Imagine if we only treated lung cancer and never tackled smoking. Is that what we’re doing with depression? We always ask people struggling with depression to reach out. But maybe we should also ask whether anyone is within reach.
Every October, Depression Awareness Month urges us to recognize the symptoms and seek help. As a physician, I support that message. As a public health and preventive medicine practitioner, I also ask a larger question: What are we doing to make depression less likely in the first place?
The scale of the problem makes the question urgent. In the first quarter of 2026, Gallup found that 19.1 percent of U.S. adults reported currently having or being treated for depression, up nearly nine percentage points since 2015. Nearly 30 percent (29.5) reported a lifetime diagnosis. These are self-reported measures, but the sustained rise is alarming, especially among adults under 30 and lower-income households.
Loneliness is a likely companion. Gallup also found depression in 33 percent of Americans who reported recent loneliness, compared with 13 percent of those who did not. Globally, about one in four people report significant loneliness. In 2023, the World Health Organization (WHO) launched a Commission on Social Connection to treat loneliness as a pressing global health threat. And the U.S. surgeon general compared its health risks to smoking up to 15 cigarettes a day.
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Rather than focus on treatment, a public health approach asks a larger question: Why are so many people lonely or depressed, and what scaffolding can we build into society so that fewer are?
Obesity, as we’ve come to realize, is more than an individual health issue. It is linked to environments that discourage walking, limit access to anything but processed, high-calorie food, or promote sedentary work and school routines. So are environmental and societal factors also shaping mental health? Do certain communities discourage social connection by limiting access to nature, parks, or public gathering spaces? Is digital connection encouraged over in-person interaction in schools and workplaces?
Public health works by targeting multiple parts of society at once. Consider smoking. In 1965, about 42 percent of U.S. adults smoked. By 2024, the rate had fallen below 10 percent. Better access to treatment was part of that story, but it could not have happened without a multifaceted approach that shifted the culture of society itself: education campaigns and scientific warnings, aggressive counter-marketing, heavy taxation, and smoking bans in restaurants, workplaces, schools, and other public settings. The goal was to erode the habit’s affordability and social acceptability, and, over time, it worked.
So what can communities do to improve mental health?
Like smoking, addressing depression and loneliness at a societal level will require a multifaceted approach.
1. Education
Right now, we treat social-emotional skills as something people simply pick up. Some may; many don’t. Because recognizing and labeling emotions, effectively managing stress, listening with empathy, resolving conflict, and asking for support all require deliberate teaching and practice. Organisation for Economic Co-operation and Development (OECD) survey data link stronger social-emotional skills to better outcomes, including higher life satisfaction and less anxiety. The data also suggest that these skills tend to weaken as kids age. (They are lower at 15 than at 10.) Communities need to keep teaching and reinforcing them through the teenage years, while building safer, kinder environments that reduce bullying and loneliness. Safe after-school programming can help. Iceland made it part of a multi-layered effort, along with parent education and involvement, curfews, and stricter alcohol rules. As a result, among 15- and 16-year-olds, reported drunkenness in the previous month fell from 42 percent in 1998 to a mere 5 percent by 2016.
2. Expanding support beyond the traditional mental health workforce
The WHO’s Mental Health Atlas 2024 reports a global median of just 13 mental health workers per 100,000 people. In the U.S., 137 million people, roughly 40 percent of the population, live in federally designated Mental Health Professional Shortage Areas. Where shortages like these exist, teaching basic mental health literacy and first aid to parents, teachers, and co-workers can extend supports within the community. Colorado offers one example. Sources of Strength, a peer-led program that trains student peer leaders and adult advisers to build connection and help-seeking, was associated with a 29 percent reduction in suicide attempts in a study of 20 Colorado high schools. The state’s youth suicide rate has since fallen to its lowest level since 2007, as a result of a multi-pronged societal approach.
3. A nuanced approach to social media and online tools
Digital tools can be a blessing or a curse depending on who they serve. They can offer real support, especially for people who struggle to find community locally. Working-age men, for example, face stigma around face-to-face care. Man Therapy, a humor-driven, online mental health program, was tested in a randomized trial in Michigan. Men offered the program sought help more often than those offered standard screening and referrals, and both depression and suicidal ideation fell over time.
For other groups, however, digital engagement can bring harassment and comparison, or displace sleep and time with friends. One recent National Bureau of Economic Research working paper compared schools with and without phone bans. For schools enforcing bans, the study found that, after an initial dip in the first year, students reported higher levels of psychological well-being.
What does this mean? It means communities need a nuanced approach to social media and online tools, based on their demographic makeup and target audience. The key is assessing connection and whether these tools are increasing or decreasing genuine connection within a certain group.
What can physicians do?
We can ask about connection alongside symptoms. We can add social prescribing to our toolbox, connecting patients to community-based activities and support programs that address the social and emotional roots of their mental health challenges. That might mean building referral pathways to peer groups, after-school programs, community gatherings, senior programs, nature groups, or activity-based clubs. The evidence for social prescribing is early but encouraging. A 2026 preprint meta-analysis of 33 randomized trials found modest reductions in depressive symptoms and improvements in quality of life.
Physicians can also be uniquely powerful advocates for community-based social programming due to their trusted status and clinical insight into how isolation impacts both physical and mental health. Beyond recommending existing programs, physicians can drive systemic change at local, organizational, and legislative levels.
This Depression Awareness Month, we need to make it easier for people to ask for help, and where community support exists, we need to connect our patients to it. If we keep asking people to reach out, we must help build a society where someone is within reach.
Tista Ghosh is a physician, epidemiologist, award-winning health journalist, and author. She served as Colorado’s chief medical officer, an Epidemic Intelligence Service officer at the Centers for Disease Control and Prevention, and an appointee to the U.S. Community Preventive Services Task Force. During the pandemic, she advised Fortune 500 companies on worker safety. She now focuses on worker health, including stress management and burnout prevention.
Her writing has appeared in Fast Company, Business Insider, Inc., HuffPost, and KevinMD, and her media appearances include Today, CNN, and NPR. In 2021, the American College of Occupational and Environmental Medicine recognized her health journalism with its media excellence award. Her scientific publications are available on ResearchGate.
Her latest book, Before the Next Crisis (Columbia University Press), shares everyday Americans’ pandemic experiences, exposing communication gaps and misunderstandings. These stories inspired her to found the Institute for Personal & Public Health Literacy (IPPHL), dedicated to translating health science into clear, trustworthy guidance that empowers people to make informed decisions. She shares updates on Instagram.
