We Need More Than Pills; We Need People: Mental Health in St. Louis

Illustrated by Parveen Dhanoa

Mental health encompasses more than just clinically diagnosed conditions that don long, scientific titles. According to the National Alliance on Mental Illness, mental health is an umbrella term used to characterize any “condition that affects a person’s thinking, feeling or mood” (1). Mental health struggles can present in drastically different fashions for different populations. For some, mental health problems can have few symptoms, if any, and for others, they can lead to suicidal ideation. 

The statistics regarding mental health disorders highlight their widespread effect on almost every demographic. 20% of adults experience a mental illness every year in the United States and 1 in 6 people between the ages of 6-17 experience a mental health disorder every year. Alarmingly, in 2018, only 43.3% of patients diagnosed with a mental illness actively sought treatment for it (2). 

Multiple factors play a role in the mental health of individuals: social environment, physical health, nutritional health, genetics, academics, self-esteem, and abuse (34). In cities such as St. Louis, where racial and economic inequality rates are high (5), these issues worsen. 

The Delmar Divide is a stark representation of geographical socioeconomic and racial segregation. According to statistics collected in 2017, North of Delmar Blvd., the neighborhoods are 99% African Americans and the average household income is $22,000; South of Delmar Blvd., the neighborhoods are 70% Caucasian and the average household income is $47,000 (6). Such sharp income differences directly affect affordability and access to care. 

According to the American Psychological Association, socioeconomic status (SES) is both a direct and indirect risk factor for mental illness (7). People of low SES are directly more likely to encounter difficulty accessing resources and support for mental health compared to those of higher SES. Additionally, people of lower SES are often burdened with external stressors such as working multiple jobs, a lack of health insurance, and difficulty paying bills, all of which exacerbate the effects of poor mental health. Without the funds for basic necessities, mental health treatment and care is out of the question. 

SES and race seem to follow one another closely. According to the For Sake Of All (FSOA) report created by Washington University and Saint Louis University professors, the number of emergency room visits due to mental health illnesses for African Americans was 121% of what it was for Caucasians in the St. Louis County in 2011. In-patient hospitalization rates for mental health reasons were also 64% higher for African Americans than they were for Caucasians (8).

The pendulum swings both ways. The FSOA report also found that those with mental health conditions have an increased risk for “school dropout, imprisonment, and lower income throughout their lives” (8).

Within St. Louis, college students also face extremely stressful circumstances that can compound the effects of mental health issues. Tara Suresh (Class of 2020), a Peer Health Educator focused on Mental Health issues at Washington University in St. Louis (WashU), helped place the issue of mental health in the context of this college campus. 

According to Suresh, “At WashU specifically, most people from low SES may exhibit issues with depression from being dropped into an entirely different community like most first years. [In addition, they] also suffer from imposter syndrome, [and] general stress from higher expectations to succeed at WashU from both their local community and from their status as being “token students.” I think that the issues with access to resources on campus also have to do with the fact that most of them are only available during business hours. Most students from low SES do have some aid from the school and donations but many of them need to work jobs or do a [federal] work-study program, which also happens during business hours. Mental health counseling is also not typically covered by health insurance.”

Issues such as these make it harder for students and St. Louis citizens at large to access professional help. From the perspectives of college students who are passionate about placing mental health awareness at the forefront of our discussions, we are left asking the most pressing question: What can we do about this? 

Since mental health issues are both biologically- and environmentally-derived, finding a definitive cause for them can be difficult. Although preventive care is critical to maintaining mental health, perhaps we don’t need to completely understand its cause to start crafting an action plan. 

Mental health issues on college campuses and beyond continue to be stigmatized and oversimplified. Misconceptions about mental health disorders are incredibly harmful to those who suffer from them. The first step towards tackling any issue is understanding the issue; mental health education is essential. Learning about the various kinds of mental health that exist aids in both identifying issues and detecting tell-tale signs of mental health degradation. Furthermore, the added comfort of being able to identify the issue can actually aid in gaining confidence with tackling the issue itself. 

Second, self-care and caring for those around you goes a long way. As college students, we have added pressures that can exacerbate the issue. Suresh adds, “Because many people have to go through countless trials to get the education they need to even get an internship, they constantly feel like they have to be perfect in order to get ahead. We never got to choose to live in a society with a huge perfectionism pressure… I know for a fact that I feel an unending push to excel because I feel worried that if I don’t, I may fall behind.” 

Often in college, human interactions and self-care practices are repeatedly replaced with late night hours at the library. However, eventually, these practices can turn into habits. Mental health issues can worsen with time. As Aadit Shah (Class of 2020), a volunteer for Provident’s Mental Healthcare and Suicide Prevention Hotline, puts it, “[Mental health] issues arise by not taking the time to recognize your mental state. If you cut yourself and are bleeding out but you don’t do anything about it, eventually you’re going to faint. The same thing goes for [mental health]. You have to treat it as something that can’t be fixed in one day and is ever-changing.” 

