Our Mental Health Blind Spot – We fund foreign wars not our at-home war against mental health
- Josh Jones
- Feb 24, 2022
- 20 min read
Updated: Feb 26, 2022
There’s 150,000 Russian troops surrounding Ukraine right now and a war is breaking out. There is another, bigger war that has been right in front of our faces, bombs exploding in the form of mental and physical destruction with approximately 150 to 200 deaths in the US every day. Whether those deaths are the result of substance abuse, suicide, depression, anxiety, compulsion disorders or other causes – we have a single enemy to focus ourselves against in mental health.
Here at home, the COMBINDED funding from charitable donations to the top 10 mental health organizations totals only $300 million dollars OVER THE LAST THREE YEARS (2018 to 2020). As a society we ignore mental health, look the other way. The causes we support clearly demonstrate this. The 9th leading cause of death in the US is kidney disease, which was funded with over $325 million dollars IN JUST THE LAST YEAR. So we must think differently about the causes we support, pay attention and pay with our donations to support mental health causes.
We fund wars, but then we don't fund mental health causes for our soldiers, with military personnel among the greatest sufferers of mental health issues, and disproportionately serious ones that end in suicide.
Suicide, just one small component of the mental health war and pandemic, is the 10th leading cause of death in the United States. We underfund, under support and underappreciate the impact of mental health in our society today, suicide being just one aspect to demonstrate the conclusion. Furthermore, we have not learned from so many prior events that had the chance to change our perception of mental health and begin to truly fight the battle. Here we look at a few remarkable tragedies in New York surrounding mental health and then look at how we support different charitable organizations aiming to put a dent in the mental health epidemic in the US.
Take a step, donate to a great mental health cause: https://nami.org/About-NAMI/Donate-to-NAMI
Many times I find things are so backwards, upside down, or inside out. This inside vs. outside concept is so critical for us to all recognize when speaking about mental health. Don’t judge a book by its cover, don’t take strength at face value. Look at your clothes, whether a simple t-shirt or sweatpants, yoga pants, tailored suits, dresses – all will tell the same story. All the seams are on the inside, the scars of the fabric, the labels with all the important details of the material and care instructions are on the inside so the look from the outside is pretty, neat and refined. The tags and stitches against your skin are a nuisance, give you discomfort, are scratchy – something you deal with to have that beautiful look on the outside. Why not put that stuff on the outside in order to feel good on the inside, smooth on your skin, be clear about the instructions for use and care, for me that’s the priority beyond coverage and function? I often wear my clothes inside out around the house, just for that reason. The inside is more important to me. Mental health is a parallel in this way, so many of us are managing stitches and seams that are barely holding things together, that are scratching and irritating on the inside, just so we can look so well put together on the outside. I am thinking more about the fact that I only wear things inside out around the house, where there is no fear of ridicule, I feel safer and protected from any blowback or ridicule – that is another concept to consider when it comes to mental health and why we don’t feel comfortable to show our scars and the care we need out in the open vs. in the confines of our own bubble.
I wrote a prior article about how mental health is underserved from the spending perspective, but that was just the start of my mission of determining if my inclination that mental health as a disease class and a cause is underserved.
Statistics around healthcare spending showed we are clearly missing the mark by $150 billion in the US each year. That’s a hefty miss for mental health every year, imagine the progress that could be made if we injected those additional funds into the system. That is the government spending angle on this, but there is more. I wanted to triangulate this thought that mental health is fiscally overlooked by examining the inflow of donations and funding for private organizations, charities and foundations that serve mental health. Charity fund-raising is a barometer of what causes we feel as a society are impactful, important and served and my thought is we will see the same blind spot as with government spend. How does the everyday Joe up to the billionaire Elon ZuckerBezos feel about mental health, what are they saying with the powerful voice of their pocketbooks and checkbooks (or should I say through their paypal, square and crypto)? Well, I got another great education in just how big the hole is, how large the blind spot is (or more accurately that we are totally blind on this matter). What is a blind spot? The point of entry of the optic nerve on the retina, insensitive to light. An area where a person’s view is obstructed.
