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The Mental Health Discussion: a Mixed Bag

July 17, 2013 By Annalise McGrail, Undergraduate Research Fellow

Few medical issues are as widely misunderstood as mental illness. As many as 1 in 4 Americans experience a mental illness or substance abuse disorder each year, yet we still approach the topic with fear and confusion.

This year’s tragic shootings have given unprecedented attention to mental health. While the state of mental health has long been in desperate need of this focus, the reason for the spotlight is troublesome. Highlighting mental health in context of the shootings gives the impression that individuals with mental illness are by in large dangerous. This is false. "Only about 4 percent of violence in the United States can be attributed to people with mental illness," according to a New York Times commentary quoting an American Journal of Psychiatry article. In these cases, weapons are used only 2 percent of the time, according to another Times article published after the Sandy Hook shooting. Furthermore, individuals with mental illness are 11 times more likely than the general population to have violent crimes perpetrated on them.

Mental health care is broken in more ways than one. That is why last month President Obama called for a new national conversation about mental health. We need improved access to care, more research, and a national dialogue that seeks to understand the issues.

One of the most complicated components to mental health is the stigma accompanying it.

One survey found that 90% of young adults with a mental health concern report experiencing negative treatment as a result of their illness; and as many as 40% of those experience that treatment on a daily basis. Lisa Lambert, executive director for the Parent/ Professional Advocacy League and mother to a child with a mental illness, explains:

"We all live in a society where the stigma around mental illness can stop us in our tracks. It’s far more serious than a lack of understanding. People repeat things to you that cut you to the quick and you learn not to tell them what you are going through."

This stigmatization is a major barrier to accessible care. Mary Brainerd, the CEO and president of HealthPartners explains in a May press release, “most people live with the symptoms of a mental illness for up to 10 years before seeking treatment, largely due to stigma.” A significant portion of the American population goes without care, because society has not created a safe enough environment for accessible care.

Minnesota has set out to change this. A little over a month ago a collaboration between the Minnesota chapter of the National Alliance on Mental Illness (NAMI-MN), HealthPartners, Regions Hospital, and many metro community organizations launched the Make it OK campaign, seeking to normalize the mental health discussion, create understanding, and make it easier for individuals to access necessary care.

Sue Abderholden, executive director for NAMI-MN explains, “'This is really about … how do we create empathy and respect for somebody who is going through this, how do we make people more comfortable? What we’re talking about is different than raising awareness. It’s the next step.'”

In addition to the Make it OK campaign, Abderholden explains how the legislature recently passes 17 new measures to improve children’s mental health services in the state, which includes doubling funding for school-based mental health grants. 

What makes these new initiatives different than their predecessors is the much needed inclusion of individuals with mental illness in the discussion. Instead of enacting programs for individuals with mental illness, the reforms are made with them. 

No individual should go without proper medical care, especially on account of fear. “Like any other medical condition, mental illnesses are biological in nature, and should be treated with the same urgency as diabetes or heart disease,” says Abderholden.

In addition, mental illness has severe affects on general health. A 20-year study examining people in Western Australia found men with mental illness die on average 16 years earlier, and women die 12 years earlier, a mortality difference on par with life-long smoking.

Lastly, current mental health care, or lack there of, creates inequality. Individuals with serious mental illness on average earn $16,000 less and are at a greater risk for poverty. This affects us all, as it costs the country a $193 billion annual loss of earnings, $150 billion on direct care that is ineffective or incorrect for their condition up to half of the time, and over $140 billion on indirect public safety-net services, according to a NY Times article citing a 2008 American Journal of Psychiatry study. By continuing research and implementing effective policies that highlight outreach, a cost effective solution that betters the livelihood of individuals with mental illness and improves society as a whole could be found.

Minnesota has a mental health care shortage in all but the counties surrounding the Twin Cities and Rochester, with many of these areas having little to no psychiatry care for youth. Many of the changes in the state will certainly have substantial effects for those in the metro, but will still leave those in rural communities underserved.

Minnesota is most certainly on the right track, but more needs to be done to help all citizens.

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