Good mental health is not a privilege; it is a right. It’s becoming increasingly important for college students to be proactive in their choices. This includes not only reaching out to resources nearby, but also engaging in healthy practices. Sleep deprivation, malnutrition, and poor physical health can amount to large effects on mental health. However, at the same time, struggling with mental health is not a choice. People often fall too far into the idea that mental health issues are synonymous with being “weak” or “incapable of handling the stressors that everyone else seems to be fine with.” Thus, it is essential to internalize the mantra: “Don’t be afraid or ashamed to ask for help.” Problems can arise out of nowhere, affect others in different ways, and persist for various lengths of time. As Shah puts it, “I sometimes feel that people think that mental health is something that you struggle with in college, and then it magically goes away afterward. Think about the ridiculousness of you breaking your arm in March of your senior year and then once you [graduate], thinking it would have healed automatically. I think college students are now getting the skills and tools to start combating mental health, but [they] need to recognize that it is a lifelong journey.”

The body is an intuitive machine; when considering all the factors that go into the equation of mental health, the pain makes sense. However, at the end of the day, although providing resources and professional support is incredibly important and helpful, the disheartening truth is that sometimes that’s not enough. Mental health is an issue that people can carry with them for weeks or for decades. Furthermore, with the socioeconomic and racial divides in St. Louis, the question is not always whether someone should get access to mental health support, but rather whether someone can afford that access. 

We, as a community, need to stop treating mental health as a condition that affects “the man at the grocery store” or “the girl who lives down the hall.” We need to stop treating it as an issue that can be cured with a couple of pills daily. We can’t keep placing band-aids on crevices created by prolonged pain or biological phenomena. 

Even those of us who may not feel trained to discuss or address this issue could start listening to those around us more, reminding them that they are loved and wanted. Talk about mental health more often, and do so with pride, not shame. Words and hugs are free. Every action counts. 

For Washington University in St. Louis students in particular, there are both student-led and organizational services for student-use. Resources on campus include the following: 

  1. Mental Health Services (MHS) at Habif Health and Wellness Center offers both group and individual mental health counseling services with trained professionals that students can book. They are confidential and also provide off-campus referrals. 
  2. Uncle Joe’s is a group of Washington University peer-counselors who have had 100+ hours of training covering a variety of pressing issues regarding mental health, especially as it applies to college students. Uncle Joe’s is equipped with on campus and off campus resources and is a confidential resource available to all members of the WashU community. They have walk-in hours every night of the week from 10 pm to 1 am and are available by phone 24/7. To call an Uncle Joe’s peer counselor, you can call 314-935-5099, leave a voicemail with a name and number, and a peer counselor will call you back within 20 minutes. 
  3. The Relationship and Sexual Violence Prevention (RSVP) Center is available for student usage with 24 hour service. They offer support for survivors of acts of sexual violence, relationship and sexual violence reporting options, and educational information for all students. They are available for immediate assistance with regards to hospital care and violence reporting as well. 
  4. S.A.R.A.H is an anonymous and confidential peer-counselor run helpline designed to support the members of the WashU community who might be connected to or who are survivors of sexual assault or rape. S.A.R.A.H counselors have 100+ hours of training to and are available 24/7 to serve the WashU community by offering counseling on topics including, but certainly not limited to, sexual assault, sexual harassment, intimate partner and sexual violence, relationships, mental and sexual health and any feelings that someone might go through as a result of these experiences. To reach a S.A.R.A.H counselor, you can call the helpline at 314-914-8080, leave a voicemail with a name (can be a pseudonym) and number and a S.A.R.A.H counselor will call you back within 20 minutes.
  5. Mental Health Peer Health Educators are undergraduate student volunteers trained by Health Promotion Services staff members who serve as ambassadors for the mental health services on campus and who put on mental health-centered events, focused on topics such as anxiety awareness and Imposter Syndrome (9).
  6. The Let’s Talk Program is a way for students to converse with professionals briefly in a casual, easy-to-access setting. It is also run through the MHS and is free. They have separate locations and times for every weekday. Details can be found at https://students.wustl.edu/wp-content/uploads/2018/08/Lets-Talk-Fall-2019.pdf
  7. The St. Louis Queer+ Support Helpline (SQSH) is a free and confidential peer-counseling service. To use their services, call 314-380-7774 and press “1” to reach the Behavior Health Response crisis hotline or press “2” to reach the St. Louis Queer+ Support Helpline. More information is at https://www.thesqsh.org
  8. Stressbusters is a group of Washington University students who provide five-minute backrubs and wellness information. They are trained by licensed massage therapists and their services are free for all students, staff, and faculty. 

Edited by: Soyi Sarkar
Illustrated by: Parveen Dhanoa

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