Perhaps with respect to mental health, the blind spot is signifying our inability to shine light on the issue, see the magnitude of the issue that is right in front of our eyes? And society and norms and perceptions are truly obstructing our view and impeding progress, dimming any light, keeping us from the courage to open up and take steps in the right direction. Perhaps, but first lets dive into the numbers in terms of charitable organizations and donations in 2020. Lets see if the reality matches the perception on mental health as an issue we rally behind with the power of money, the voice of cash.
Forbes just put out a great article, rich with data, just the thing I like to eat up, showing the top 100 charities in the US for 2020. https://www.forbes.com/top-charities/list/
I feel good with the top-line, $54 billion in aggregate 2020 support warms me up on a cold Chicago morning, somehow the frigid wind does not pierce me in this moment:
The nation’s top 100 charities reported a 10% increase in private donations during their most recently reported fiscal years, collectively receiving $54.4 billion in support. That’s one of the highest percentage increases in the 23 years Forbes has been compiling this list, and stands in sharp contrast to last year’s performance, when donations to the top 100 fell 4%.
But then the wind rips off my coat and shows me another side, I am frozen as I reflect deeper on the data. We have a mental health blind spot, the strong feeling in my gut was right on. The facts show we don’t have any spotlights, any flashlights for that matter when it comes to funding mental health causes, and I know we are missing daily meaningful discussions about mental health that are needed as a first step. You know, the first step of recovery is realizing you have a problem, and then you have to talk about it. We are addicted to not solving mental health it feels like, we are in denial.
So I examine the list, and ask you: Do you even know the top mental health charities in the US? Most people do not. Mental health is a devastating disease class, on par with cardiovascular disease as the top threat from a financial ruin standpoint (and of course we all know about the American Heart Association). And mental health is far more significant than cancer, I know just reading that seems shocking, we all know about 10 cancer-focused charities. And don’t get me wrong, all of these other charities are doing great things, unbelievable things and they need every cent they have to put even the slightest dent in these complex, heartless and cancerous diseases. My point is that our government healthcare system spending is drastically underfunding mental health, that is a shame. But a bigger shame that reflects our societal blind spot within a blind spot, is that we not only aren’t giving to mental health charities, we are not even sure who they. No wonder mental health sufferers feel alone or a pariah. Afraid to come out just as so many other underserved causes and populations in our history, we continue to repeat the history that we are so ashamed of.
Why do we turn away from mental health, is it because we don’t want to face the real beast that impacts so many of us each day, we don’t want to let the beast know we recognize it, thinking that is a way to defeat it? We all know that stance is childish, a mental midget mindset and instead we must rise up, rally around the topic and put our resources into the battle.
So back to my initial question, and fighting with education and data – the top mental health charitable organizations are the following (and yes I understand many know about the suicide prevention one because of every news broadcast highlighting the loss of another great musician, public figure is where they flash the call number up at the end):
8. StrongMinds
13. Active Minds
Not a lot of household names that ring true like the American Cancer Society, the Salvation Army, the Mayo Clinic, Planned Parenthood, Feed the Children, etc.
Here’s another list to see what pops up on both, another perspective with background on each one:
1. National Alliance on Mental Illness (NAMI) NAMI.org
2. Mental Health America (MHA) mhanational.org/donate-now
3. The Jed Foundation jedfoundation.org
4. American Foundation for Suicide Prevention (AFSP) supporting.afsp.org
5. Project Sanctuary projectsanctuary.us/donate
6. American Psychiatric Association Foundation (APAF) secure.givelively.org/donate/american-psychiatric-association-foundation
7. Active Minds suicide prevention organization
8. To Write Love on Her Arms (TWLOHA) twloha.com/donate
9. American Academy of Addiction Psychiatry (AAAP) aaap.org/about/donate.
10. Battlefield Addiction battlefieldaddiction.com/#donate
11. The Trevor Project give.thetrevorproject.org
12. Trans Lifeline translifeline.org/donate
My thoughts are so bipolar on this, no pun intended. On one hand, I am so happy to see more and more emphasis on mental health, the voice has never been louder, the drum beat grows louder – I want to feel that. But the beat is still so faint off in the distance and I’m not so sure its approaching us or standing still, or even moving farther away which I truly fear.
