The Truth About Mental Illness
Theresa Presley MSW, LCSW, RPT, CTS, and Community Services Director at Pathways Community Health chats with Tonia Wright about the impact of mental health stigma and the challenges faced by those with mental illness.
Q: Where are we in the fight against mental health stigma?
A: It’s human nature to fear what we don’t understand. We know that stigma is based on lies, but it’s also built within a social context and permeates throughout our relationships. The effects of stigma are felt in the silence and shame that surrounds mental health issues. Stigma has created an “us and them” attitude in our society. The stigma that is attached to mental health issues is very powerful and the struggle to change the stigma won’t happen overnight. We have to continue to increase the dialogue about mental health. The more we learn the truth, the quicker we can move towards healing and recovery as a society.
Q: Which disorders are more widely accepted and which ones are stigmatized the worst?
A: I think disorders such as ADHD (Attention Deficit Hyperactivity Disorder), depression and adjustment disorders, like struggling after a divorce or a death, are more socially acceptable. However, that being said, there is still a vast number of people in our society that believe depression or suicide only affect the weak. The reality is that because we are all human, any of us could suffer from mental health issues in our lifetime, anything from an adjustment disorder to more serious issues such as bipolar, schizophrenia, addiction or suicide.
Q: What is the truth about mental illness?
A: According to the National Alliance on Mental Illness (NAMI), one in four adults experience mental illness in a given year. One in 17, live with a serious mental illness such as schizophrenia, major depression or bipolar disorder. Approximately 20% of youth ages 13 to 18 experience severe mental disorders in a given year. For ages 8 to 15, the estimate is 13%.
Approximately 60% of adults and almost 50% of youth ages 8-15, with a mental illness, received no mental health services in the previous year. One-half of all chronic mental illness begins by the age of 14; three quarters by age 24. Despite effective treatment, there are long delays - sometimes decades - between the first appearance of symptoms and when people get help.
The direct and indirect costs of untreated mental illness in America is huge! Serious mental illness (SMI) costs Americans $193.2 billion in lost earnings per year. Individuals living with SMI face an increased risk of having chronic medical conditions. Adults living with serious mental illness die on average 25 years earlier than other Americans, largely due to treatable medical conditions. Over 50% of students with a mental health condition age 14 and older, who are served by special education, drop out. They constitute the highest dropout rate of any disability group. (NAMI)
Suicide is the 10th leading cause of death in the U.S. (more common than homicide) and the third leading cause of death for ages 15 to 24 years. More than 90% of those who die by suicide had one or more mental disorders. Other indirect costs due to untreated mental illness include incarcerations. Those with severe mental illness are 10 times more likely to become incarcerated compared to the general population.
Individuals suffering with SMI have many barriers to overcome to obtain and maintain employment. Lack of treatment further exacerbates the difficulty. Mental illness occurs in 20% of children in the U.S. Left untreated, many mental health disorders can continue into adulthood. If we do not provide early childhood mental health services, the implications will be felt throughout our society. A child that is suffering is not learning, and we know that education is the answer to combat risk factors such as incarceration and poverty. We either pay now or pay later.
Q: Some argue gun control over more mental health resources. Is this a chicken before the egg issue, as news headlines showcase mentally ill persons with firearms who murder and injure innocent people in masses? These incidents perpetuate mental health stigma. What’s your take on this?
A: First, let me say that people with mental illness are much more likely to be the victims of violent crimes than perpetrators of violence. I believe that both issues need a frank discussion but want to caution against stigmatizing people with mental illness. The mental health care system in our country is fragmented and under funded. Actually, funding has been cut! We have to start talking about issues to alleviate the issues. The correctional system in America makes up the largest mental health care provider in the nation; that should concern all of us! We don’t treat mental illness like other medical conditions such as cancer. We deal with cancer with early diagnosis and the best treatments available - not so much when it comes to mental illness.
There has been a lot of media coverage on mass shootings in the U.S. While that is tragic, what I find most alarming is that it is not until after the crime has been done and lives are lost that the perpetrator’s mental illness is realized or treated. We have hurt people, hurting people! For most mental health conditions, prevention works, treatment is effective and people do in fact recover. But the fact remains that mental health care spending has been dramatically cut in recent years. People are facing barriers with insurance coverage and accessibility to care, in addition to stigma.
People that are seeking help for mental illness require a lot of support, which could include primary care, therapy services, case management, social and vocational services. NAMI estimates that the economic cost of untreated mental illness is more than $100 billion each year in the U.S. Yet, states cut over $4 billion in funding for mental health services between 2009 and 2012, and the federal government passed a budget in 2013 that cut federal funds for mental health by over $20 million. As a nation, we need to look at the state of mental health in America.
Q: What is it going to take to make meaningful strides in the fight against mental illness and the stigma that comes with it? And what about our veterans?
A: Stigma is the biggest hurdle for veterans, or anyone suffering from mental illness, to get the help they need. Veterans worry about appearing weak and what a mental health diagnosis could mean to their career. Military culture plays a significant role in stigma, by feeding the stereotype that military members that seek mental health treatment are weak. What has to change is the perception among military members that if they do step forward, there will be dire consequences. This change will come with educating military leaders and through one-on-one relationships throughout the ranks.
Q: How can we best look out for our individual mental health as well as those who we care about?
A: Mental health affects everyone. The more knowledgeable people are about mental health issues, the less stigma will be associated with these common life challenges. The more aware people are of what effective supports and treatments exist, the more people will get the appropriate help they need. Just like your physical health, there are actions you can take to increase your mental health. Boost your well-being and stay mentally healthy by following a few simple steps:
Connect with Others. Develop strong relationships with people around you that will support and enrich your life.
Enjoy your life. Take time each day to do something you enjoy, like taking a walk or having coffee with a friend.
Contribute to your community. Volunteer for a cause you care about, or help out a neighbor.
Take care of yourself. Mental health does not happen in isolation. You have to eat right and stay active. Physical health and mental health are closely linked.
Challenge yourself. Learn a new skill. Learning improves your mental fitness, builds skills and confidence, and gives you a sense of progress and achievement.
Deal with Stress. Stress is a part of life and affects people in different ways. It only becomes a problem when it makes you feel uncomfortable or distressed. A balanced lifestyle can help you manage stress better. If you have trouble winding down, you may find that relaxation breathing, yoga or meditation can help.
Rest. Get plenty of sleep. Allow yourself some unfocussed time each day to refresh; for example, let your mind wander, daydream or simply watch the clouds go by for a while. It’s okay to add ‘do nothing’ to your to-do list!
Ask for help. The perfect, worry free life does not exist. Life is a journey and on that journey there are ups and downs. The key to navigating the downs is to create a life where you surround yourself with relationships and have people around you that can help
If you are struggling with a mental health issue, or are concerned about someone else, please contact Pathways Community Health’s 24/7 crisis line at 1-888- 279-8188. Find us online at PathwaysOnline.org.