Most conversations about mental health aren't straightforward. Instead, they're often rich and rewarding, but also complex, difficult, and even painful.
The same goes for the most impactful mental health moments of 2023.
There have been triumphant events, like the film Everything Everywhere All At Once, with its message about the healing power of connection, sweeping the Oscars.
Stigma-defying moments, including Sen. John Fetterman's decision to seek treatment for depression and singer Ed Sheeran's discussion of his own mental health challenges, have helped show the public that no one should be ashamed to receive help.
But other turning points have been more alarming than reassuring. U.S. Surgeon General Dr. Vivek Murthy has issued two separate advisories this year raising concerns about the loneliness epidemic and youth social media use. A chatbot meant to support people with an eating disorder gave harmful suggestions about weight loss and body measurement instead.
In general, people may still feel the effects of COVID pandemic isolation, distress that may be compounded by increasing hostility toward minority groups and national tragedies, says Katie Lee, director of communications at Mental Health America, a nonprofit advocacy organization.
Lee notes that anti-immigrant and anti-LGBTQ+ rhetoric, mass shootings, and the violent deaths of people of color have taken a toll on people's well-being, particularly those targeted by hate speech and discriminatory policies.
She adds that conversations about mental health this year have pointed back to the importance of prevention, before a specific challenge gives way to crisis. Still, a prevention approach is often hamstrung by stigma that makes people feel ashamed, the reality that accessing help or treatment is frequently hard or expensive, and social and economic factors that disproportionately breed stress and uncertainty for some, putting them at increased risk for worse mental health.
"I think collectively as a nation we're hurting right now because of all of these negative events, but there is hope," says Lee.
She believes that the year in mental health so far could point the public toward meaningful changes that would decrease stigma and increase access to help.
Here are seven of these conversation-shifting moments:
1. U.S. Senator John Fetterman seeks treatment for depression.
In February, when Sen. John Fetterman, a Democrat representing Pennsylvania, took a leave of absence from his Congressional duties to receive treatment for depression, many hailed his decision as a move that could empower others to take care of their mental health needs.
Though Fetterman wasn't the first nationally elected politician to openly acknowledge struggling with mental health, he was under tremendous pressure to prove that he could handle the demands of public office after he suffered a stroke in May 2022.
Fetterman's use of closed captioning during a debate with his opponent in October, as well as relying on assistive technology once he arrived in the Senate, prompted critics to suggest he wasn't capable of fulfilling his duties. Experts pointed out that stroke survivors commonly use auditory processing and speech aids during their recovery, and others argued that the accusations perpetuated stigma surrounding physical disabilities.
Then Fetterman began experiencing severe depression at the start of his term; developing the condition following a stroke is common. He likely anticipated the intense scrutiny that would come with asking for help, and being hospitalized for his illness. That he did so anyway sent a powerful message to people living with mental health conditions who may fear the stigma that can be associated with seeking treatment. The fact that his decision was applauded by members of both parties also gave the public hope that such stigma is receding.
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Fetterman has promised to share more about his experience in the future. But upon his release in March from Walter Reed National Military Medical Center, where he received inpatient treatment for six weeks, he encouraged people to get the support they might need.
"For now, I want everyone to know that depression is treatable, and treatment works," he said. "This isn’t about politics. Right now there are people who are suffering with depression in red counties and blue counties. If you need help, please get help."
2. Survey says: Teen girls and LGBQ+ teens are not OK.
A report released in February by the Centers for Disease Control and Prevention (CDC) demonstrated just how poorly teen girls fared in 2021. The findings set off a broader, much-needed conversation about why and how teen girls ended up in such dire straits.
Reporting and commentary focused on contributing factors like sexual violence, misogyny and online hate, social media content that preys on teen girls' vulnerabilities, and the fact that poor mental health is a reasonable response to all of these experiences. Regardless of the exact combination of risk factors, the CDC's report helped the public recognize and take seriously the mental health crisis afflicting teen girls.
Based on data from the Youth Risk Behavior Survey, the report found that while all teens had experienced increasing mental health challenges, girls reported worse outcomes than boys on nearly every measure.
"High school should be a time for trailblazing, not trauma."
In 2021, more than half of U.S. teen girls felt persistently sad or hopeless, a significant increase since the last time they'd been surveyed, and double that of boys. The findings also indicated that teen girls reported "record high levels" of violence and suicide risk. One in five girls said they'd experienced sexual violence in 2021, a 20 percent increase since 2017.
Things weren't any better for youth who identify as lesbian, gay, bisexual, or questioning. (The survey does not ask about gender identity.) Those respondents reported "ongoing and extreme distress." Twenty percent of LGBQ+ youth said they'd been forced to have sex, compared to eight percent of heterosexual teens.
