Mental Health NOW: the Opportunity for Wellness
What would be possible if Mental Health Conditions were viewed as gifts that require effective management and responsible use? How would healthcare protocols and delivery be impacted? These, and related questions, will be the inspiration for this blog
Evolutionary psychiatry and breakthroughs in neuroscience are rapidly blurring the lines between adaptive and maladaptive changes. (See the provocative Survival of the Sickest by Dr. Sharon Moalem; also Quantum Change by Miller and C’ de Baca and Spiritual Evolution by Dr. George Vaillant.) What would be possible if we put our attention on, gave money and resources to mental wellness instead of mental illness? The re-election of President Obama provides another opportunity for us to create a future for ourselves and our children that we could be proud to leave as a legacy, especially as it relates to how mental health is defined and considered in the body politic and media. Imagine mental wellness. Together, we can!
An open letter to President Obama
Please update your statistics and revisit your policy on Mental Health. As a person who successfully lives with bipolar disorder, I have a commitment to altering the conversation for mental health. Mental Health parity is only a belated beginning to creating procovery* structures for people living with mental health conditions.
In the four years since you became president, the mental health statistics have not improved. The NIMH states that 26.2 % of the US population has a mental health condition which translates into 1 in 4, not 1 in 5 Americans, as stated on your website. Quoting from NIMH “Mental disorders are common in the United States and internationally. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — that suffer from a serious mental illness. In addition, mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44. Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to co-morbidity.
“The burden of mental illness on health and productivity in the United States and throughout the world has long been underestimated. Data developed by the massive Global Burden of Disease study conducted by the World Health Organization, the World Bank, and Harvard University, reveal that mental illness, (including suicide) accounts for over 15 percent of the burden of disease in established market economies, such as the United States. This is more than the disease burden caused by all cancers.” (My emphasis) The WHO (World Health Organization) shows that Depression is one of the top ten diseases in every nation and increasing worldwide.
Presently, the prevailing view of psychiatric disorders is mostly occupied with despair, danger and drain, particularly in the wake of the recent Aurora, CO shooting, and previously Norway, Gabby Giffords and like incidents. Little media attention is paid to acknowledging those who contribute to the social good in spite of, or because of, living with a mental health condition. A case in point, TIME magazine’s 100-most-influential-people has listed Dr. Craig Venter, the genome maverick, for two years running. Though he has quite publicly self-described himself as having Bipolar Disorder (see The Hypomanic Edge, by John D. Gartner, Simon & Schuster, 2005), there was no word of this in either article.
Philip Burguières, a former Fortune 500 CEO who has had major depression, now works with executives who have mental health conditions. From a Newsweek article (2/26/07, p.44): “Today he is fully recovered and spends 10 hours a week counseling other CEOs. ‘The way you get to those positions in today’s world, you have to be a little more obsessive, more driven. Those qualities are things that lead to depression.’ He’s met hundreds of CEOs and boldly estimates as many as half of the people running Fortune 500 companies have the disease.” (My emphasis)
Largely missing in the public discourse is the recognition that many people successfully manage their mental health issues. Who might be inspired to seek treatment or create structures for wellness if there were more discussion? How would health care protocols and delivery be impacted? How would people with mental health conditions be viewed and how would they view themselves? What would be available to us as human beings? Even without modern treatments for depression, Abraham Lincoln served as President of the United States and Winston Churchill as Prime Minister of England.
Physical health cannot be maintained or obtained without first addressing issues of mental health. The most cost effective and therapeutically effective protocols have been proven to be evidence-based practices. National implementation of these community-based, integrated approaches is being supported by NASMHPD (National Association of State Mental Health Program Directors) and SAMHSA (Substance Abuse and Mental Health Services Administration), but it will take continued political will to have these procedures supersede the dependence on medication alone. As a leading advocate and researcher, Dartmouth’s Dr. Robert E. Blake noted in a Harvard Psychiatry Conference lecture, science is driven by biases that dollars should go to medication rather than studying self-help and support though we know they work (lower incidence of relapse, and less time in hospital if relapse occurs). Add lifestyle choices like exercise, nutrition, meditation and other awareness or spiritual practices and routine management of these conditions could become the norm.
As Chair of the Depression Bipolar Support Alliance–the leading peer-led support group network organization for mood disorders–I see the efficacy of our programs every week. Procovery is a process and requires many partners. I hope that your administration will take meaningful action on mental health in the next four years.
Our world is created in language, and altering the conversation begins with re-languaging how we speak about mental health conditions, the people who have them, ourselves. I choose “procovery” over recovery for several reasons. Recovery infers a return to something, a looking back to what may or may not have been. Procovery begins in the here and now. For me, procovery is a proactive, present-based process and a powerful place to stand in realizing mental wellness.
I wish I could take credit for the concept but it belongs to the work of Kathleen Crowley. ”The fundamental focus of Procovery is one of moving forward when you can no longer move back, of letting go of what was and rebuilding new dreams. …Procovery offers individuals diagnosed with serious or chronic disorders an approach to attaining [and maintaining] a productive and fulfilling life….” (From the website www.procoveryprimer.com).
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
I’m pretty sure “god” has it covered by using choice words such as “salvation” and “redemption”.
Re: “The re-election of President Obama provides another opportunity for us to create a future for ourselves and our children that we could be proud to leave as a legacy, especially as it relates to how mental health is defined and considered in the body politic and media.”
Comment: The television advertisements that ran during the summer of 2009 promoting ‘Obamacare’ were funded by the Pharmaceutical Research and Marketing Association (PhRMA).
