @decolonizingtherapy, @marielbuque, @themindgeek, @the.wellness.therapist, and so many more.
The UC Berkeley Library has many books written by psychologists that may be interesting or helpful that you can access for free with your student ID. Here are just a few, and many more can be found via Oskicat:
Borsboom, D. (2017). A network theory of mental disorders. World Psychiatry, 16, 5-13.
Cohen, B. (2016). Embracing Complexity in Psychiatric Diagnosis, Treatment, and Research. JAMA Psychiatry, 73(12), 1211-1212.
Heneghan, C., Goldacre, B. & Mahtani, K.R. (2017). Why clinical trial outcomes fail to translate into benefits for patients. Trials, 18, 122.
McAlpine, D. D., & Mechanic, D. (2000). Utilization of specialty mental health care among persons with severe mental illness: the roles of demographics, need, insurance, and risk. Health Services Research, 35(1 Pt 2), 277.
For those of us interested in either being literate in psychological research or in doing research in the field of psychology or mental health ourselves, real-world applicability might be a feature we hope our research possesses, but that may actually be difficult to achieve. For example, research on behavioral treatments for DSM-defined anxiety may have a high level of control and a strong design, thus producing high internal validity, but lack external validity, or its applicability outside the lab, due to numerous factors, from the low caseload of researching psychologists compared with that of practicing LCSW or MFT therapists allowing for more preparation for each client, to the exclusion of folks with comorbidities (necessary to establish causation) despite comorbidity being the norm (Heneghan, Goldacre, & Mahtani, 2017). Thus, there are some ways to potentially increase applicability and some highly applicable areas that need further study:
Below are some databases and other resources that Berkeley students have access to through the UC Berkeley Library system, that may be helpful if you're interested in psychological research, are working on an honors thesis, etc.:
If you need help learning how to access the databases, how to navigate the databases, or how to find search terms to use to generate results that match what you're looking for, these links will take you to other Psychology LibGuides that go into these topics in more depth.
The UC Berkeley Library System also has many books that can help with research in psychology, in addition to the databases. Here's a list of a few books available through the UC Berkeley Library system that may be helpful in summarizing and conceptualizing psychological research that maintains a high degree of applicability:
If you want to find more books on psychological research available through the UC Berkeley Libraries and Oskicat, check out this Psychology LibGuide on finding books: