World Mental Health Day is a time to celebrate the substantial advances we have made in promoting and protecting mental health while acknowledging the challenges we still face.
Over the last decade, the stigma of admitting and seeking help for mental health issues has been significantly reduced. In addition to formal media attention, “everyday, regular people” have been openly writing, posting and blogging about their encounters with anxiety, depression, substance abuse and other mental health problems.
People are discussing their personal suffering as well as how they have been impacted by the suffering or even horrible loss of friends and family members. At the same time, celebrities and others of renown no longer routinely shield the public from their struggles. Even personalities considered “macho heroes” have very commendably spoken clearly and passionately of the need to acknowledge and seek help for emotional difficulties. These include actor Dwayne Johnson and rock legend Bruce Springsteen.
However, too many people (again, from every station of life) are still fearful of allowing friends, family and/or employers/fans to know of their troubles; or assume that seeking mental health treatment will be an indelible negative mark on their future.
We are slowly moving toward viewing mental illness and addiction as problems that can afflict anyone, of any social circumstances, from any background, in any family.
We are becoming more aware that mental illness is neither a “weakness” nor a “moral failing.” Mental illness and addiction are conditions to be addressed with care, compassion and appropriate intervention — rather than reasons to denigrate, demean or bully the person who is suffering (or sadistically standing back with a holier-than-thou sneer while “watching the train wreck”).
Compared to even a dozen years ago, we currently have numerous additional psychotropic medications to efficaciously treat moderate and severe mental illness — anxiety, depression, ADHD, PTSD, bipolar disorder, psychosis, etc. — Persons who not long ago could receive, at best, some partial relief from their malaise and compassionate supportive care now can have their suffering and symptomatology significantly reduced, put into remission or even resolved.
None of these medications are perfectly effective and all require a careful weighing of potential benefits against possible significant or serious side-effects. While much more research is needed to approach an optimal ability to provide safe and effective psychopharmacological intervention, many people are now leading reasonably comfortable and productive lives that would not have been possible less than a generation ago.
Prescribing professionals, pharmaceutical researchers and the public need to understand that, as in every other field of medicine, the use of powerful medications can be extremely effective but is neither a panacea nor a dangerous scourge.
Notable advances have also been made in addressing less-serious but still disruptive emotional and psychosocial problems through different types of counseling, stress-reduction techniques and supportive interventions.
We understand much more regarding what protocols are usually most effective for specific issues such as emotional lability, impulsivity, substance abuse and/or interpersonal difficulties. We don’t have to rely on a single therapy. Nonetheless, progress in this area has been somewhat hampered by an ongoing quixotic search for a “quick fix” and an over-reliance on psychopharmacological intervention.
Narrowly-focused approaches may reduce specific symptoms but will not improve coping skills or resolve acute or chronic personal or interpersonal conflicts.
Fortunately, we now have many additional safe and effective mental health treatment protocols available; unfortunately, many interventions are still too expensive or, shortsightedly, not covered by medical insurance. There needs to be additional education to the fact that addressing an individual’s emotional struggles not only allows that person to be more comfortable and productive but reduces the risk of distress, dysfunction and disability occurring in related friends, family and co-workers.
The short-term financial cost of treating mental illness is not negligible. Medications can be expensive. Comprehensive counseling can be time-consuming and involve significant cost.
At times, without a period of respite from every-day demands, such as via a hospitalization or a full or partial residential mental health treatment program, sufficient progress cannot be made to restore adequate safety and functioning. Addressing substance abuse requires medically-informed detoxification, sophisticated use of counseling and possibly medication as well as supportive involvement in the treatment of family members and significant others.
Especially on World Mental Health Day, we should be extremely thankful for the growing knowledge regarding identifying and treating all forms of mental illness. Even if there are significant short-term expenses to be paid, the long-term financial and human price of ignoring mental illness is exponentially costlier.
This day should be a time of celebrating the meaningful progress we have made in recognizing, accepting and being able to provide treatment for mental illness and emotional/psychosocial problems.
World Mental Health Day should be a time of embracing the task of committing ourselves to push further toward reducing distress and tragedy and promoting the scientific and technical advances that are serving to render such suffering unnecessary.
David M. Reiss, M.D., psychiatrist, private practice, San Diego, CA
The views expressed by contributors are their own and not the views of The Hill.