Jan 12, 2013

"Our Mental Health System is Terrible"

Oh yes. Oh yes it is. It is difficult to access, impossible in some cases, expensive, rarely comprehensive and laden with taboo and stigma. I will not deny this. I could give a case in point at the effort, personal and monetarily,  it takes a for even a functionally troubled person to access mental health services in our society. But that isn't my point

I've been reading this statement, frequently these days, often in response to events of violence, or suicide. And while I agree I am struck with many things: mainly many assumptions, the macro judgement of such statement, and how many jumps there are from point A to point Z. When it strikes me there is so much more going on that one can't even enumerate the issues. But I'll give it a try:

1. First off: our HEALTH system sucks. Antiquated, with huge gaps, it allows huge chunks of the population to go without necessary, often inexpensive preventative healthcare, forcing them to access care at it's most critical point, when things have become so inflamed, so aggravated, that care is ten times as expensive, and often more complicated and less effective than it would have been if caught at an earlier point.
         A. Our mental health system is a subset of this with even less access, even less services available. Even those with comprehensive  health insurance often find they cannot access the mental health services they need. And they effect each other in both a loop and continuum like a mobius strip.
         B. Our physical health system has a catchall, a last ditch effort to prevent death: the emergency room,  and so does our mental health system: they will commit you! Temporarily! Depending on how much you are danger to yourself and others
            i. while many health conditions can be recognized well before the moment of death or true damage, mental health conditions may not present as such...slowly moving towards suicide, having bad bad thoughts? bummer. wait until you are truly on the edge...
            ii. if you go to the er with a truly concerning "symptom" that appears alarming they will test you and try to keep you from getting worse. not so much with mental health, unless that symptom is suicidal rage
           iii. mental health conditions do not have quick fixes like antibiotics or adjusting meds many times. they are stopping you from hurting someone, not helping your actual illness
           iv  people having a breakdown don't tend to want to wait during triage in an ER
           v. and so on.

2. Our ATTITUDE AROUND HEALTH SUCKS.  This is a bigger key point to me. Health in America centers around lack of pain. Ways to cure symptoms. Drugs to mask issues. Quick fix dietary solutions and the demonization of foods, drugs, and other pieces of daily life vs. a holistic approach at obtaining maximum performance from our body and brain, at finding balance, at finding health.  As entitled as we seem to towards comfort, we have a weird attitude about deserving and pursuing actual health... and this effects our mental health.

3. Logically, given my structure,  this should maybe be a subpoint, but it really isn't, because we've learned to separate our heads from our bodies pretty successfully, and that is my main point here, and it is HUGE in my mind.  Which is to say OUR ATTITUDE TOWARDS MENTAL HEALTH SUCKS.
          i. our attitude towards those experiencing anything other than sunshine and rainbows is intolerance, annoyance and fear. Seriously, when people express "bad thoughts" we are trained to deny them, argue them out of it, find a quick fix solution. What does this tell people other than they aren't allowed to be sad, mad, frustrated, or disenheartened.
          ii nowhere is blaming/shaming the victim more evident than with those experiencing a mental health issue or dilemma. dude, pull yourself together. be stronger. turn that frown upside down. motivate. this doesn't bother johnny! and that is just the minor note. the whole symphony communicates that you should be stronger than to be controlled by your thoughts and emotions, and down right ashamed if you let them truly bother you or effect your health or success
         iii people are trained to avoid, look away and otherwise deny signs of mental illness. you can see it. they look away like they do from a bleeding wound. I can't think of how many times I or someone I know has said "there is something wrong with person A" only to have people deny it up and down, to try and pretend it is not there. and that is just people beginning to experience mental health issues. I guess it scares them. about the person having an issue and about themselves
       iv we like to exaggerate things around these parts, which makes it hard for someone to seek help around the time they start to suspect there is a problem. I mean, if someone's blood pressure was elevated and they went to the doctor or hired a physical trainer we wouldn't look down on them for trying to help themselves, or act like they were dying or sidle them with a label. But people who are experiencing mental health issues that they suspect may be about to increase, or block their ability to live a fulfilling productive life are not encouraged to do so. They are sidled with thoughts like "crazy" and "problemed" versus congratulated for looking after their health.

And I am not even getting into the variety of ways our society cultivates the anxiety, depression, hopelessness and neurosis that might bring people to this point.

But I just want to diverge a little a few of my sub points.
-Not every society believes that people have the burden of always believing and thinking happy thoughts, not every culture labels and judges thoughts so harshly. The way we view feelings, and especially talking about feelings (and this goes triply so for men)...especially "negative" feelings encourages people to bottle things up, act out, increase  aggression, and makes the entire world of mental health access that much more problematic. You have people with everything in the world to live for, feeling trapped, stressed, overwhelmed and sick.  Perhaps if we allowed people to express a variety of emotions and thoughts from a young age, allowed them to work through them without value judgement, this would be less of an issue and they would be more apt to let you know when someone was wrong at an actionable time, more apt to make health decisions.

-I truly think that we are not trained to really look and evaluate people in this society, for fear of what we might find, and what it might say about ourselves. Critical judgement and value judgement are not the same thing, and learning to listen closely, look closely, take in what people are telling us, in a variety of ways, is invaluable.  It is fascinating. We are all about value judgement...we'll examine some one's weight, or hair, and deem them lesser or more,  but not look in their eyes, take in the various physical and verbal cues letting us know when they are not okay. People walk about throwing up sparks and all we do is jump out of the way...no one checks their thermostat, no one offers them a wet wash cloth. I guess we fear insulting people, I guess we fear what it might say about us if our close ones are sad, or very simply not okay.

And there is more. And to be clear, this is just my highly unprofessional personal opinion. But I think about this a lot. Especially in response to some of the facebook posts and articles in wake of some of the more recent violent tragedies. Yes, we need better access to mental health, yes better evaluation of how we interact with violence, violent weapons etc. But also key: a different attitude in how we interact with those needing mental and physical is needed, with a more pragmatic, open and caring approach that allows people to be sick so we can help them heal. So we can help them be healthy.
If you won't look at the wound you can't heal it.




Anonymous said...

Here here. And thank you for making the leap to advocate. As a health care professional, your opinion carries greater weight. Why, may I ask, do you use the term "unprofessional"? Is it unprofessional to profess an informed opinion?

daff0dil said...

I am not a mental health professional. I am not a psychiatrist.I am not a sociologist or a political theorist. Just because I work in the healthcare field does not mean I am an expert in all areas of it, and I wanted to make clear that this was just my opinion, not an expert one, not one expressed in a professional capacity.

Also while I work for an wonderful healthcare agency and have many years in the healthcare arena, I would not want to represent my opinion in any official capacity, that too would be unprofessional.

It was, again, a poor choice of words, thank you for calling that to my attention.

It should read, this is my personal, inexpert opinion.