Mental Health Awareness Month

May is mental health awareness month. Mental illness is a very common and often an under diagnosed set of conditions. Mental illness includes disorders that affect thinking, mood, behavior, and cause difficulty in day-to-day responsibilities. There are many ways to treat mental illness, such as learning healthy ways to cope with stress.

The Problem

About 1 in 4 U.S. adults have a mental illness, and nearly half of all Americans will develop at least one mental illness during their life (CDC, 2011). According to one CDC Report, “Mental Illness Surveillance among adults in the United States” (2011), anxiety and mood disorders, such as depression, are some of the most common conditions. Mental illness can also begin in childhood. Experts estimate between 14-20 percent of kids are affected by mental illness every year (National Research Council and Institute of Medicine, 2009). These numbers are concerning not only because of the impact on the mental health of the population, but also because of the association with chronic disease. Many do not realize, mental illness is a risk factor for diseases such as diabetes, obesity, and heart disease. Persons with mental illness are also more likely to use tobacco and alcohol, which place them at a greater risk for many chronic medical conditions. Mental illness also contributes to more disability in developed countries than any other condition, including cancer and heart disease.

Recognizing and talking about mental illness is an important first step. It can be hard to tell when thoughts or emotions become a problem, so it’s important to learn the signs. Some common signs and symptoms of mental illness in adults and teenagers include:

  • Difficulty controlling worry or anxiety
  • Extreme sadness
  • Difficulty concentrating
  • Restlessness
  • Mood swings
  • Irritability
  • Insomnia
  • Unusual increase or decrease in appetite
  • Avoiding social situations or typically enjoyable activities
  • Abusing substances like alcohol, prescription and over-the-counter medications, or illegal drugs
  • Having physical symptoms without a cause, such as headache, or abdominal pain
  • Thinking or talking about suicide or harming others

Encourage patients to talk with you or another health care provider if symptoms exist. In an emergency, don’t wait; get help right away. Resources for patients include the National Suicide Prevention Lifeline at-1-800-273-8255 or for Emergency Services in the U.S. call 911.

The Solution

Treatment for mental illness varies depending on the condition, available resources, and the goals of the person affected. Involve a mental health professional; most successful plans include some form of psychotherapy. The treatment plan might need to change, and regular check in is important so the plan stays current. Treatment may also include:

  • Therapy:
    • Examples include cognitive-behavioral therapy, interpersonal psychotherapy, psychodynamic therapy and problem solving therapy.
  • Support groups:
    • Examples include; spending time with social groups, joining a community group, gym or volunteer organization, or an online support group.
  • Medication:
    • Help patients understand medication side effects and ask about their preferences. Some medication types may be better tolerated based on individual preferences.
  • Coping strategies:
    • Coping strategies take time to develop, encourage your patients to set aside time every day.

Stress Reduction

Taking good care of mental health is just as important as physical health. Learning stress reduction and coping strategies early is a great way to help promote mental well-being. The CDC estimates only 17% of U.S. adults are in a state of optimal mental health (2013). This suggests most of us can benefit from learning stress reduction techniques. Here are a few to consider offering your patients or practice yourself to manage stress at home or work:

  • Music therapy:
    • Creating (active) or listening (receptive) to music that you enjoy, and inspires you.
  • Mindfulness Based Stress Reduction:
    • This is kind of meditation can be done while sitting or walking. It involves being aware of the present moment. Be aware of your thoughts and feelings, but don’t judge them.
  • Centering Prayer:
    • This is a kind of meditation that involves focusing on a spiritual word or phrase. Choose a word, phrase, or sacred image that is meaningful to you and brings you peace.
  • Deep Breathing:
    • To do this, expand your stomach and inhale slowly through your nose. Hold your breath for 3-5 seconds, then exhales slowly, allowing your stomach muscles to relax.
  • Muscle Relaxation:
    • This involves intentionally tensing muscles then relaxing them. For example, tense your hands into fists as hard as you can for 5 seconds. Then release all the tension in your hands. Repeat this with other muscle groups in your body.