Maybe part of the problem is that mental health is not a single demon, mental health is far more complex, many medusa heads on all the arms of a mighty octopus. A snake head on each suction cup, its nasty with multiple heads to understand. I surmise this fragmented, multi-faceted beast as a factor to consider in our future mental health strategy after reading about Michael J. Fox’s Parkinson’s charity. Parkinson’s disease is a paralyzing, traumatic disease and importantly, a single enemy with a very recognizable face and leader. This ability to identify the single target, fight a single, deadly entity may be part of the why behind the $200 million in donations. Also very highly commendable for Fox’s charity making a debut on the list, the high percentage of donations that are directly aimed at the beast (known as a high charitable commitment ratio, proportion of total dollars spent on the stated mission). So I am hopeful that we will make advancements against the Parkinson’s beast.
Among the most notable first-timers is the Michael J. Fox Foundation for Parkinson’s Research, which debuts at No. 84, with $200 million in donations. Fox stands out among single-illness charities for the combination of its significant research, its high charitable commitment ratio (the percent of total expenses spent on the stated mission, as opposed to fundraising or other overhead) and its high fundraising efficiency (the percent of donations remaining after fundraising costs).
But as I look further at the list, maybe we are missing our umbrella effort that pulls it all together for mental health, maybe we have not put the pieces of the puzzle together to show the face of this true beast. Maybe we need our white knight spokesperson to lead the charge? Certainly we need all of that and more. I would like to see the mental health organizations team up – form a consortium of sorts.
As I sit here in Chicago, looking out over the city and read the Forbes 100 list about the Barack Obama Foundation and so many others that are worthy causes, have great missions and leadership, I am feeling empty and almost want to jump out the window. But I will instead jump further into this cause. [for your information the Barack Obama Foundation ranks #98 on the list and brought in $172 million in private donations for 2020, the mission is to oversee creation of a presidential library in Chicago and runs several other programs. God I hope mental health is a part of those several other programs add-on at the end of their mission description.]
I look at the Forbes list 4 times, and I do see many social programs that have a mental health undertone or connection, but not a single of the biggest and most developed mental health charities in the US is on the top 100 list. There are many charities that fall into the health, domestic needs and cultural categories that are in some ways connected to mental health, but I yearn to see direct hits and names of mental health organizations on this list. And I am wanting to see that single entity that pulls all the efforts together to focus the support we must garner. Its that important, and this evaluation gives me another point to scream out about our blind spot and unwillingness to accept that mental health is a crisis and a terrible monster we must fight harder to defeat. The last thing I will say about the list is this, The Humane Society for animals ranks on the list at #99 on the list bringing in $169 million in private donations. Yes I realize we all love our animals, I am very guilty of this in that I treat my Luna Mar and Jimmy better than I treat most humans on this planet, and now I know that I must further change – treat myself differently, act differently myself as a small step in the right direction so we can all collectively act differently and treat each other differently. We have to be more humane and deal with mental health differently from top to bottom as the funding is just one feather on the bird.
Ok so I will throw out a few more on the list that help make the point, I can’t stop looking at the list and asking why isn’t mental health ever-present from a donor standpoint when we know the cause is ever-present on all of our true lists of action needed, our internal, private collection lists only I guess. I imagine people who truly have the means to help, truly are struggling themselves are scared to contribute to the cause based on the stigma that could follow. Maybe people think if they wear the free mental health charity t-shirt out in public they will be ridiculed, that shows how far off we are, how big the opportunity here really is. Fear and ridicule, that is the topic of my next article, about Larry Miller from Nike.
Forbes list notables, that make you ponder what is wrong with us regarding getting behind the cause of mental health:
93. Metropolitan Opera Association $182 million in 2020 donations
72. Wycliffe Bible Translators $224 million in 2020 donations (google translate anyone? Bueller?)
63. American SPCA $282 million in 2020 donations (again, I love animals and know they need to be cared for but between SPCA and humane society we have almost 3x the funding of NAMI the leading mental health charity in the US).
