Iceberg Ahead: The Hidden Mental Health Crisis, Chronic Disease And Healthcare Costs

by | Apr 14, 2021

Almost everyone is familiar with the tragic story of the ship Titanic which struck an iceberg and sank in 1912, killing more than 1,500 passengers.

Since then, the metaphor of the iceberg to describe unseen dangers has become ingrained in our language. This is because that while an iceberg may appear small on the surface, 90% of its bulk (and danger) lurks hidden beneath the surface.

Nowhere is this analogy more appropriate than describing the current mental health crisis facing America today. Like an iceberg, mental health issues typically hide below the surface our awareness – unnoticed and unaddressed.

Even before the COVID-19 crisis, many adults were experiencing mental health issues that often went either unrealized or unreported.

In addition to the personal toll, these mental health issues take, the added impact on chronic disease is worsening overall health outcomes and driving healthcare costs.

We’re going to share a few sobering mental health statistics, some of the causes of this hidden crisis, and show you sustainable solutions to this problem. 

How Many Americans Experience Mental Health Issues?

Even before COVID-19, the number of adults in America reporting mental health issues was rapidly increasing. Just a few key facts highlight this:

  • Between 2017 – 2018, at least 19% of adults reported experiencing mental illness, an increase of 1.5 million people from previous numbers1
  • Nearly 1 in 25, or about 10 million, adults in America live with a serious mental condition
  • In 2019, 51.5 million adults (20%) experienced some form of mental illness2

Since the COVID-19 pandemic began, these numbers have only worsened. Fear of getting sick, social-distancing isolation, job loss, and overall stress have especially increased depression and anxiety.

  • According to a Kaiser Family Foundation poll, 45% of adults reported their mental health had been negatively affected by the COVID-19 and 19% said it had a “major impact”3
  • 36% reported sleep problems, 32% eating problems, 12% substance abuse, and another 12% reported worsening chronic conditions

Why The Mental Health Crisis Is Hidden

Studies and surveys have consistently shown that the prevalence of mental health issues in the adult population is often underreported. As many as 56% of adults with mental illness don’t receive any type of health treatment1.

The reasons are two-fold:

  1. Lack of awareness – many people may write it off as “feeling a little down” or blame stress, even when it has become an everyday occurrence.
  2. The social stigma of mental health problems prevents many from seeking help.

In addition to these two main reasons, lack of resources (health insurance) and access to mental health services also contribute to keeping this crisis underreported.

Like an iceberg only showing a hint of its danger above water, mental health issues that may appear as insignificant as daily stress can greatly impact physical health. 

How Mental Health Affects Physical Health And Health Insurance Costs

Mental health and physical health cannot be separated; they are two parts of a whole. This interaction is even more prevalent with chronic diseases such as heart disease and diabetes.

Anxiety can affect hypertension. Depression often leads to eating disorders, poor diet choices, and a sedentary lifestyle that can exacerbate diabetes. Worsening chronic diseases also negatively affect a patient’s mental health in a vicious feedback loop.

“The evidence shows that mental health is the foundation for overall health,” says Psychologist, Aaron Quinn, Ph.D. “All health activities and conditions interact with mental health.”

This negative health feedback loop is a major driving force of the growing healthcare costs in America today:

  • 47% (150 million) of Americans have at least one chronic disease
  • 30 million have five or more chronic diseases
  • Chronic diseases cost an estimated $3.7 trillion annually, or close to 20% of U.S. GDP
  • Mood and anxiety disorders are leading causes of mortality and disability
  • Mental health conditions are the leading driver of decreased workplace productivity

For both individuals and employers, this means higher coverage costs. For families, over the past decade, costs have increased more than 67% from $4,617 to $7,7264.

For employers, healthcare cost projections are expected to rise 5.3% with premiums and out-of-pocket expenses projected to average over $15,500 in 20215.

This is due to three main factors:

  • Increased spending on drugs and medication
  • Increasing or worsening chronic diseases
  • Loss of productivity

With most experts projecting these numbers to continue rising, what are the remedies to improve emotional and mental health?

The Solution: Adherence Through Emotional Health And Active Monitoring

Even with digital behavior monitoring and health coaching, a high number of people quit their health programs.

Studies have shown that non-adherence to medical recommendations can be as high as 50 – 80%.6

The main reason people quit, even if it means worsening physical health and chronic disease, is they fail to also improve their emotional and mental health. If someone is stressed, anxious or depressed they aren’t even going to want to make healthy lifestyle changes.

So what’s the solution?

Active, evidence-based health coaching with a robust focus on emotional health.

Even the most technologically-advanced, human-led behavior change platforms will have poor results if the primary focus isn’t on improving emotional and mental health. That focus must be strengthened by actively involved health coaches rather than relying on self-administered programs.

That’s why AlbumHealth’s digital care platform doesn’t just give patients access to the latest behavior monitoring technology – our health coaches take an active, invested role in the health of their clients.

We help our clients turn healthy behavior changes into lifelong habits by placing a robust focus on emotional and mental health, tackling the main cause for non-adherence to a program.

That’s why adherence to our system is second to none: an 84% adherence rate with 100% of target health outcomes approved.

Explore our website or contact us today to learn more about why AlbumHealth is the digital care platform leading the way in creating better emotional health, fighting chronic disease, and cutting healthcare costs.


1 https://www.mhanational.org/issues/state-mental-health-america

2 https://www.nimh.nih.gov/health/statistics/mental-illness.shtml

3 https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/

4 https://www.healthsystemtracker.org/brief/tracking-the-rise-in-premium-contributions-and-cost-sharing-for-families-with-large-employer-coverage/

5 https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/employers-project-health-plan-cost-rise-for-2021.aspx

6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4988401/