Pulling for a New Reality: from Mental Illness to Mental Wellness

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.

*PROCOVERY

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).