The problem is that, if you're in a position where you are having serious depression, for example, it doesn't really matter how objectively or subjectively helpful it is, you can't even bother getting motivated to do things you are certain you enjoy, let alone something unknown.
This is the same problem with CPAP machines - they nominally have a huge efficacy rate, and a rock-bottom rate of people sticking to them, because for a lot of people, they're deeply invasive and uncomfortable, and insurance (in the US) in many cases has stopped paying for them if their obsessive babysitting doesn't swear you've used it 95% of the time, so people just say "hell with it" and stop stressing about, say, not being able to take a hike for a few days of camping because their insurance will stop paying for it.
It all goes back to the fundamental premise of "if your solution requires changing people, you will not succeed."
Imagine that on top (or even instead) of the chemicals and therapy a personal trainer would make sure you go to meet him (or he comes to your apartment) and does a session with you. This can work even with a severely depressed person.
We prescribe these methods for physical therapy, so why can't there be physical therapy for the mind?
We might be able to lower obesity/morbidity/depression by so much if we operated this way.
Can you please elaborate? You’re saying that CPAP is effective but people don’t use it consistently, and insurance monitors its use and if they determine the % of use is lower than 95%, insurance will bill you instead? I thought people who require CPAP have severe enough sleep apnea that they could die from the lack of oxygen.
Also how is this related to depression, you said “this is the same problem” after you mentioned depression.
The parallel intended was that if you propose a solution that is technically a fix but not feasible for some reason beyond preference, it's not going to help.
CPAP machines are often prescribed for people who are not necessarily at acute risk of death so much as having no consistent high quality sleep, which has a lot of complicated possible knock-on effects. Unfortunately, since it takes a long time sometimes to notice positive effects, while they're uncomfortable to use from the start (among other reasons), it becomes difficult to convince people to keep using them for unseen benefits. (To my understanding, yes, insurance will just stop paying for it if you don't hit some threshold of usage. I've not had insurance that did that, but I have personally known multiple people who had to avoid certain activities because they would have been away from electricity for too long.)
Similarly, if you suggest exercise, an activity that requires a significant investment of mental effort for many people to engage in absent habit, as a sole treatment for a condition where people sometimes cannot manage to invest enough effort to eat, an activity which many people enjoy doing, it will not be constructive.
(I'm not arguing against either as part of a larger treatment plan, but if you don't consider the reasons that people might not have done them beyond "I didn't know it was an option", then you will often end up giving advice that is technically correct but not usefully actionable.)
Chronic sleep disruptions that are treatable with CPAP machines are also strongly correlated with depression. Improving the effectiveness of sleep is a contributing factor to positive mental state.
This is the same problem with CPAP machines - they nominally have a huge efficacy rate, and a rock-bottom rate of people sticking to them, because for a lot of people, they're deeply invasive and uncomfortable, and insurance (in the US) in many cases has stopped paying for them if their obsessive babysitting doesn't swear you've used it 95% of the time, so people just say "hell with it" and stop stressing about, say, not being able to take a hike for a few days of camping because their insurance will stop paying for it.
It all goes back to the fundamental premise of "if your solution requires changing people, you will not succeed."