Smashing the Stigma
We all have or had that one not-exactly-right family member that we not-so-secretly wished didn't make it to those family gatherings each time. Or maybe we did, because we were nihilists and it would make the typically boring get-togethers a whole lot more interesting and unpredictable.
More than 1 in every 6 American has a mental illness, according to the National Institute of Mental Health. That's 17.9%, to be exact. A stat that doesn't even account for our homeless population. When you add in that the low estimates diagnose 1 in every 5 of our homeless as mentally ill, you're talking about very safe estimates of over 43 and a half million of us that suffer from a mental illness.
And it's not surprising to see why less than 15% of Americans seek help for their mental health. The stigma is real. The perception of weakness behind acknowledging any kind of mental health help is strong. The labels are tattoos on your name with no option for laser removal.
If we as a society are serious are about making our cities safer, making our mentally ill healthier, more financially independent and therefore all of us in a better place, some things need to change.
What Needs To Change
Make mental health a part of the regular societal dialogue. And not just when there's a mass shooting. Not just when gun enthusiasts hijack the gun regulation narrative to blame a tragedy solely on our mental health system. (Instead of redirecting the talk from gun rights to mental health to demonize it, how about we just collectively make it harder for those diagnosed with severe mental health disorders to obtain a firearm?) People stigmatize and demonize those of which they are not knowledgeable about. Let's educate the public and make it socially acceptable to recognize, empathize and understand mental illnesses. With the number before of about 1 in 6, the odds are fairly high we all encounter someone on a regular basis struggling with their own mental health.
Not have such itchy ink fingers for signing off on psychotropic prescriptions. Psychotropic medications are those most commonly prescribed with a mental illness. Millions of people are on psychotropic medications every year. More than 78 million Americans, to be more clear. And while many of those are absolutely needed and beneficial, just as many are not.
For our nation's foster care system specifically, a report by the inspector general at Health and Human Services found quality of care concerns in more than two-thirds of claims for psychotropic drugs paid for by Medicaid, the health insurer for most children in foster care. That included too many drugs (37 percent); wrong dose (23 percent); poor monitoring (53 percent); or wrong treatment (41 percent).
We do the tens of millions of Americans that are treated for a mental illness a great disservice when they're shuffled recklessly through a healthcare system that is deeply rooted in the interests of a privatized pharmaceutical industry making over $10 billion a year in profits ensuring we're all medicated. Needed or not. Safely or not.
Return the funding to mental health treatment. Federal funding for mental health services has been dropping since the '80's. Government monies spent for private industry like Big Pharma and our medical providers has led to mass exploits due to a lack of transparency. Any amounts of money, let alone millions, spent to private industries with no oversight, will lead to corruption 101 times out of 100. And no one's naive enough to think there will ever be a budget without waste. But more transparency can go a long way to more efficient allocation of funds.
To possibly invest in more clinical psychologists, or as they're typically called, therapists. The way the system currently operates, is you're paired with a psychiatrist and a therapist. The initial psychiatry visit will follow right after your initial therapy visit. That psychiatry appointment will often be both an opportunity to meet you and decide to prescribe you a medication within that first visit. The fact that this is common means that psychiatrist needs to be incredibly accurate with their diagnoses and pin-pointing the most appropriate medications for that individual. But far too often, that is not the case.
"There is a huge financial incentive for psychiatrists to prescribe instead of doing psychotherapy," he says. "You can make two, three, four times as much money being a prescriber than a therapist," says Daniel Carlat, MD, associate clinical professor of psychiatry at Tufts University. Instead of incentivizing psychiatrists to churn out as many pill-dependent customers as time efficient as possible, the treatment model should be re-evaluated to seek therapy, first and foremost. And because short term, once a week, outpatient treatment is often not enough, more frequent sessions for therapists, when the clients can, should be welcomed. Only after a series of therapy appointments, when necessary, should a psychiatry appointment be made.
The incentive for insurance companies are there, as well. Many studies have shown the trend of over-prescribing medications has grown with increasing medical costs. Medical costs that they are looked to cover. Lower medical costs can lead to savings on premiums for them in the long run.
The mentally ill aren't all a bunch of people that hear voices. They're not pariah's. They're your brother, friend, mother, neighbor, cousin or co-worker. And by making some changes to the way we treat the term and process of mental health, we can make it a much more comfortable experience for everyone going forward.