You wouldn’t simply wear the exact same suit or dress that others are wearing rather than one that actually fits your size, shape, personality, interests and current situation, would you? Why, then, would you expect a single approach or single set of approaches to mental health to work for everyone?
After all, psychology and mental health are whole lot more complex than buying clothes. One size or style certainly does not fit all. Rather there is a need to tailor different mental health approaches to different people’s characteristics, surroundings and situations, which brings us to the concept of precision mental health.
The word “precision” means bringing more exactness or accuracy to prevention, diagnosis and treatment methods that, in the case of precision mental health, relate to mental health. There is certainly no shortage of mental health preventative, diagnostic and treatment approaches out there. Over the years, scientific research has generated a growing body of insights about what affects mental health and how to deal with these different factors and processes. There are now a range of different therapy programs, books, talks and apps out there along with various medications. If you want to address mental health issues, there are certainly many more options today compared to several decades ago.
Yet, many statistics suggest that over the past several decades mental health has continued to get worse and worse in the U.S. and other countries around the world. For example, a 2021 survey by the American Psychological Association showed that the demand for psychologists to treat anxiety and depression increased from 2020 to 2021, continuing an upward trend that had begun before the Covid-19 pandemic. The Centers for Disease Control and Prevention’s (CDC’s) Youth Mental Health Survey found that 42% of those surveyed “experienced persistent feelings of sadness or hopelessness” in 2021, a sizeable jump from the 28% in 2011. And a study published in 2023 in The Lancet Psychiatry predicted that one out of every two people in the world will develop a mental health disorder in their lifetime, based on surveys of over 150,000 adults from 29 different countries.
So why hasn’t the existence of more mental health preventive and treatment options translated to fewer mental health problems among the population? Why have trends instead gone the opposite direction? Well, one possible reason is that over the past several decades many environmental, social, political and economic conditions have continued to change in our society. For example, social media has gone from a twinkle—or some may say a tinkle—in Silicon Valley’s eye to a predominant form of social interactions. And much has been written about the potential adverse effects of social media on mental health.
Social media may be exacerbating what was already an issue, people spending less and less direct time with each other. A 2023 U.S. Surgeon General’s Report entitled “Our Epidemic of Loneliness and Social Isolation” described how Americans have been feeling less and less connected with each other and more and more lonely. Yes, times they are a-changin’ can certainly apply to the past few decades in these ways and others, which means that mental heath approaches that may have worked previously may no longer be as precise and effective.
Another possible big reason is the potential lack of coordination among the potpourri of mental health approaches in how they are being applied. The right combinations of programs, apps and other options may not be available and implemented to the right people in the right manner. When a new mental health approach is being touted on social media or elsewhere, there can be a tendency to suggest that it works for everyone or not specify who would most and least benefit from the approach. In other words, one has to ask how precisely are the different available mental health approaches being used?
A third issue is that many mental health approaches right now may be more focused on addressing the consequences of mental health issues rather the root causes. Medications, for example, may help reduce symptoms but may not address the environmental, social, developmental and other factors that led to the condition in the first place. When you are chasing after the results of a problem rather than more proactively dealing with the causes, your approaches can end up being a lot less effective and a lot less, you guessed it, precise.
The past decade has seen the rise of more precision approaches to health and health care in general. Back in his 2015 State of the Union Address, then-President Barrack Obama mentioned the launch of the the White House’s Precision Medicine Initiative. The White House described this initiative as “Health care tailored to you” and moving away from the historical trend that “most medical treatments have been designed for the ‘average patient.’” And things designed for the average patient could, surprise, surprise, lead to very average results.
Since then more and more health-related precision terms and approaches have emerged. For example, in 2022, the National Institutes of Health (NIH) launched its Nutrition for Precision Health (NPH) consortium, which I have covered for Forbes. There’s also the term precision population health, which I described for Forbes in 2023. Ultimately, you could place the word “precision” in front of practically any health or healthcare term. You can have precision oncology, precision epidemiology, or even precision proctology.
In all cases, achieving more precision means better understanding and addressing the whole system of factors that may be affecting each person that you are trying to protect, diagnose, treat or otherwise help. For mental health, this system can be quite complex and quite different for each person. A person’s mental health situation can depend on what’s happened earlier in the person’s life—ranging from upbringing to environmental exposures during childhood—what’s been happening in the person’s life—ranging from the person’s workplace and family situations to the person’s diet and physical activity—and what will soon be happening in the person’s life. Therefore, achieving more precision mental health will depend on using more systems approaches to further elucidate this complex system.
Our society is at an inflection point. It’s in the midst of growing mental health crises. At the same time, there is more data, more scientific information, more technology including more computer-based approaches such as artificial intelligence (AI) and more mental health preventative, diagnostic and treatment options available. Will all of these be used in combination to better tailor mental health approaches to different people and their needs? Or will more of a one-size-fits-all approach be pushed? That is precisely the question.
