We hear all the time how this person or that is battling one disease or another. We often hear of someone losing their battle with cancer in the knowledge that they have passed away due to it. In general, the rationalization is that if you win your battle with a disease, you survive it, but if you lose your fight, you die from it. This holds true in every case except mental health. Mental disorders or diseases are the only diseases you win your battle with by also dying. Dark right? OMG, why is this guy writing such a horrible thing? Which is probably what you should be thinking right now. Unfortunately, it is true and until people, and especially medical professionals and politicians start looking at it this way, life, what of it we have, will be exponentially difficult for people with mental illness.
First off, mental illness is the one group of common diseases that the world still shies from discussing. They are our last medical “dirty little secret,” and we need to stop that immediately. To be quite frank, mental illness of some type in the US alone is more common than hearing loss which affects an estimated one in seven people. In fact, mental illness, with its average of affecting one in four, is more prevalent than heart disease, diabetes, and obesity. The only ailment in our country right now that rivals mental disorders in fatal prevalence, is cancer. The tragic truth here is, cancer can be survived. It can be cured or at least removed. Forty percent of all cancer survivors will be deemed cancer free at some point after their initial diagnosis. They will be likely to have cancer reappear, but for some point, after they get it, many people will not have cancer anymore. However, in the case of every mental disorder, there is no cure. At all.
Mental illness can not be cured, it can not be removed, not even for a little while. It can be managed to varying degrees, but to put it bluntly, every single person diagnosed with a mental disorder will die with that disorder. Knowing this, how does one win their battle with mental illness?
Unfortunately, every single person who is diagnosed with a mental disorder will only win their fight with that disorder when they die from something not mentally related. To put it another way, the only cure for mental illness right now is death, the only indicator of winning or losing your battle with it is how you die. More people worldwide have died with or from mental illness in the last five years than died from gunshot wounds during the Vietnam war, and we as a civilization are hiding it, minimizing it, and for the most part ignoring it. Depression in America kills more people here than AIDS every year. Where are the marches? Where are the rallies? Where are the pamphlets in the schools telling people how to keep themselves safe, how to find help and how to manage it better? We spent nearly two years raising all the funds the internet could find for ALS, while more people have died with Bipolar disorder in the last four years than have from ALS since we discovered and named it. Where are the viral videos and fundraisers for the Bipolar Ice Bucket challenge or whatever?
Until we as a society take mental health seriously, until our government starts spending as much money on research and care for the mentally ill as they do for methadone clinics, until our medical personnel are trained as thoroughly to diagnose and treat mental health as they are sexual health, this will continue. Until mental health issues are covered by insurance companies at the same percentages as other diseases, people will continue to die from mental health care failures, and at an ever-increasing rate.
Why am I on this soapbox? My eyes were just opened to this issue when my father passed away. He battled Bipolar disorder for forty-nine years, and when he passed away peacefully in his sleep, we celebrated the fact that he had won his battle with mental illness. What did that mean? What we really meant was that he never chose suicide as an end to his disease. Why in the hell would we think or feel that? Very simply, it was an option. We as his family had braced ourselves years earlier to that probability. We had helped him every way we could, he had doctors and mental health care professionals that he consulted, the medication that he took, therapy that he attended, but in the back of our minds, we knew that he always had the option to end his sentence. In his case, all his hard work, all our support, all the medical and mental health professionals, it all worked. He won his fight, but only by dying of something else. Then I realized how disgusting and utterly unacceptable this mindset is. I started to look at other health issues, and I realized that mental health is probably the last medical vocation where accepting the fact that you will die with your disease is the preferred outcome as long as you don’t kill yourself or anyone else while living with it as long as possible. I will discuss my own journey a bit later, but for now, let’s stay on track.
Our handling of mental illness is so substandard compared to other diseases that we have even created different vernacular to describe the end of life options. If a cancer patient decides that they are in so much pain that they choose to end their life, that is euthanasia, if a mental patent does that, it is suicide. Our inability as a culture to accept that mental illness causes as much pain as physical illness is sickening to me.
Physical illness is considered a tragedy, something beyond one’s control and many concessions are made to facilitate people who are affected. Look no further than our ADA accessibility laws for a prime example of this. If your legs or your eyes are damaged, special treatment is expected. Ramps are installed, audible queues, provisions for leader dogs, special parking, the examples are endless. Conversely, how many accessibility options are required for the mentally disabled? Do we have clubs with code required quiet rooms so that the people anxiety disorders can enjoy them? Do we enforce cleanliness or organizational guidelines in grocery stores so those suffering with OCD can shop more easily? Do we ban videos that have graphic battle scenes to protect and facilitate those with PTSD? “Of course not!” “Don’t go overboard.” “We can’t bubble-wrap the world.” These are the responses to these ideas that I hear every time I bring this up, but my response is “Why not? Imagine if my response to your demand for a wheelchair ramp was “Just choose to go to a place that has one,” Or “we can’t bubble-wrap the world,” or “these people are just going to have to adapt.” That would sound harsh, cold, and ludicrous. If I said something that heartless and uncaring, I would be crucified and rightly so, but these are the very attitudes that are displayed as soon as any concession is proposed for the mentally ill. Heck, most people are afraid to even talk about mental health in more than vague, amorphous terms.