27. Cru (Campus Crusade for Christ) $570 million in 2020 donations (God help us all)
15. Nature Conservancy $868 million in 2020 donations (our environment is important, but if we are all hopelessly crazy what does it matter)
So I repeat, NAMI as well as ALL of the other top mental health organizations are absent from the Forbes 100 list. As I look more into the numbers for mental health organizations, its difficult to even find contribution numbers for comparison to the Forbes list. You have to dig, luckily I have a sharp spade shovel ready to break ground.
NAMI’s annual report is a first target: https://www.nami.org/NAMI/media/NAMI-Media/PDFs/Financials/NAMI-2020AnnualReport-FINAL.pdf
$25 million in contributions for NAMI in 2020, $28.3 million in total revenue. No typo, no zero missing, that’s it. There’s a lot of positively-trending information in their annual report, but this contribution number shows we are hopelessly optimistic – NAMI should be screaming to all of us to wake up. Its like trying to build and run a tech company with dial-up internet service, no bueno. So while government spending on mental health is off by 75%, we see here that the charitable contributions that speak for our private sector’s feel for this cause and mission is off by much more than that. I would say we need to be on par with $200-500 million a year for NAMI to be doing what it truly needs to do. So a factor of 20X or 2000%, that’s all we are missing.
And NAMI is just barely staying on top of things, not saving for the future, healing and fighting paycheck to paycheck – putting everything they have into the fight with expenses of $20 million in 2020. Every line item below is missing a zero, we should be 10X the spend we are at, perhaps 100X and we still wouldn’t feel uncomfortable based on the opportunity in front of us to defeat mental health. Or at the very least, to put up a real fight.
Then lets look at the American Foundation for Suicide Prevention, and I bring forward the statistic again that suicide is the 10th leading cause of death in the United States, with approximately 50,000 deaths each year. So in three years you can line up all of the victims and encircle Ukraine just as we see today with 150,000 Russian troops waging war. Mental health, with suicide being just one facet of the complex disease class, is the target for our war, we must fight this battle at home in the US. So for the 10th leading cause of death, I would expect a healthy donation stream to serve the weaponry needed to win this war. Lets see if the AFSP annual report provides the data in support of that, or further shines the light on our blind spot https://annual2020.afsp.org/; financial statements: https://afsp.org/financials
So for suicide, AFSP is only part of the story but here are their stats: $12.2 million in 2020 donations, $13.1 million in 2019 donations, $12.5 million in 2018 donations – so lets say $12.5 million in annual donations to the 10th leading cause of death in the US. That does not feel like the right number to me.
What happens when we add in the donations to the JED foundation, another leading charitable organization for fighting suicide. https://jedfoundation.org/financials/
JED’s stats: $6.9 million in 2018, 13.7 million in 2019 and $8.8 million in 2020 – wider variation but lets say on average $10 million a year in donations for a three year average.
In total, AFSP and JED bring in $22.5 million a year.
Then let’s add in the Trevor Project, another significant organization in fighting against suicide – they brought in $22 million in 2020. This one is a pleasant surprise and gives me hope because the Trevor project is aimed at mental health and suicide prevention in the LGBTQ population and focused on our youth. https://www.thetrevorproject.org/financial-reports/
JED: $22 million in 2020, $15.6 million in 2019, $8.6 million in 2018 – the trend looks beautiful here!
So the big three for suicide prevention organizations combined donations we have JED, AFSP and Trevor. And the grand total, no drumroll needed because its more like deafening silence: we have $45 million roughly in annual donations for preventing suicide in the US. How does that stack up against comparable other leading causes of death or health impact in the US? The silence becomes even more awkward and dark.
The 9th leading cause of death in the US is: kidney disease which kills roughly 52,000 a year in the US
There’s a big two for Kidney-related disease fund-raising, awareness, research and programs:
American Kidney Fund: 2020 $328 million; 2019 $314 million; 2018 $297 million
The National Kidney Foundation: 2020 $12.3 million; 2019 $12.1 million; 2018 $12.5 million
That big two, and man are they big, brings the total for kidney-related donations from these two top organizations to $325 million annually. That is more than 7X the donations to suicide prevention and they are comparable killers each year in the US. Ouch. Blind spot confirmed in my mind from this analysis. Similar to the total healthcare burden and spending point of view. So that is two strikes. What about how often we are talking about the topics, is there a way to get data in this regard?
