The transition from teenage years to adulthood can be a stressful shift for many people. Making decisions that shape their future and becoming more self-sufficient can be made even more challenging with mental illness. Young adults between 18 and 25 have higher rates of mental illness and substance use disorder than adults 26 years of age and older. Some argue that rates of mental illness in contemporary young adults can be attributed in part to advancements in technology. By actively participating in social media, many of today’s youth compare themselves to their perceptions of their peers as modeled online. According to Larkin Callaghan of the 2×2 Project, a public health science site, teenagers especially “now rely so much on external and immediate gratification, social status and image, and the superficial gain they get from social media that they are forgoing values that contribute to a sound internal life.”

Existing data on mental illnesses in young Americans exposes the unfortunate reality that a significant portion face significant challenges.

• Nearly 6.4 million people aged 18 to 25 had mental illness, representing almost one in five young adults in America.
• 10.6 million people in 2012 reported an unmet need for mental health care.

Even though adolescents and young adults are extremely vulnerable to mental health problems, many go without proper treatment services. These clinical interventions are imperative in supporting the transition to a healthy adulthood while minimizing damage to the individual. During this formative period it is important to reduce the negative consequences and promote positive mental health awareness. Read on to understand what is being done about mental illness in young Americans.

Depression

There are a vast amount of mental illnesses that people may suffer from, and often an individual may have more than one at a time. Everyone is not affected the same way by the same disease, and there is not a one-size-fits-all cure. The following is only a glimpse into depression, one of the more common illnesses affecting young adults.

It was once believed that children could not suffer from depression. If a teen were to show symptoms, they were written off as being moody and that it was a normal part of the growing-up experience, but we now know that that is certainly not the case. Although the signs of depression may differ from those of depressed adults, young adults are susceptible to this illness as well.

According to the National Alliance on Mental Health, approximately 11 percent of adolescents have a depressive disorder by age 18. For both girls and boys aged 10 to 19 years, depression is the predominant cause of illness. It is more common for girls to have depression as compared to boys; twice as many girls as boys are diagnosed.

One of the most tragic results of depression is suicide. Behind traffic accidents and deaths from HIV/AIDS, suicide is the third most common cause of death for people aged 15-24. Depression is not the sole cause of suicide, which is the result of many complex factors. Ninety percent of those who commit suicide are diagnosed with a psychiatric disorder. While more females than males are diagnosed with depression, there are four male suicides for every female suicide.

• It is estimated that there are eight to 25 attempted suicides for every death.
• One out of 10 adolescents aged 16 to 17 had major depressive episodes in the past year, and three quarters of these adolescents were female.
• 67 percent of young adults with mental illness do not receive treatment.

Policies

In an attempt to help those suffering with mental illnesses the government has sponsored various agencies and policies to focus on mental health reform.

Substance Abuse and Mental Health Service Administration

In 1992 the Substance Abuse and Mental Health Service Administration (SAMHSA) was created within the U.S. Department of Health and Human Services. The mission of the agency is to lessen the impact of mental illness and substance abuse on the American people. SAMHSA makes services, information, and research more accessible.

SAMHSA has an annual budget of $3 billion, with one third devoted to mental health and the remaining two thirds for substance abuse prevention and treatment programs. The grants distributed to states by this agency serve as the main source of funding for public substance abuse and mental health treatment, usually through community mental health centers.

One of the ways SAMHSA has helped those with mental illnesses is by funding the National Child Traumatic Stress Network (NCTSN). The mission of NCTSN is to provide access to treatment and care to children who have been exposed to traumatic events.

The reason SAMHSA provides so many resources is that the agency acts on the assumption that prevention works, treatment is effective, and that people can recover from substance use and mental disorders

Helping Families in Mental Health Crisis Act of 2013

Introduced in the House of Representatives in December 2013 by Representative Tim Murphy, the Helping Families in Mental Health Crisis Act “fixes the nation’s broken mental health system by focusing programs and resources on psychiatric care for patients & families most in need of services.” As of July 2014 the bill has 94 co-sponsors; 59 Republicans and 35 Democrats, but has yet to be signed into law.

The Subcommittee on Health investigated the federal mental-health systems and worked with advocacy groups, professionals, and families. The bill has numerous proposals, such as:

• Creating an Assistant Secretary for Mental Health and Substance Use Disorders within the HHS. The Assistant Secretary will direct and supervise the Administrator of SAMHSA.
• The Assistant Secretary will also establish a National Mental Heath Policy Laboratory to: 1) collect information from grantees; 2) evaluate and distribute to grantees the best practices and services delivery models.
• Direct the Assistant Secretary and the HHS Secretary to, “award planning grants to enable up to 10 states to carry out 5-year demonstration programs to improve the provision of behavioral health services by federally qualified community behavioral.”
• Medicaid would be amended to forbid a state medical assistance plan from barring payment for same-day primary care service or mental health service to an individual at a federally qualified health center or community behavioral health center.
• Prescription drugs used to treat mental health disorders would be covered by Medicare.

