May is Mental Health Awareness Month and as with other designated months, the laudable goal is to educate and raise awareness – and there is good reason.
According to the U.S. Surgeon General, at least one in five people have a diagnosable mental illness in a given year. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that serious psychological distress, such as major depression, schizophrenia, bipolar disorder, panic disorder, obsessive compulsive disorder, borderline personality disorder and post traumatic stress disorder affected 24 million adults over the age of 18 in 2007.
The good news is that treatments for mental illnesses are highly effective. In fact, the National Alliance on Mental Illness (NAMI) reports that with adequate treatment, 70 – 90 percent of seriously mentally ill individuals will have a significant reduction in symptoms and a greatly improved quality of life.
The bad news is that according to the National Institute of Mental Health, barely more than half the people in need of treatment ever get it: Why is that – why do nearly half the people who need treatment go without it? There are many parts to the answer.
One barrier to seeking treatment is the stigma of acknowledging mental illness in oneself, a family member or friend. Myths about mental illness are still common – that the affected person is weak, has a character flaw, is not trying hard enough, is "giving in." Not surprisingly, acknowledging a mental illness often brings a sense of shame or failure, and with it a reluctance to seek treatment. This is tragic, not only for the ill person but to our national economy. It is estimated that the cost of untreated mental illness is more than 100 billion dollars each year.
Another barrier is individual expense. Health insurance coverage for mental illness is often insufficient for adequate treatment and out-of-pocket expenses can be daunting. Recently enacted Congressional legislation mandating some degree of parity with other illnesses has helped considerably – but not nearly enough.
However, I suspect many people don’t seek treatment because they find the prospect of mental illness terrifying. We avoid facing mental illness in ourselves or others in every way we can. The very name of this month – Mental Health Awareness Month – is an example. We tell ourselves it is about mental health when it really is about mental illness. When someone has a heart attack we don't say he/she has a heart health problem. When someone is dealing with a cancer we don't say he/she has a cell health problem. Indeed, in the not-too-distant past "cancer" was a term to be avoided at all costs – doctors didn't tell their patients and patients who knew their diagnosis didn't tell their families or friends.
Effective treatments for cancer and other diseases have helped greatly in easing the stigma of illnesses. Effective treatments for mental illnesses have not eased the stigma because of the way we perceive ourselves. Mental illnesses affect our thoughts, feelings, memories and our sense of self-awareness – in other words our sense of who we are, what we know of ourselves, our very being. The fact that thoughts, feelings and consciousness are all brain functions and can be affected by diseases of the brain, the fact that the brain in one sense is just another organ that can malfunction, is lost on us. It is lost on us for the very reason that these malfunctions are a threat right to the core of who we are, our knowledge of ourselves and our sense of control over ourselves.
Two important ways to further decrease these stigma-related problems are public education and the ease that comes with familiarity. Education comes with disseminating advances in mental illness research and treatment and with the many courageous people who continue to come forward to share their own experiences with illness.
The ease that comes with familiarity is something that each of us can work on. It is often very clear when someone is depressed or has a thinking problem. It is often very clear that someone has trouble behaving in socially conventional way, evidently because of some form of illness. In these situations we tend to avoid interacting with someone who, after all, may seem strange and perhaps frightening.
But think of this: Inside that strange being is a person – a person who is more like you than different from you, with hopes and fears similar to yours, who may be struggling but who is also aware of being shunned, a person with his or her own humanity.
If you know the person you might try saying hello, or smiling or acknowledging him or her in some way. You might ask how they are doing. You might, in other words, treat them as a person. With some simple generosity of spirit on your part you may soon have this unexpected benefit -- that mental illness doesn't seem so frightening anymore. With the comfort that comes with familiarity you may be helping yourself as well as someone else and may be contributing your small part to diminishing the stigma and fear still associated with mental illness.
We look forward to your comments on this and all Silver Hill Hospital posts.
Silver Hill Hospital’s blog is intended only to provide information; it is not intended to provide diagnosis or treatment. If this is an emergency, please call 911.