Ep. 134: Dr. Jonathan Schaefer — How Better Mental Health Epidemiology Can Lower Stigma

by Seth J. Gillihan, PhD

​I had a great conversation in this episode with Dr. Jonathan Schaefer. Jon is a clinical psychologist and an expert in psychiatric epidemiology, which addresses questions about how common psychiatric diagnoses are.

As you’ll hear, it’s far more common to experience a mental health issue than was previously thought. The main takeaway seems to be not that mental illness is becoming more common, although that’s part of the issue, but that previous methods of measurement had probably undercounted, for reasons that Jon explains very nicely. I was certainly blown away by the most recent statistics. Topics we covered included:

  • Jon’s article in Psyche entitled “If You Stay Mentally Well Your Entire Life, You’re Not Normal”
  • Findings from the National Comorbidity Survey (NCS) and NCS Replication
  • The underreporting problem with most epidemiological studies of mental health conditions
  • Recall failure and state-dependent memory in retrospective studies
  • The benefits and limitations of epidemiology data from national healthcare registries
  • Jon’s groundbreaking work in mental health epidemiology
  • The challenges and advantages of longitudinal cohort studies
  • The Dunedin study in New Zealand
  • The most common types of mental health conditions
    • Anxiety (58%)
    • Depression (48%)
    • Substance Use Disorder (41%)
  • Common comorbidities involving both an internalizing (e.g., depression) and an externalizing (e.g., alcohol use disorder) disorder
  • The potential effects of high lifetime prevalence numbers on mental health stigma
  • Surprising factors in psychiatric stigmatization
  • Extrapolating from longitudinal cohort studies
  • The common concern about potentially “medicalizing normality”
  • Predictors of “enduring mental health” (staying diagnosis-free throughout life)
  • The challenge in distinguishing simple correlates from causes
  • Jon’s ongoing work with twin studies
  • Pluralistic ignorance in the context of mental health
  • Positive outcomes associated with enduring mental health
  • The growth that often comes through our mental health challenges
  • Rumi’s famous quote that “The wound is where the light enters you.”

Jonathan D. Schaefer, PhD, received his doctorate in Clinical Psychology from Duke University, and is now a postdoctoral fellow at the Institute of Child Development and Minnesota Center for Twin and Family Research at the University of Minnesota.

Jon’s research focuses on understanding the relationship between individuals’ environments and their mental health.

He has authored over a dozen peer-reviewed articles looking at associations between early-life exposure to environmental factors that can affect brain development (e.g., victimizationenvironmental pollutantsdrug use), and psychiatric outcomes, using longitudinal and twin methods to strengthen causal inference.

Jon is also passionate about decreasing the stigma that still surrounds many common mental health problems.

He has published several articles on the ubiquity of these conditions in academic journals as well as written editorials on the topic for outlets including Scientific American and Psyche.

You can connect with Jon on Twitter.