Strengthening Mental Health in Our Communities Act of 2014

Sponsored by Congressman Rob Barber, the Strengthening Mental Health in Our Communities Act of 2014 would create a White House office on Mental Health Policy in the Executive Office. As of July 2014, the bill has been referred to the Subcommittee on Crime, Terrorism, Homeland Security, and Investigations. The President would appoint a Director who would be charged with many duties including:

• Monitoring Federal activities with regard to mental health, serious mental illness, and serious emotional disturbances.
• Making recommendations to the HHS Secretary.
• Reviewing the Federal budgets on mental health services.
• Work with NGEs, state and local government to improve community-based mental health services.
• Annually updating and developing a summary of advancements in serious emotional disturbances and mental illnesses research.

Affordable Care Act

The Affordable Care Act (ACA) has made it somewhat less challenging for young people to receive mental health care. Federal health law now requires insurance companies to extend the same amount of coverage for mental health as a surgical or medical treatment would receive. Also, young people can remain on their parents’ insurance until they are 26 years old. If they do not stay on their parents’ insurance they are able to receive low-cost coverage through federal or state exchanges.

Influence of Technology

Technology is both a blessing and a curse to those with mental illness. By continuously being surrounded by technology, the brain is less able to unwind and de-stress. Excessive use of technology can lead to a feeling of isolation, and over-use of social media sites such as Facebook can promote narcissism. Users depend on others ‘sharing’ and ‘liking’ their posts to receive superficial gratification. Displaying individual success has taken priority over working with others to better the community.

However, advancements in technology are a practical way to provide people living with mental illness with helpful resources. It is now easier for individuals to quickly reach healthcare providers and find supportive online communities. By having care readily available, a greater portion of the population is able to receive treatment and support.

Apps, such as CBTReferee, are an example of this pioneering technology. CBTReferee allows users to catalog their thoughts as they occur, making them able to monitor flawed thinking. It is then easier for the person to evaluate and assess if their thoughts are unrealistic, unfair, or untrue.

BellyBio Interactive Breathing is a smartphone application aimed at helping those with anxiety and stress. The app generates soothing music and monitors breathing patterns while guiding the user through deep breathing exercises.

Conclusion

Mental illnesses disproportionately affects young Americans. By finding proper treatment. either through government programs or private care facilities, individuals with mental illnesses can be supported and managed in a healthy way.

Resources

Primary

Congress: H.R. 3717

Congress: Cosponsors: H.R.3717

HHS: Administration Issues Final Mental Health and Substance use Order Disorder Parity Rules

Congress: H.R.4574 – Strengthening Mental Health in Our Communities Act of 2014

World Health Organization: WHO Calls for Stronger Focus on Adolescent Health

Additional

SAMHSA: Serious Mental Health Challenges among Older Adolescents and Young Adults

2×2 Project: The Declining Mental Health of Millennials: Is Depression the New Normal?

Psych Central: The Many Problems with the Helping Families in Mental Health Crisis Act

NCTSN: National Child Traumatic Stress Network

SAMHSA: Who We Are

NAMI: Depression in Children and Teens

American Foundation for Suicide Prevention: Facts About Suicide and Depression

CBTReferee: Cognitive Behavioral Therapy

Alex Hill

Alex Hill studied at Virginia Tech majoring in English and Political Science. A native of the Washington, D.C. area, she blames her incessant need to debate and write about politics on her proximity to the nation’s capital.

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Childhood and adult obesity is highly reported as a growing epidemic in the United States, yet less often do we hear of the negative psychological and physical ramifications of eating disorders. According to the National Institute of Mental Health, anorexia nervosa is the most fatal mental disorder, “[with] an estimated mortality rate of around 10 percent.” According to the National Eating Disorder Association, “20 million women and 10 million men [in the United States] suffer from a clinically significant eating disorder at some time in their life.” Although these types of disorders may not always be obvious, they are taking a toll on many young Americans who suffer in silence until it is too late.

What is an eating disorder?

An eating disorder is a life consuming mental illness that forces an individual to consciously diet or consume to an extreme, detrimental point. People who are affected by an eating disorder constantly obsess over calories, food, and their body weight. In the case of anorexia, the person limits his or her calorie intake to an extremely low and unhealthy number and adheres to a strict diet only consisting of “safe” foods. An individual with bulimia binges until he or she is uncomfortably full, then purges by vomiting. These disorders cause serious physical and psychological damage and can ultimately result in death. They are fueled by personal angst, trauma, and are essentially a way to cope with negative feelings, including personality disorders such as Obsessive Compulsive and extreme perfectionist tendencies. Eating disorders go beyond the surface desire of wanting to be thin. If left untreated through cognitive therapy and support, eating disorders will progressively consume the victim, until his or her entire life revolves around appeasing this internally violent illness.