To further put the 2020 kidney disease donation total of $325 million in context relative to mental health, I combed through the financial statements of the top 10 mental health charities in the United States and found that the COMBINED TOTAL DONATIONS FOR 2018, 2019 and 2020 amount to approximately $300 million dollars. That is a gross underfunding, and something each of us can change by supporting mental health organizations that need far more resources to be equipped against this enemy.
So kidney diseases are common, impactful and not surprising when you consider the prevalence of dialysis centers across the United States relative to suicide prevention centers. There are approximately 7500 dialysis clinics in the US. You can’t find any truly dedicated suicide prevention centers but if you look at overall total registered mental health treatment facilities in the US, we have 12,472 in total (97888 were less than 24-hour outpatient facilities and 1,892 are 24-hour inpatient facilities). I go back to the statistic from NAMI where I started this article and there are over 825,000 people in New York alone treated for mental illness, something is not adding up.
I am not sure what conclusions to directly draw from the number of facilities in the US, but its interesting and informative. At least there are some places to go and seek help whether you are suffering from a variety of mental health issues or kidney disorders.
What is very interesting when you look at things from a number of deaths perspective, you see heart disease and cancer are far outweighing the others – but when you look at things in terms of total healthcare system impact and add in treatment costs to get total financial burden, mental health is at the same level as heart disease, and a much bigger burden relative to cancer. So we have to be careful how we look at things, what information we anchor to. Same with the mental health journey, we can’t only look at one aspect of our shortcomings and devote all of our support in that area, we need to reach complete health and take a broad approach to have lasting impact. And much of the analysis here relies on components of the mental health epidemic where we can get good statistics - we are zeroing in on suicide, which is just one small component of mental health, but the easiest one to use death statistics on for comparisons. So let’s not forget how big the overall picture is for mental health – substance abuse, depression, anxiety, obsessive compulsive disorders, addiction are horrifically common other facets.
And also lets not always think with our hearts, we focus on death statistics when that is just the final straw, not the overall impact - Heart disease and cancer account for 46% of deaths but a lower overall percentage of healthcare burden.
Up to 50% of the general population in middle- and high-income countries will suffer from at least one mental disorder at some point in their lives.
Mental health and substance abuse disorders constituted 10.4% of the global burden of disease and were the leading cause of years lived with disability among all disease groups.
In relative terms, when you apply the VSL (value of statistical life) model, mental disorders are responsible for more total cost than any other disease group (almost 4 times the cost of cancer, diabetes or chronic respiratory diseases which each are about $2-2.5 trillion each, and mental health comes in just larger than cardiovascular diseases, both around $8.5 trillion in 2010 dollars (again that number doubles or triples when we get to 2030, a time and a place not far off).
And if you use another model, the value on economic growth, mental health is the largest disease class from a financial impact perspective at 16.3 billion compared to $15.6 billion for cardiovascular diseases and $8.3 billion for cancer.
Our mental health blind spot even stretches to medical doctors, who commonly underdiagnose anxiety and under-recognition is another term that makes me cringe, now I’m really scared if someone is able to take the first step to seek help and their condition is misdiagnosed or discounted. Then you truly do feel ‘crazy’ or alone. https://www.leidenpsychologyblog.nl/articles/a-blind-spot-in-recognizing-common-mental-health-problems
I’ve stepped back for a few hours and thought more about the lack of awareness, the lack of voice and support for mental health and here are my takeaways to explore more:
Is it oddly and unfortunately ironic that mental health, a smorgasbord of conditions and issues, fragmented in totality and each fragmented in the sufferers head, is also fragmented in terms of the organizations that are working to address the issue, make progress? I repeat myself I know, but what I mean is that there is no single evil target to point to that leads to a single entity we can rally behind and drive with powerful examples and spokespersons to push the message and cause. Is there a spread too thin effect working against us also? We need to pull it together as a mental health unified front and face.
