Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness

TLDR

Psychological interventions have advanced, yet they fall short of reducing the burden of mental illness, as the demand for services far exceeds the limited reach of individual psychotherapy. The authors argue that a portfolio of diverse delivery models, including multidisciplinary collaborations, is essential to reduce the burden of mental illness. They illustrate how technology, alternative settings, nontraditional providers, self‑help, media, and integrated prevention–treatment systems can be leveraged to expand access and monitor mental‑illness burden.

Abstract

Psychological interventions to treat mental health issues have developed remarkably in the past few decades. Yet this progress often neglects a central goal-namely, to reduce the burden of mental illness and related conditions. The need for psychological services is enormous, and only a small proportion of individuals in need actually receive treatment. Individual psychotherapy, the dominant model of treatment delivery, is not likely to be able to meet this need. Despite advances, mental health professionals are not likely to reduce the prevalence, incidence, and burden of mental illness without a major shift in intervention research and clinical practice. A portfolio of models of delivery will be needed. We illustrate various models of delivery to convey opportunities provided by technology, special settings and nontraditional service providers, self-help interventions, and the media. Decreasing the burden of mental illness also will depend on integrating prevention and treatment, developing assessment and a national database for monitoring mental illness and its burdens, considering contextual issues that influence delivery of treatment, and addressing potential tensions within the mental health professions. Finally, opportunities for multidisciplinary collaborations are discussed as key considerations for reducing the burden of mental illness.