What is a Pro-Ana/Mia website?

A Pro-Ana/Mia website is a public forum on which people, the majority of whom are women, with eating disorders share tips for maintaining an anorexic or bulimic lifestyle. Members share diet, beauty, and fitness tips that revolve around the theme of being thin. Discussions are not all illogical, yet the majority of them are fueled by the intense desire to remain in control, with the ultimate goal of reaching the most emaciated state possible. The sites often feature photographs of extremely thin people whose bones protrude and bodies that appear sick and gaunt. According to Children’s Mercy Hospital and Clinics, “there are now over 400 pro-ana/mia websites.” These sites encourage people to embrace their disorders as a lifestyle and assure victims that they are not abnormal or alone in their choice to live with an eating disorder. They promote and enhance the typically negative image that eating disorders support. Woman offer each other support to fuel the disorder, continuously telling it that the body is not (and never will) be thin enough. According to the National Association of Anorexia Nervosa and Associated Disorders characteristics of a pro-ana site include:

• The glamorization/idolization of images of emaciated or very thin individuals

• The implication that food and weight are the enemy

• Encouragement and teaching of dangerous eating disorder behaviors

• Promotion of thinness at any cost, denial of the seriousness of the illness

• Insistence that eating disorders are choices rather than illnesses

• Attempts to mask toxicity by being exclusive and elite

What the investigative report below on the dangers of pro-anorexic (pro-ana) and pro-bulimia (pro-mia) websites.

Do Pro-Ana/Mia Websites constitute free speech?

Eating disorders continue to carry a negative connotation despite their increasing popularity among teens and young women. This doesn’t stop women from openly spilling their diet and exercise secrets, no matter how extreme and unhealthy. The pro-ana maxim is “thinspiration.” Girls motivate one another to maintain their eating disorders and are virtually assisting each other in a prolonged suicide.

This information is accessible to children. Girls mature faster than boys and are susceptible to the influence of their peers as early as the age of eight. If curiosity about weight loss becomes appealing, the individual has this controversial information right at her fingertips. Proponents of the movement feel that if these websites are not censored they will continue to corrupt youth and increase eating disorders among younger generations.

Watch the video below of four recovered women sharing the harm Pro-ana/mia websites can inflict on someone struggling with an eating disorder.

According to Article 19 of the International Covenant on Civil and Political Right, “[The right of freedom of expression may] be subject to certain restrictions…For the protection…of public order or of public health or morals.”  Pro-Ana/Mia websites portray anorexia and bulimia in a positive light and increase the likelihood of individuals who view them developing an eating disorder. This could be considered a danger to the overall public health, and gives government the incentive to block or censor them.

Pro-Ana supporters argue that the “thinspiration” movement gives individuals the opportunity to gain support and share tips with others who are experiencing the same thing, yet all of the exchanges on these sites seem to be negative. People motivate one another by saying things like they need lose more weight, and giving them tips on how to achieve that dream state of being virtually weightless and emaciated. The sites lack any positive effect on the community or individuals suffering with an illness. Therefore, they have little to argue regarding their need to stay accessible to the general public or their effect on the community.

Case Study: Valerie Boyer’s Bill (Ban on Pro-Ana)

A short clip from the documentary about the pro-anorexia movement in France, and the legislation to make it illegal:

France passed legislation in 2008 outlawing the portrayal of extreme thinness in the media as a desirable or positive trait. Additionally, Valerie Boyer, a  right-wing member of the lower house of Parliament, created a bill to enforce the elimination of Pro-Ana websites. The bill called for media outlets to face potential fines and possible jail time if they embraced the message that emaciation and eating disorders are attractive. The bill did not pass, yet it helped to draw more attention to the issue and awareness in both France and the United States has been increasing since the proposal. In the United States, servers such as Yahoo have worked to ban several pro-anorexia websites from their server.

Case Study: Social Media Bans Pro-Ana

In an effort to stop the glamorization of eating disorders throughout social media, Instagram, Pinterest, and Tumblr all updated their policies in 2012 to ban some of the attention that pro-ana websites receive online. Tumblr issued a statement outlining its plan to eliminate blogs that actively promote self-harm. If a user types in a trigger word such as “anorexia” on Tumblr, instead of receiving diet tips or images of emaciated models, a message urging you to seek assistance will appear. On Pinterest, although pro-anorexia images still exist  upon searching “anorexia”, results are displayed below the following message:

“Eating disorders are not lifestyle choices, they are mental disorders that if left untreated can cause serious health problems or could even be life-threatening. For treatment referrals, information, and support, you can always contact the National Eating Disorders Association Helpline at 1-800-931-2237 or www.nationaleatingdisorders.org”

Although more passive in nature, this message is meant to urge the user to recognize the dangers of the disorder, and to seek professional support as oppose to the negative motivation from others who suffer from a similar illness.

