Mental Health: Change Perception–Change Reality

Reprinted from the SAMHSA blog:

Changing the Story about Mental Health in America · by SAMHSA · March 9, 2015

Today, in support of her Joining Forces initiative, the First Lady spoke at the launch of The Campaign to Change Direction, a nation-wide effort to raise awareness around mental health in America. Spearheaded by Give an Hour and co-sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), the campaign is designed to change the story of mental health across the nation by urging all Americans to learn the five signs that someone might be in distress.

While there has been much media attention on mental health in the military and veteran community, it is incredibly important to understand that mental health isn’t just a military issue — it is a human issue. Mental health conditions impact our children, our grandparents, and our neighbors. Every year, roughly one in five adults — or more than 40 million Americans — experience a diagnosable mental health condition like depression or anxiety.

"I want to encourage everyone in this country to go to" —The First Lady on learning the five signs of mental illness

— The First Lady (@FLOTUS) March 4, 2015

It’s up to all of us to change the conversation by encouraging everyone to reach out when a friend, co-worker, veteran, or loved one might be struggling, and to ask for help when we need it for ourselves.

As the First Lady said today at the Newseum in Washington, D.C.:

It’s time to tell everyone who’s dealing with a mental health issue that they’re not alone, and that getting support and treatment isn’t a sign of weakness, it’s a sign of strength. That’s something that my husband believes strongly as President. Because in this country, when you’re fighting an illness — whether that’s mental or physical — you should be able to get the help you need, end of story.

Rory Brosius is the Deputy Director of Joining Forces.

Campaign to Change Direction, First Lady of the United States of America, FLOTUS, Joining Forces, Michelle Obama, The First Lady

  ~ Sparky

The Human Spirit as an Organ

Brain-Lightbulb1-214x300May 23rd, 2014 – Santa Barbara, California: another day, another shooting rampage, a few more souls lost to mental illness. More calls for gun control. More calls for funding of public health programs. More wringing of our hands and gnashing of our teeth where as a society we wrestle with what we can do to prevent disturbed individuals like Elliot Rodger from senselessly taking the lives of others.

I’d like to take a pragmatic approach to what we might do, starting with gun control.

As we saw recently, opponents of gun control are very effective politically at making impassioned arguments that owning a gun is the manifestation of a God-given right to defend personal self and property against threats from others – and most particularly in the minds of some political activists  (i.e., the Tea Party), the government. And they have huge lobbying strength.

Now I feel I have to share, that even for those most zealous gun enthusiasts with huge caches of automatic weapons I truly don’t understand how they would expect to defend their neighborhood against an AH-64 Apache helicopter should there ever be a military-supported government coup. Can’t you see it? A long row of sixty-something Harley riders with ammo strips strapped over their shoulders, long grey hair flowing from under their skull n bones bandanas. Waving their AK-40’s wildly as they fall like dominoes. Sort of like us fifty-something’s having to get under our desks in grade school during the 60s to rehearse protecting ourselves against a nuclear attack. But I digress.

Humor aside,  I think it’s important in this discussion to understand that gun ownership is a culturally ingrained part of wide swaths of our society. Unless that changes gun control legislation and regulations will have about as much success in the 21st century that Prohibition had against controlling alcohol production and consumption in the early 20th century. And perhaps there is a measure of truth in recognizing that in both instances the policy focus is misplaced by not recognizing the ultimate responsibility of acts committed under the influence or with a weapon (or both) lies with the individual, not the bottle or the gun.

So ruling out much hope for gun control as a viable approach to prevent these types of tragedies we next turn to doubling down on promoting policies that will expand access to mental health services.  But what if rather than spending more money to treat mental illness and its symptoms as distinct and separate from physiological well being we instead doubled down on efforts to understand how critically important it is to treat mind and body together.

I realize there are earnest efforts all across the country to integrate physical and mental health and move toward holistic well being. But from what I have seen those efforts are mostly incremental in nature and not going to create the transformational shift in health practitioners’ approach that can ultimately have the type of impact on mental illness we seek.

I think what is required is a paradigm shift in thinking about where and how mental health integrates with the overall health and wellness of the individual. We need to begin recognizing that mental well-being is a spiritual reality that, while ultimately the manifestation of physiological attributes, exists independent of those attributes.