"High school should be a time for trailblazing, not trauma," Dr. Debra Houry, Chief Medical Officer and Deputy Director for Program and Science at the CDC, said in a statement. "These data show our kids need far more support to cope, hope, and thrive."
3. Everything Everywhere All At Once wins Best Picture at the Oscars.
In March, the delightfully absurd film Everything Everywhere All At Once (EEAAO) surprisingly dominated the Oscars, scoring not only a Best Picture victory but also wins for Best Director, Best Supporting Actor, Best Supporting Actress, and Best Original Screenplay, among other awards.
While it wasn't explicitly acknowledged from the Oscars stage, the action-comedy contained moving depictions of how to support someone experiencing emotional and mental health distress. In the film, a Chinese American immigrant named Evelyn Wang (Michelle Yeoh) must repair her fractured relationship with her daughter, Joy (Stephanie Hsu).
As it happens, an alternate universe version of Joy, Jobu, is conspiring to destroy human existence as she grapples with nihilism that Joy expresses as profound depression. But instead of talking about hopelessness and suicide, Jobu creates an "Everything Bagel," a literal bagel topped with every experience and emotion that will turn the world into a void.
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Amidst the hijinks, Evelyn's journey to save Joy, and Jobu, comes down to a simple act: insisting on lovingly being in the present moment with her daughter, even when things between them are rough.
In an interview with Mashable prior to the film's Oscars triumph, Brett Wean, director of writing and entertainment outreach at the American Foundation for Suicide Prevention, said the movie highlighted the importance of kindness and genuine connection.
"It's the story that life is messy and our connections with other people are what make us whole and give us balance, and ultimately that makes things OK, and that's where the true meaning of our lives comes from," Wean said.
EEAAO proved that Hollywood can make a movie that promotes positive messages about mental health support and suicide prevention without ever calling it that.
4. Singer Ed Sheeran opens up about experiencing severe depression.
In an interview with Rolling Stone, published in March, pop hitmaker Ed Sheeran opened up about experiencing depression and hopelessness. Closely timed tragedies — the unexpected death of his best friend and a brain tumor that afflicted his then-pregnant wife — sent Sheeran into a tailspin.
"I felt like I didn't want to live anymore," he told Rolling Stone. "And I have had that throughout my life... You're under the waves drowning. You're just sort of in this thing. And you can't get out of it."
Sheeran addressed the shame he felt as a father living with depression, but described how his wife urged him to seek help. In a move that may inspire other young men to consider receiving support for their mental health struggles, Sheeran talked about how therapy has helped him.
"No one really talks about their feelings where I come from," he said. "People think it's weird getting a therapist in England... I think it's very helpful to be able to speak with someone and just vent and not feel guilty about venting."
Sheeran put some of these experiences into a new four-part Disney+ docuseries about his life, which began streaming in May.
5. The Federal Trade Commission cracks down on deceiving digital mental health consumers.
The digital mental health boom may seem like an unequivocal win for consumers. After all, professional mental health help is expensive and often difficult to access. Apps that promise to seamlessly connect users to trained clinicians, for an arguably more affordable price, may seem like the answer. But as the Federal Trade Commission (FTC) demonstrated this spring, companies in this space may seek to capitalize on users' sensitive health information by sharing it with third parties.
In March, the federal agency announced that, for years, the online counseling service BetterHelp pushed users to disclose personal information through an intake survey. It promised those same users that data would help the company match them with a therapist, and that the information would remain confidential.
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Instead, BetterHelp shared their email addresses with social media platforms like Facebook, Snapchat, and Pinterest, so those companies could target the users with related advertising, according to the FTC's complaint. The FTC estimates that BetterHelp made millions of dollars as a result of these deals. Its proposed settlement would require BetterHelp to pay $7.8 million for deceiving consumers.
The settlement, which isn't yet final, should signal to other digital mental health companies that deceptive practices that violate users' privacy won't be tolerated.
6. The death of Jordan Neely puts spotlight on violence against people with mental illness.
When Jordan Neely, a New York City man who experienced mental illness and homelessness, was killed by a bystander on a subway on May 1, it sparked a national reckoning. Neely, a 30-year-old Black man, developed new mental illness as a teenager after his mother's murder. He was known both as a street performer and as chronically homeless.
Moments before his death, he'd reportedly shouted at and scared fellow subway passengers, though no one who witnessed the incident has described Neely as violent. Daniel Penny, another rider, put Neely in a chokehold for several minutes, killing him. Penny, who is white, has been charged with second-degree manslaughter.