The stigma our society attaches to mental health is so strong that if I check “yes” to occasional recreational drug use on a medical questionnaire no one bats an eye or asks any further questions. If however, I check yes to the “do you feel desperate or overwhelmed” or heaven forbid the “do you have thoughts of harming yourself” questions then everyone panics, they run for the straight jackets and sedatives then have hushed conversations about a suicide watch. No wonder most people, especially kids, are afraid, to tell the truth about how and what they feel. Back to my example above, if I did admit to drug use, the doctor would have a calm, reasonable discussion with me regarding the dangers, the causes and the outcomes of my choice. Wouldn’t that also be a better response to thoughts of self-harm? And this is the nugget at the core of my rant here. When we overreact and treat the mentally ill as the second-rate, or the permanently flawed, we reinforce in them the thought that there is no help, no hope.
If instead, we greeted them warmly, with love, companion and kindness, and with actual medical knowledge, a realistic treatment plan and a proper bedside manner would they accept help with their condition more easily and start working to survive it the same way cancer patients do? Conversely, if we treated cancer patients with the same cold deference and standoffish bluntness, wouldn’t more of them decide that it was hopeless and just give up? Patients with a terminal illness live longer and happier when they are informed of their disease and its outcome by a caring human who shows hope, love, and kindness, then backs that up with real options including calculated treatment plans, medications, and reassurance of positive outcomes.
The only way to see this real change in our society is to start educating people about mental health. We need to talk openly and freely about mental health, depression, and suicide. We need to destigmatize these issues then throw research money at them the way we did cancer and AIDS in the past. While we do that, we need to teach and encourage our health care providers to take a second look at how they treat mental health patients, and how they diagnose and treat these diseases. When we do that, we will begin to see a decrease in the number of fatalities caused by it, because unlike cancer, which can kill you directly, most mental health issues can’t. They just make you WANT to die, and medical professionals, in my opinion, are more often reinforcing that want by making it the only perceivable solution due to a lack of compassion, a lack of education, and a lack of affordable specialists and treatments.
Now as I promised near the beginning of this, lets talk about my own experiences, During this loss of my father, I realized that I also had some issues I needed to address and in my attempt to do that, I came face to face with the massive differences between mental health care and all other types of healthcare. Most notably, the fact that my insurance, which is some of the best available to my family, only covers mental health at 50%, making psychiatric health care in my case 30% more expensive than cancer treatment or a broken leg. (both of which cost the public much less over the long run as cancer can be successfully treated and/or cured in so many cases, a broken leg has a 100% recovery expectation, and neither poses a broader health threat to the public if untreated.) Then my research took me to the fact that quality, reputable mental health care is basically unavailable to anyone without insurance or on social services. Yes, they are technically offered and your caseworker will “tell” you there are people there to help, but in most cases, these people are overbooked, understaffed, or just burned out by the sheer volume of cases they are loaded with to the point that offering proper compassionate quality care is just not an option. Don’t get me wrong, I am not in any way putting this on the health care workers. I am not blaming them. I am pointing out a problem in our society where it is more common to fight for funding for places like the free methadone clinic or planned parenthood while completely leaving the public mental health services unfunded and understaffed. Again, I am asserting that if we as a country spent as much on mental health treatment as we do on sexual issues, unplanned pregnancies, or drug addictions, this massive gap in help and treatment of this hugely underserved and vast portion of our population, these patients quality of life may increase to the point were there is hope other than suicide, a point where death isn’t the only way out of mental illness. Additionally, if we address these patients in this way, the threat that some few of them pose to society, in general, would be greatly reduced, thus providing a immediate measurable benefit for the rest of us.
Now back to my own revelations, I found that along with the anxiety issues which I have suffered from and dealt with since childhood, I now had a new, very foreign problem to deal with, grief. In my search for assistance with this new issue, I ran across a service online called BetterHelp. They are not a sponsor (but as I so often state, I would love it if they were) They are instead a service which I use, I pay for, and I am growing to deeply appreciate. They are confidential, secure, and not as expensive as some other local therapists and grief counselors are. Also, since they are not local to me, I am more comfortable talking to them about specific issues as I know my problems will not end up being the water cooler chat at the local hospital, or parish. They also have convenient times, often after hours, which work wonderfully for me, and they have a scholarship program so that people in need can get help at a reduced rate. Lastly, because they are a large network, they were able to refer me to a licensed, certified professional that specializes in my exact need, in my case grief and loss. All of these things together made BetterHelp the very best choice for me and I can sincerely say, if you need help, if you have issues and can’t get help, don’t know where to turn or where to start, give them a look, they may be the help you need to get on the road to a better, happier you. This is not an ad and BetterHelp is not a sponsor, but they are important enough for me to name by brand.
In closing I would like to reiterate; kindness, love, and compassion from you and I, backed up with real science, positive action, and a real budget at the state or federal level, could change the world for its largest group of suffering people. Will you choose to be that change? Will you be the one that looks around sees the mental health crisis we as a world are in and decide to change it? If so, these are the steps as I see them.
One, talk openly about feelings, about depression, about mental health, and most importantly about seeking help. If you talk about it openly and often, your family and friends will hear you and may realize that getting help doesn’t equal weakness. Be open, be honest and let everyone around you know that you care and you will help them if they need you. By reducing the stigma attached to mental health issues, we increase the number of suffering people willing to seek help.
Two, Vote. Make the government change what you don’t like by voting your feelings. They work for you, so only hire people who have a solution that you accept. You are a unique person with your own worldview and morals. Vote those. Only when people in power realize that the only way to get or keep their jobs it to fix this will there be real reform and real advances to the treatment of mental health on the national level.
Three, Show everyone love and kindness. You never know what kind of a crisis that person in front of you is having. A simple smile or a kind word could make all the difference in their world right then, heck, a small showing of love and compassion could save a life. It could show them the hope they need not opt out, or the kindness to not hurt others.
It has to start somewhere, let that change begin with you and me.