JAMA Health Forum Conversations National Policy to Support Better Mental Health in the US
Sep 12, 2025
Ruth Shim, a leading expert in cultural psychiatry from UC Davis, joins the conversation on the urgent need for mental health reform in the US. They delve into the alarming rise in depression and anxiety, highlighting systemic inequalities and access challenges. The discussion emphasizes integrating mental health into primary care and the transformative impact of telehealth, particularly post-pandemic. Shim advocates for comprehensive policies that improve care for marginalized populations, underscoring the importance of community support and addressing social determinants of health.
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Stigma Drove A Fragmented System
- Stigma is rooted in societal norms and leads to policies that isolate and devalue people with mental illness.
- That societal stigma produced a separate, unequal mental health system that harms access and quality of care.
Redesign Systems To Reduce Stigma
- Redesign mental health systems to prioritize access, affordability, accountability, and compassionate high-quality care.
- Make recovery attainable to reduce self-stigma and improve treatment uptake.
Integrate Care And Invest Early
- Integrate mental health into primary care to reconnect it with general health and improve outcomes for common conditions like depression.
- Invest in early-intervention programs (e.g., coordinated specialty care for psychosis) despite their workforce intensity.
