I am the number 60. That is, I have scored a 60 on the M3 Screen, a tool now widely promoted by Mental Health America (MHA). More importantly (according to an alarming box that popped onto the center of my screen before I could even read the rest of my post-test assessment), some of my answers “raised a red flag” that prompted the recommendation that I either call the National Suicide Prevention Lifeline or proceed directly to an Emergency Room for “immediate treatment.” And in case I had not already rushed off to the ER, the results further recommended that I “contact [my] physician or a mental health care provider as soon as possible to begin a discussion of [my] M3 results.” All this was surmised from a three-minute(!) test for “Depression, Anxiety, Bipolar and PTSD.” Three minutes. Wow.
This self-screening tool is being promoted along with a pledge that reads:
“I am pledging to help end the stigma and ignorance that exists with mental health disorders today. I promise to take care of my mental health. I just took Mental Health America’s M3 screener to evaluate myself, and I promise to continue to monitor myself and learn ways I can live a mentally healthier life. Please join me by taking this pledge, the M3 screener, and sharing this post with your friends.”
It was posted to MHA’s Facebook page on Tuesday, December 18th, only a few short days following the Sandy Hook Tragedy. Opportunistic self-promotion? Perhaps. Well intended? Maybe. But what on earth does it all mean? And what would happen to me if I followed those insistent instructions to seek immediate help? For better or worse, I can answer that last question with a fair amount of certainty. Because I’ve been there.
On more than one occasion I have reached out to mental health providers, convinced there was something wrong with me and that only they would know how to ‘fix it.’ Each time, they have responded with authority. They, too, believed they knew what to do (or at least what they were supposed to do) and that generally included therapy, medication and – at times – hospitalization. I can actually remember the excitement and satisfaction of receiving my first diagnosis. I wore it home gleefully (clutching my first ever prescription for psychiatric drugs), and introduced it proudly to my roommates. In the long run, though, the labels and services were not helpful. In fact, some of them were quite damaging, and I now typically credit my stubborn-born ‘non-compliance’ with saving my life.
However, many people are still caught up in desperation, hoping someone else does have the answer and praying for that answer to be easy and direct. Abstractions and complexities are not favored. Most people are more than ready and willing to grab ahold of any basic framework that at least seems like it might make some sense. Unfortunately, that leaves them particularly vulnerable to any brand of salesman, be his intentions honestly driven or not.
When I took my son in for his 9-year physical, the receptionist at the doctor’s office nonchalantly handed me a form to complete. After a few moments, I realized that the form was asking me to answer questions that were quite similar to what can be found on the M3. She had handed me a mental health screener for my 9-year-old son! When I refused to fill it out, my son’s doctor acknowledged that they actually get paid(!) for each completed mental health screener. I was stunned into silence and didn’t act fast enough to find out by whom they were paid, but after just a little bit of research I can say it at least seems clear who is paying Mental Health America. According to several documents (including their own website and annual reports), MHA has received literally millions in funds from pharmaceutical companies including Eli Lilly, Bristol-Myers Squibb, and Pfizer.
So, who does the M3 recommend seek treatment? Not surprisingly, just about everyone. According to the M3, scores over a 33 mean that one’s life may be impacted by a mood disorder and professional consultation should be sought. Alas, do not fear should you happen to land with a score of under 33! There’s a caveat that I uncovered when I backtracked and answered every question with a ‘rarely’ experienced, and managed a lowly 28. It read, “Your LOW overall M3 Score means that your condition is perhaps somewhat milder than average. However, mild symptoms still may have a negative effect on your well being and, when left untreated, can grow worse with time. You should find the time to contact your physician or a mental health care provider to begin a discussion of your M3 results.”
Looking deeper, there’s another frightening (but all-too-true) message to be found in the fine print. For individuals who report suicidal thinking, the M3 states that a mood or anxiety disorder can usually be ‘found.’ It goes on to say, “This is true even for those who feel that due to life circumstances they have legitimate reasons for having such thoughts.” Go figure. A person in distress goes to a provider who has been rigorously trained to diagnose people for both treatment and billing purposes. That person’s life circumstances are ignored – or at the very least, seen as somehow secondary – and the person comes out with a psychiatric label. Shocking. Given that those labels are applied strictly through a process of subjective opinion (there is, after all, no blood or any other sort of objective test for psychiatric labels) and cultural and financial pressure to come up with the ‘answer’ abounds, it should be no surprise that people end up diagnosed. And yet, what on earth does it prove?
Not once does the M3 ask, “Do you have the support you need,” or “What does this mean to you?” It fails entirely to raise issues about trauma, relationships and environment. (This is in spite of the fact that there are several articles about the Adverse Childhood Experiences [ACE] Study – one of the most influential studies available linking trauma histories to mental and physical health issues – on other parts of the MHA website.) Nowhere does it refer to the potential for support found with people other than medical professionals. (Pass the Zyprexa, please!) It does, however, come with a disclaimer: “The maker and provider of this form disclaims any liability, loss, or risk incurred as a consequence, directly or indirectly, from the use and application of any of this material.” The warning seems apt, given this mental health screener (like all others I’ve ever seen) appears to be specifically designed to feed anyone who takes it seriously into the same formulaic ‘treatment’ mill that has already harmed so many.
I am the number 60. In the past, I’ve been reduced to a label – Major Depression, Generalized Anxiety, Borderline Personality Disorder and more. Now I’m a number on a one-hundred point scale, but that number only seems to lead back to more of the same. Funny how, in actuality, I have managed to live without any of that for most of my 30’s. Yes, I still think about suicide. (I have since I was a teen.) Yes, I still experience a number of ups and downs. Yes, at times I still struggle more than some others might. And yet, I’ve learned that those same self-reflective, intensely analytical qualities that lead me to feel so deeply are also a large part of what make me good at the work that I do.
And that anger and hurt about what has happened to me in the past that sometimes still makes my mind race and floods me with images I can’t always control, it also energizes me to want to fight for social justice and change. The stark awareness of all that is painful around me makes some days hard to move through and leaves me feeling socially awkward in many situations, but also motivates me to want to keep going and be the best mother I can be to my two children. These are not symptoms waiting to be diagnosed. These are me as I have come to be with all I have learned and loved and lived through. This is life. Instead of disrupting my family, my work and all to which I am currently connected by following the M3’s recommendations, I think I’ll just keep living it.
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.