And in this way it is just as much a vital organ as is the heart, the brain and so on. And that leads me to believe we should be thinking of human mentality as an organ. Just as our physical organs are necessary to provide human cells with basic needs to sustain life, we are learning more every day how important our human mentality is to cellular health.

I believe if we can broadly achieve this vantage it would change the way we approach research, the way health practitioners integrate awareness of mental health into diagnoses and treatments, the way we approach and treat symptoms of mental illness – and it would change the way we view mental health policy.

Your thoughts?


Mental Health in Crisis

The cost of not caring: Nowhere to go ~ The financial and human toll for neglecting the mentally ill is the first in a new series of articles being produced by USA Today tackling this hugely critical issue (by Liz Szabo). Rep. Tim Murphy, R-Pa. (a child psychologist) declares that, "we have replaced the hospital bed with the jail cell, the homeless shelter and the coffin. How is that compassionate?"

Mental health services and programming has taken it on the financial chin as an unfortunate lesser of evils political choice among state programs that have traditionally provided funding. According to Robert Glover, executive director of the National Association of State Mental Health Program Directors, $5 billion was cut from 2009 to 2012, while 4,500 public psychiatric hospital beds were eliminated (a 10% reduction).

Mental illness is still not broadly well understood in a way that even starts to approximate its impact on society. The USA Today article estimates that approximately 10 million Americans with serious mental illness are not receiving care. While at the same time, individuals with serious mental illness have a probability of dying 23 years younger compared to others.

The costs to society are dramatic: in excess of $440 billion a year. And only about one-third of that total goes to medical care. Much of it reflects disability payments and lost productivity. And that amount does not include lost earnings or tax revenue spent on prisons.

The timing is not good. State budgets are already being stretched and the national focus is on how to take costs out of the system – not add more. Medicaid expansion is likely to help identify greater need for mental health services without any commensurate plan in place to address those needs.

Yet we simply cannot afford to continue down the care delivery path we have forged. Mental illness is often a root cause for various physical illness and chronic conditions. Tragic events like Sandy Hook Elementary, Virginia Tech and Fort Hood remind us of the potential incident costs of untreated mental illness – but a fitting analogy of those events to the broader problem might be comparing the tragedy of an airplane crash to the number of traffic fatalities across the country each year.

Recently in true Washington partisan fashion Republicans and Democrats illustrated their shared compassion for those suffering from mental illness by drafting legislation designed to promote political distinctiveness rather than policy progress (though it should be noted that in this instance the Democratic initiative has to be viewed as politically reactive). Here’s hoping maybe someday that will change and this country can start having the very serious and much needed conversation on how to address this terrible crisis.


The Pain of Mental Illness

Hidden not far at all beneath the tinsel and tapestry of joy that retailers and their ad companies ask us to gorge upon is the painful reality this “season” means to millions of individuals whose conscious awareness of emotional pain and loss is heightened at this time of year. For most of us in that boat it’s a time of year you just try and suck it up and get through. But for the millions of Americans and their families living with mental illness there is no emotional reprieve awaiting as the calendar page flips to January 1.

In June of this year, CNN reporter Wayne Drash was invited into the home of Stephanie Escamilla and her family to observe and understand the trials and tribulations of caring for a child with a mental illness. Her 14 year-old son Daniel (not his real name) has been diagnosed as having bipolar disorder with psychosis. Their story – of the deep emotional pain that attends mental illness – is chronicled in Drash’s story, My Son is Mentally Ill So Listen Up, featured on CNN’s web site.

Stephanie’s invitation was her way of trying to bring greater awareness and understanding of the challenges and caregiving concerns that have a tremendous impact on the informal caregivers of the mentally ill. And it was also her way of drawing attention to the tragic reality we face in this country that way, way too often treating mental illness is entirely reactive.

I’m not going to add anything here that hasn’t already been better articulated by clinicians and mental health practitioners in terms of advocating for the same proactive approach to diagnosing and treating mental illness as has been given to heart disease or breast cancer, as examples. I just wanted to share this story with you and hope you will take the time to listen. I think it is tremendously important.