And wouldn’t mental health progress have a dramatically positive impact on so many other issues in our society? I believe so, wholeheartedly. It feels to me like mental health could be a lynchpin for progress on so many other fronts. I need to do more research on this, but I believe mental health is the true root cause of many other issues in society, a contributing and amplifying factor at minimum. With improved mental health we raise our IQ about so many other things and raise so many other boats, like that of social injustice as an example. Empathy, acceptance, truly being comfortable turning ourselves inside out will benefit us as a collective in so many ways. Hiding, masks, blind spots, not talking about what we really should, alternate explanations to feel better, all takes so much energy and resources which could be put to good use.
Do we have an impossible unfulfillable prophecy or spiral here – its like the opposite of a self-fulfilling prophecy but I’m not sure if I am making this clear or explaining my thought clearly. We won’t talk about mental health, won’t get it out in the open because we are afraid of the stigma or backlash so we keep everything bottled up and that drives us farther away from the solution and drives more and more to deeper depths every day. Yeah, downward spiral or worse. We are making progress far too difficult to achieve, if we would just get out of our own way to build a little positive momentum, greatness would follow. You can’t get help if you don’t speak up, you can’t speak up to get help, nobody will help you because they are afraid too. That can’t continue. Seek help, speak up and ask for help, confide in someone close to you, surrender and that is the path to true victory. Empty your heart and soul to become full. Its all so counter-intuitive yet crystal clear. Please, work every day to make others around you feel secure to expose who they truly are, let them know you truly care and are an ally. Make a donation and wear the t-shirt.
“The road to easy street goes through the sewer.” We have to get more than our hands dirty to drive change. Very true words spoken by a man who connected with so many, made nearly everyone he met feel comfortable. I was lucky enough to meet him and feel that warmth and genuine care that he exuded. Maybe that larger-than-life stature was the necessary body and frame to fit his great giant heart, that quote comes from John Madden.
There are so many ways to look at all of this, I think we have more work to do to truly understand the significance of our blind spot, but I feel there are many different angles thus far that tell us we are not winning the war, we are not adequately funding ourselves to have the capacity to fight such an opponent. We must change our attention around mental health as one of many steps in the right direction. Maybe I am just fully paralyzed by this information and how I feel.
In my opinion the blind spot is so large, our lack of focus and support for mental health has me defaulting to type ‘mental help’ every time I type mental health. We need more help, we need to scream out for help! Our melons, our heads, are blind to mental health.
I always have a song in my head, or have said many times that my connection with music is a big part of who I am. I can’t help but sing a song by Blind Melon when writing this. That was a big hit from my teen years, No Rain. Here I feel the mental health mission and parade is getting nothing but a downpour and we need no more rain, we need sunshine and spotlights to show us just how significant this issue is. The lyrics are speaking to me again:
Maybe one day we can have it made. Because I have just started to complain, it almost ripped my life away, it was for so many years a great escape. ESCAPE E-S-C-A-P-E ESCAPE. Its not sane. I hope you do like my point of view, and I’m insane.
Lyrics to No Rain by Blind Melon:
Oh, oh, oh, oh Oh, oh, oh, oh
All I can say is that my life is pretty plain I like watching the puddles gather rain And all I can do Is just pour some tea for two And speak my point of view But it's not sane It's not sane
I just want someone to say to me Oh, oh, oh, oh I'll always be there when you wake, yeah, yeah You know I'd like to keep my cheeks dry today, hey So stay with me and I'll have it made (I'll have it made)
And I don't understand why I sleep all day And I start to complain that there's no rain And all I can do is read a book to stay awake And it rips my life away, but it's a great escape Escape Escape Escape
All I can say is that my life is pretty plain You don't like my point of view and I'm insane It's not sane It's not sane
I just want someone to say to me Oh, oh, oh, oh I'll always be there when you wake, yeah, yeah You know I'd like to keep my cheeks dry today, hey So stay with me and I'll have it made
I'll have it made (I'll have it made) And I'll have it made (I'll have it made) Oh no, no You know we're really gonna Really gonna have it made You know we'll have it made
I’m sure the girl from the Blind Melon video had issues after being laughed off the stage. Stung by another bee of judgement, ridicule. We all just want somebody to be there when we wake. All of our melons are blind to the war around us, the battle against mental health in all of our melons.
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