Mental Disorders: If one in four Americans suffers, why don't we get help?

By: Staff   Mar 28, 2011

The Relevant Research Lecture for Spring 2011 will be delivered by Dr. Joshua Swift of the Department of Psychology
on April 1 at 7 p.m. in Arts 150

In any given year, one in four Americans suffers from a diagnosable mental disorder. In a group as small as 10, that means at least two people are struggling with some sort of psychological burden.

These include depression, anxiety and stress disorders, often considered common elements of everyday modern life. In fact, these disorders are the leading cause of disability in the United States and Canada. Depression is number one, according to the National Institute of Mental Health.

So, why don’t we get help? And when we do, what factors help us succeed?

Spring 2011 Relevant Research Lecture is on mental disorders, delivered by Dr. Joshua Swift at 7 pm April 1 in Arts 150Those issues are the subject of research for Dr. Joshua Swift, UAA professor of psychology, and this spring’s speaker for the College of Arts and Sciences Relevant Research Lecture Series. His talk will review his own and current research that examines which individuals are more likely to engage, remain and improve in therapy.

The good news, according to Swift, is that these mental disorders are all highly treatable. Over the past 50 years, research has demonstrated that psychotherapy is highly effective in helping individuals address and overcome these problems.

The bad news, Swift reports, is that as little as 13 percent in need seek help, and of those, nearly 30 percent complete treatment without improving. The goal of his research work is to gain a better understanding of how to help those with mental disorders start treatment, stay in treatment and recover through treatment.

Swift is new to UAA and Alaska, taking his position in the Department of Psychology eight months ago. He was born in California, grew up in a Seattle suburb, did his undergraduate work in psychology at Brigham Young University in Utah and completed his doctorate at Oklahoma State in Stillwater. That included a predoctoral clinical internship at State University of New York, Upstate Medical University, in Syracuse. His research is in psychotherapy outcomes, with an emphasis on what makes treatment work. UAA is his first teaching position.

Swift says he knew he wanted to work in a “helping profession,” but he chose psychology as an undergraduate, after he participated in research activities and found his passion in exploring questions around therapeutic success.  He encourages undergraduates to actively seek research opportunities that may shape their interests and their academic lives.

“I got into graduate school because of my undergraduate research opportunities,” he said. “Don’t wait for a professor to offer you an opportunity. Go ask for it.”

Especially intriguing to Swift is research that shows treatment techniques are estimated to explain only 15 percent of successful outcomes. Other components for success include:

  • a patient’s expectations that he will get better (estimated at 15 percent)
  • the therapeutic relationship -- is the therapist sympathetic, genuine, really listening (estimated at 30 percent)
  • “extra therapeutic” factors, such as change initiated by the client in his or her own life (estimated at 40 percent)

In his research, Swift looks at this whole picture, trying to integrate all the factors for success.

A key finding for Swift and other researchers is the client’s influence on success. If he has a take-home message out of his Relevant Research talk, Swift says he would tell therapists to  “let your clients take more of a role, to really listen to them, and don’t just go with what you feel would be the best.”

For clients, those seeking services, the message is to “be assertive; you play an important role in therapy, you’re the one who makes it work, so make sure that there’s that relationship” with your therapist.

Swift acknowledges that a major deterrent for people seeking help is the stigma attached to all mental disorders. Portrayals of extreme cases, like people who open fire in public places, get heavy treatment in the media. Sure, that’s mental illness, but a very extreme form. Many other more routine and commonplace disorders take their toll on people everyday. Yet, fear of being catalogued alongside the extreme case keeps people from voicing their need for help and getting it, he says.

Another issue in sustaining a treatment program is client expectations and misperceptions about therapy.

“I’m unlikely to go into therapy,” Swift suggests, “if I think … I’ll have to lay on a couch and talk about my dreams.”

Swift said clients also often consider therapy as a medical treatment model: I go in with a problem and get the treatment. End of story. 

“The majority of clients are expecting about two sessions to lead to recovery,” he said. “No treatment works that fast. Research shows 50 percent recover after 15 sessions. But if a client is expecting recovery in two, and after the second session  they don’t feel better, they may think, ‘this isn’t working,’ and stop coming.”

An educated clientele would help this understanding, and Swift suggests the National Institute for Mental Health as a good resource guide, filled with explanations and definitions aimed at the general public. Another good source is the American Psychological Association.

In addition to his research, Swift teaches in the masters program in clinical psychology and supervises students doing their clinical work in the community.  He also practices in the Department of Psychology Psychological Services Center, a mental health clinic available to the Anchorage community on a sliding-fee scale.

This talk is free and open to the public. Parking is free on the UAA campus on Fridays. For more information or interviews, contact Cassidy White at (907) 786-1691.