Why? Because the drugmakers have a *lot* to gain with the new system (at least initially), which will eventually lead to the collapse of private payer healthcare, and an expansion of a *one-size-fits all* paradigm of care, as we move from (the despised) system of privately-managed care to an even *worse* system of government-managed care.
Simply put, it will mean drugs, drugs, and more drugs – which is precisely why the drugmakers pushed so hard for the passage of the legislation.
Dr. Peter Breggin (the “conscience of psychiatry”) predicts a catastrophic amount of drugging in the area of mental health teratment under this new system. I predict he’s right on the money.
It’s *not* good.
“If people let government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny.” – Thomas Jefferson
Duane Sherry, M.S.
Re: “… but it will take continued political will to have these procedures supersede the dependence on medication alone.”
Comment: Why *depend* on medications at all?
Or, at least… Why not work at making them an absolute *last resort*?… For adults only (not kids). With *fully* informed consent. In the *smallest* amount possible, for the *least* amount of time. *After* providing the options you mention? … So our country can begin to *lose* our *dependence* on mind-altering, brain-damaging, body-injuring, spirit-numbing drugs!
Ohh, by the way, does the Depression Bipolar Support Alliance (DBSA) receive drug money” If so, how much? NAMI has been required to provide public records. All the non-profit, 501(c)(3) organizations should be required to do the same.
Re: DBSA and Pharma Money
Gotta love Chuck Grassley! –
Yes, DBSA has never hidden the fact that it does accept pharma money AND we in no way endorse medication or specific medications for everyone or anyone. Our organization, including staff and board, is required to have 50% of personnel self-identify as having experienced depression and bipolar. We encourage mental health research of all kinds, including alternative and non-medical treatments/management structures.
Medication is a personal choice, and as any enlightened psychiatrist will tell you, often an imperfect one. For some it doesn’t work at all, or makes matters worse. DBSA uses money from investors, including from individuals, pharma and government contracts, to provide peer-led support groups nationwide, education and resources about mental health, advocate for mental wellness and put peers first in the mental health conversation.
I’m not for or against medication. As all the enlightened psychiatrists I have met concur, they are not optimal. Side effects can be as bad or worse than the conditions; and finding ones that work, if any at all, is more art than science. My reference to Obama was not about universal healthcare–it is still almost useless for people with serious mental health symptoms since too often people have to pay out of pocket first which they cannot afford, let alone wait for the partial reimbursement…–but about Obama’s point of view. Personally, I don’t believe in pathologizing neurological differences, and clearly, when people are in pain or in danger of hurting themselves or others we need effective ways to help them. Lots of work to do! Thanks for writing.
Lucinda, Thank you very much for your post, and welcome to this site. I do have one thought, however, that would give a lot more hope to those with a diagnosis of schizophrenia. It’s great that people with bipolar (often indistinguishable from schizophrenia) and depression (ditto) can lead productive lives, but failing to include names of those with a schizophrenia label who have successfully recovered from or managed their “schizophrenia” sends a message that this particular mental health condition is hopeless. The stigma around schizophrenia is way bigger than that attached to depression or bipolar. Perhaps you didn’t intend to stigmatize schizophrenia, but by omitting people like Elyn Saks, David Oakes, or Keris Jän Myrick, the message I get is that schizophrenia is an entirely different beast. Anyone with it may as well give up trying to recover and leave their future entirely in the hands of medical professionals. Was this an inadvertent omission on your part, or is it your opinion that schizophrenia is a different beast entirely?
I couldn’t agree more, Rossa. DBSA focusses on depression and bipolar only though I believe that all mental health conditions are actually neurodiversity–and far from being pathology are evolutionary. It will take awhile for the cultural conversation to turn and effective non-medical practices for procovery become the norm. Thanks for writing!
Thanks a lot for coming to the madinamerica website, for what will hopefully be a fruitful conversation. I take your message as a call to focus on recovery, and living meaningful lives, without assuming the illness part of mental conditions has to be chronic or permanent.
I really appreciate your introductory question: “What would be possible if Mental Health Conditions were viewed as gifts that require effective management and responsible use?” I think that question is at the core of most discussions here.
Maybe the answer starts with recognizing that diagnoses like depression or bipolar have very little predictive power, and are agglomerate labels for very diverse situations (in causes, dynamics, characteristics and response to treatments) whose commonality is only a set of non-specific symptoms. Even if we recognize some usefulness to the diagnosis of bipolar disorder, I have never seen any science justifying the lifelong prognosis generally given by doctors for that disorder to individual patients. That prognosis can become a powerful self-fulfilling prophecy, but then we might as well assume that the resulting lifelong handicap is a iatrogenic condition (resulting from bad science and the nocebo effect of prognosis) rather than a valid medical prognosis.
You said: “Largely missing in the public discourse is the recognition that many people successfully manage their mental health issues.”. I like that. But in your view, is there any difference between “successfully managing mental health issues”, and no longer having a disorder? If language defines our world, do you make any difference between: “As a person who successfully lives with bipolar disorder […]” and “As a person who used to have bipolar disorder in her past, but no longer has the disorder”.
In any case, thanks for your work and your thoughts!
Re: Updated statistics: One in four with “mental illness” versus one in five
One in five people currently take psychiatric drugs in this country, which is *why* there are supposedly one in four with a “mental illness.”…
When one in four are taking psychiatric drugs, rhe statistics will show that one in three have a “mental ilness”… When the majority of people are taking these drugs, the vast majority will need “traetment.
It’s not all that complicated.
It’s called a scam.
And non-profit organizations, such as NAMI and DBSA have been serving as front groups for this scam – for years!
My apologies to fellow readers for the number of comments.
Don’t worry about your number of comments. Just keep writing and sharing your ideas.