The furor over Neely's death has drawn attention to systemic failures in public mental health treatment and homelessness services; Neely was well-known to New York City officials as desperately needing help.
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It also prompted discussion about violence against people with mental illness. Though some research shows a link between serious mental illness and perpetrating violence, that connection is unlikely causal. Instead, other factors associated with mental illness, like childhood trauma and abuse, may drive violent impulses or actions. Additionally, research has shown that people with serious mental illness are more likely to be victims of violence than the general public.
Mental health and homelessness advocates have blamed Neely's death partly on rhetoric and policies that dehumanize people in crisis.
"One thing we can say for sure, Jordan Neely did not deserve to die, and all of us must work together to do more for our brothers and sisters struggling with serious mental illness," said Eric Adams, mayor of New York City.
7. The U.S. Surgeon General sounds the alarm over the loneliness epidemic and youth social media use.
The United States has a loneliness problem, but this isn't exactly breaking news. The debut of Robert Putnam's book Bowling Alone: The Collapse and Revival of American Community in 2001 started an urgent conversation about the psychological and physical costs of social isolation. But the rapid growth of digital technologies and social media platforms, combined with a global pandemic, has created more distance between people and their connections than we could've ever imagined 20 years ago.
In April, U.S. Surgeon General Dr. Vivek Murthy published a New York Times op-ed describing a painful bout of loneliness he previously experienced, and announcing that he'd proposed a "national framework to rebuild social connection and community in America."
That framework includes reforming digital environments to make them safer spaces for positive social connection; cultivating values like kindness, respect, and service; and enhancing public spaces like libraries, parks, and playgrounds so they help people deepen their community ties and relationships.
About a month after his advisory on loneliness, Murthy issued another report on the potential harms of youth social media use. The 19-page advisory outlined the ways in which social media can expose children to violence, sexual and hate-based content, disordered eating, bullying, and predatory and self-harming behaviors.
While noting the good that can come from youth connecting with peers, learning more about their interests, and accessing spaces for self-expression, the report underscored potential harms. It also called on technology companies and policymakers to develop solutions, rather than placing the burden of ensuring safety on children and their parents.
"Nearly every teenager in America uses social media, and yet we do not have enough evidence to conclude that it is sufficiently safe for them," said the advisory. "Our children have become unknowing participants in a decades-long experiment."
8. Chatbot to help people with eating disorders is shut down for making harmful suggestions.
Last year, the nonprofit organization National Eating Disorders Association (NEDA) quietly debuted a chatbot named Tessa to assist people seeking help with an eating disorder. In May, after Tessa was more widely used, it was taken down amid reports that it described behavior like body measurement and calorie restriction, which could contribute to or worsen disordered eating.
That decision was prompted partly by critical Instagram posts from Sharon Maxwell, a self-described fat activist and weight inclusive consultant, who shared her own experience with Tessa. In screenshots of her exchange with the chatbot, Tessa attempts to answer some of Maxwell's questions by describing different weight loss techniques, dieting strategies, and ways to measure body composition.
"If I had accessed this chatbot when I was in the throes of my eating disorder, I would NOT have gotten help for my ED."
"If I had accessed this chatbot when I was in the throes of my eating disorder, I would NOT have gotten help for my ED," Maxwell wrote in her Instagram review of the chatbot. "If I had not gotten help, I would not still be alive today."
While NEDA was initially incredulous of Maxwell's claims, the nonprofit ultimately said on Instagram that it decided to take down the chatbot. Additionally, NEDA came under fire for having laid off its small helpline staff, which had attempted to unionize.
Liz Thompson, CEO of NEDA, told the Guardian that the chatbot wasn't meant to replace the helpline, and that it wasn't a "highly functional AI system."
One of the chatbot's original developers, Dr. Ellen Fitzsimmons-Craft, an associate professor of psychiatry at Washington University School of Medicine, said on Twitter that it has not been designed to offer weight loss advice. The controversy unleashed a bigger debate about what role chatbots could or should play in aiding people struggling with mental health conditions.
"I don't want to attack AI," Wendy Oliver-Pyatt, CEO of the online eating-disorder treatment company Within Health, told the Wall Street Journal. "But one person dies from an eating disorder in this country every 52 minutes, and you can't be sloppy about this."
If you're feeling suicidal or experiencing a mental health crisis, please talk to somebody. You can reach the 988 Suicide and Crisis Lifeline at 988; the Trans Lifeline at 877-565-8860; or the Trevor Project at 866-488-7386. Text "START" to Crisis Text Line at 741-741. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 10:00 p.m. ET, or email info@nami.org. If you don't like the phone, consider using the 988 Suicide and Crisis Lifeline Chat at crisischat.org. Here is a list of international resources.