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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Mental Health Is Shaped By Society
- Social and structural contexts shape mental health at a population level and drive large trends in illness.
- Policy changes can alter those contexts to reduce mental illness and improve access to care.
Social Injustice Generates Mental-Health Risk
- Social injustice creates the social determinants that produce unequal mental health risks and outcomes.
- Policies reflect social norms about who is worthy and thus entrench advantage and disadvantage over generations.
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.