Instagram issued a new policy, to eliminate the promotion of self-harm on Instagram. The policy reads:

“Don’t promote or glorify self-harm:

1. “While Instagram is a place where people can share their lives with others through photographs and videos, any account found encouraging or urging users to embrace anorexia, bulimia, or other eating disorders; or to cut, harm themselves, or commit suicide will result in a disabled account without warning. We believe that communication regarding these behaviors in order to create awareness, come together for support and to facilitate recovery is important, but that Instagram is not the place for active promotion or glorification of self-harm.”

Instagram does not follow through with its former ban. When searching “anorexia” on Instagram, results display a long list of users who share photos of their gaunt collarbones, protruding hips, and non-existent  thighs. One photo, under the user “anorexianervosa_depression,” reads:

“Call it a sickness, call it an obsession, I don’t care, I call it perfection.”

There have been petitions to eliminate “thinspiration” tags on Twitter, yet when searched several photographs of overtly thin thighs and tiny waists appear. On Facebook, pages such as “Anorexia Tips” are easily accessible to anyone with an account. To see how websites measured up to their policy proposals, Buzzfeed compiled a list of all of social media sites efforts to ban pro-ana, and graded them based on how effectively they have eliminated the “thinspiration” movement across the web. Most of the sites received a low grade, in that most of them still permit much of the pro-anorexia community’s antics and do little to stop the community from continuing to infiltrate the social media stream.

Users have discovered loopholes. The bans do not necessarily stop users from continuing to post pro-ana material; in order to remain accessible, users can simply use different taglines in order for the material to appear when searched.The only way to truly minimize the value of the “thinspiration” movement is for people to stop liking the material, then it will eventually fade away.

Social media platforms run into some problems when they ban one type of body fad and not others, such as body building. Any extreme body manipulation could be considered a dangerous mental illness, therefore singling out a specific movement could cause the networks freedom of speech problems. To consider one group more dangerous than another becomes constitutionally complicated in that one group should not be favored over the other if they all do pose a potential threat to society. Eating disorders can be a very subjective experience and the line between the sharing of a personal experience and advocating for a disease is very thin. If pro-ana sites were to be censored or banned, would people who are simply telling their story be penalized?

The battle to remove these sites rages on between concerned medical experts and parents; yet pro-ana reigns on as a form of freedom of speech, and will continue to taint the minds of eating-disordered individuals until they are stopped.

Resources

Primary

DHS of Iowa: Pro-Anorexia/Pro-Bulimia Websites: A Dangerous Influence

Additional

ANAD: Eating Disorders and the Internet

Sociology of Health and Illness: Pro-anorexia, weight-loss drugs and the internet: an ‘anti-recovery’ explanatory model of anorexia

The New York Times: French legislators approve law against Web sites encouraging anorexia and bulimia

About Kids Health: Starved for attention: pro-anorexia websites glorify eating disorders

Body Space Society: Banning Pro-ANA Websites? NOt a Good Idea, As Web Censorship Might Have a ‘Toothpaste Tube Effect’

CBS: Despite social media bans of “pro-ana” websites, pages persist

Huffington Post: Why Blocking ‘Pro-Ana’ Sites Is a Bad Idea

Johns Hopkins University: Study Examines Pro-Anorexia and Pro-Bulimia Websites

Eating Disorders Recovery Today: Call to Ban Pro-Ana Websites

The New York Times: Point, Shoot, Retouch and Label?

PBS: Fighting social media ‘thinspiration’ with messages of self-acceptance

ABC: Pro-Anorexia ‘Thinspiration’ Photos Shouldn’t Be Banned from Social Media

Huffington Post: Can Thinspiration Really Be #Banned From Instagram?

 Debate: Should pro-anorexia websites be censored?

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Madeleine Stern (@M3estern) is a student at George Mason University majoring in Journalism and minoring in Theater. Her writing on solitary confinement inspired her to pursue a graduate degree in clinical counseling after graduation. Madeleine is an avid runner, dedicated animal lover, and a children’s ballet instructor. Contact Madeleine at staff@LawStreetMedia.com.

Featured image courtesy of [Evelina Zachariou via Flickr]

Madeleine Stern

Madeleine Stern attended George Mason University majoring in Journalism and minoring in Theater. Her writing on solitary confinement inspired her to pursue a graduate degree in clinical counseling after graduation. Madeleine is an avid runner, dedicated animal lover, and a children’s ballet instructor. Contact Madeleine at staff@LawStreetMedia.com.

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