Other ways to promote mental well-being include:

  • Regular exercise. Physical exercise can release both physical and emotional tension. The key is to find a form of exercise the person enjoys, and to do it regularly.
  • Eat a balanced diet, get plenty of sleep, and do not smoke.
  • Avoid using alcohol or drugs to relax.

What can you do?

Screen patients for symptoms of depression or other mental health conditions. Be aware of these risks in persons with chronic disease. Offer practical solutions to persons who can’t afford or may not be likely to comply with long term therapy or medications. The right education, resources and information make a difference.

Elsevier Interactive Patient Education titles include:

Stress and Stress Management

Mindfulness-Based Stress Reduction*

Generalized Anxiety Disorder

Posttraumatic Stress Syndrome

Major Depressive Disorder

Living with Anxiety *

Living with Depression *

Living with Bipolar Disorder *

Supporting Someone with Obsessive Compulsive Disorder *

Supporting Someone with Schizophrenia *

*Upcoming titles

Author Biography:

Jennifer Abfalter, MA, APRN, CNS is a Clinical Editor, with Interactive Patient Engagement at Elsevier. Prior to joining Elsevier,  Jennifer has worked in clinical and managerial roles in Acute Care Hospitals. Her clinical background is in Critical Care, Emergency Department and Post-Anesthesia Care Nursing. She currently holds a Master’s Degree in Nursing, with an APRN Certification as a Clinical Nurse Specialist. She joined Elsevier in January of 2016, her passion is empowering patients to be a partner in the health care experience.

Supporting Authors:

Kate Nelson Ward, MPH, CHES is a Clinical Content Specialist for Elsevier Patient Engagement. She is a Certified Health Education Specialist with experience in academic, clinical, non-profit, and international settings. She has published and presented on patient decision-making, chronic disease coping, and pediatric nutrition and feeding. She now specializes in addressing patient health literacy through supporting providers with quality and evidence-based content for shared decision-making and teach-back interactions.

Julibeth Lauren, PhD, APRN, CNS is currently serving as the Vice-President and Editor-in-Chief for Elsevier Patient Engagement. Previously she served 8 years for a large healthcare system Level I Adult/Pediatric Trauma, Comprehensive Stroke and Burn Center in the Twin Cities as a Director of Practice, Education, and Research. Her work experience includes practice as an APRN Clinical Nurse Specialist, Nursing Faculty, Principal Instructor, Interdisciplinary Curriculum Development, and Staff Registered Nurse. She currently holds a Doctorate in Adult Education, Graduate Certification in Business, Organizational Leadership, and a Masters Degree in Nursing. Julibeth is extremely passionate about adult and patient education to provide the right information to patients in a way which is understandable, actionable, and delivered at the most teachable moments along the patient’s health care journey.




  1. American Psychological Association. (2015). Practice guideline for the treatment of patients with major depressive disorder, third edition. Arlington, VA.
  2. Centers for Disease Control and Prevention. (2011). Mental Health. Retrieved May 17, 2017, from
  3. Centers for Disease Control and Prevention. (2013). Mental Health Basics. Retrieved May 17, 2017 from
  4. Drake, D., Schulman, R., Daimaru, D. (2016). Integrative Medicine in Rehabilitation. In Braddom’s Physical Medicine and Rehabilitation (5th ed., pp. 397–405). Philadelphia, PA: Elsevier.
  5. Minichiello, V. (2018). Relaxation Techniques. In Integrative Medicine (4th ed., pp. 909–913). Philadelphia, PA.
  6. National Association of Mental Ilness (n.d.). Know the warning signs. Retrieved, May 17, 2017 from
  7. National Research Council and Institute of Medicine. Preventing mental, emotional, and behavioral disorders among young people: progress and possibilities. Washington, DC: The National Academic Press; 2009.

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