Karen A. Adler, MD
(1) Humans are one type of animal.
(2) The brain is one part of the body.
(3) The brain is what gives rise to both mental functions and mental illness.
(4) Humans can influence both mental and physical health, but cannot fully control either.
I'm sure that many of you are reading this and thinking "Okay...obviously... and what's your point?" I certainly would be. But herein lies the problem. Whether we are aware of it or not, as a society we have ended up understanding and treating mental illness and those affected by it as if:
(1) Humans are fundamentally different from all other living creatures on earth, including our closest animal relatives.
(2) The mind is separate from the body.
(3) Mental illness is fundamentally different from illnesses that affect the other organ systems of the body (for simplicity let's call these physical illnesses).
(4) Humans have no control over a physical illness like cancer, but ought to be able to "snap out of" mental illnesses such as anxiety and depression.
Now some of you are thinking, "you are over-simplifying and over-generalizing - educated and informed people do not think that way." To which I will say, yes and no. Let me show you what I mean.
Which of these statements makes more sense/sounds more familiar to you:
(1) Mr. Z has high blood pressure as a result of his impaired kidney functioning, but he shouldn't take anti-hypertensive medication because the problem is "all in his kidney."
(2) Mr. Z gets chest pain and shortness of breath at times due to severe anxiety, but he shouldn't treat these symptoms because "nothing is really wrong, it's all in his head."
Or how about these two:
(1) I'm not too concerned that my pet cat can no longer walk to the litter box on her own because her mind is what matters most.
(2) My grandmother needs help walking and going to the bathroom, but her mind is still sharp and that's what matters most.
Now do you see my point? And do you see what the underlying assumptions are that make statement (1) sound so much more strange and unexpected than statement (2) in the examples?
So let's accept my premise for the moment and examine some of the far-reaching implications of these faulty assumptions as related to mental health care.
Stigma and blame around mental illness, both by outsiders and those directly affected, creating shame and secrecy about seeking treatment
Different rules about insurance coverage of treatment for mental vs physical illness
Different patterns of payment
Fragmentation of care providers across disciplines and locations
Lack of connection between physical health and mental health providers and systems of care delivery
Too much ability/responsibility placed on the patient to control symptoms in mental illness and too little in physical illness
Lower levels of federal funding for research on mental vs physical health
Not realizing how much we already know about why we think and feel and act certain ways because we aren't applying what we know about similar animals.
In this blog, we will explore each of these topics in greater depth as well as potential solutions and innovations. We will post news and information about new initiatives being explored or implemented, but also work together to share our own ideas and experiences. This is a place for anyone who is involved with mental health care in any role to come together to hear each other's stories and exchange ideas. I want to hear from you! Are you a health care provider or peer specialist with experiences or ideas to share? A person with mental illness who has thoughts on what could be improved about the process of getting help? A family member/loved one who has experienced the frustration and heartbreak of trying to get help for someone you love only to find that there is no help available unless they can pay out of pocket or go to an emergency room and wait for many hours or even days? Or maybe a first responder or teacher or health care provider outside of a mental health specialty who has front-line experience? Contact me or leave a comment and share your perspective. If you would like to expand your thoughts into a post of your own please send me a message and I'll be happy to work with you!
