Mental Health; MDG

MentalHealthMatters: Start talking about mental health and substance abuse issues

We need to talk about mental health issues in this country.
Participants in Kansas City's community dialog created this poster on mental health issues. (Diana Reese for The Washington Post)
Participants in Kansas City’s community dialogue shared their thoughts on mental health issues. (Diana Reese for The Washington Post)
Some people are talking — in a series of meetings in 10 cities from Sacramento toWashington – as part of “Creating Community Solutions,” the outreach program begun when President Obama asked Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan to launch a National Dialogue on Mental Health this year.
These day-long dialogues, supported by a number of organizations and agencies, invited people to come together in smaller groups to discuss their views, experiences and recommendations for change when it comes to mental health and substance abuse issues.
“There has never been anything like this in the United States,” said Carolyn Lukensmeyer, the executive director of the National Institute for Civil Discourse, who’s coordinating the mental health dialogue.
(To register for Saturday’s event in Washington which marks the last day of Mental Illness Awareness Week, click here.)
People are also tweeting about it, using #MentalHealthMatters for the conversation.
Kansas City, Mo., hosted the third such meeting Sept. 21, after Sacramento and Albuquerque, with more than 360 participants, from teenagers to senior citizens. Of those attending, 32 percent were mental health providers, 72 percent had a family member or friend with mental health issues, and 55 percent had “direct personal experience” with mental health issues.
Sebelius, a former governor of Kansas, made a startling revelation in her opening remarks: Even with all her influence and the resources available to her, she had trouble getting help for two family members with mental health problems.
“All of us know someone facing behavioral health issues,” she said. “We need to get rid of the idea that it’s somebody else. It’s all of us.”
Indeed, one in five Americans experienced a mental health issue in 2011, according, and one in 20 lived with a serious mental illness like schizophrenia.
Kansas City participants were tested on their knowledge of mental health issues at the beginning and the conclusion of the day; many were surprised to learn that half of all mental disorders appear before the age of 14 and that 75 percent of them show up before age 24.
More surprises: At least 38,000 people in the United States die each year from suicide— that’s more than twice the number of murders in the United States. And despite scare-tactic headlines that indicate the contrary, only 3 percent to 5 percent of people with mental illness commit violent crimes.
Both Kansas City, Mo., Mayor Sly James and Kansas City, Kan., Mayor Mark Holland  stayed for the entire day — from 9 that morning until past 4 in the afternoon. On a Saturday.
Holland, like Sebelius, has had a family member with mental health problems; in his case, his grandfather had schizophrenia. “I know the roller coaster my family’s been on,” he said about the experience.
Holland also pointed out another disturbing trend. Too often, those struggling with mental health issues end up in jail instead of in treatment. About 35 percent of inmates in Wyandotte County, Kan., suffer from untreated mental health problems. “We’ve decided to warehouse people instead of treat people,” Holland said.
Access and affordability are major issues in treatment for mental illness and substance abuse. The Mental Health Parity and Addiction Equity Act should help correct that by putting treatment for mental health on the same level as treatment for a “physical” ailment like a broken bone or diabetes.
The Affordable Care Act will require coverage for mental health and substance use disorders as one of the 10 Essential Health Benefits; it also adds another layer of protection for mental health patients by preventing them from being turned down for insurance because of preexisting conditions.
“Nothing was harder than getting a patient into inpatient mental health care [without health insurance], even if they were a direct threat,”  Eileen Dreyer, a former emergency room nurse in St. Louis, told me. “I remember one time the cops brought in a guy who had been standing on one of the Mississippi River bridges, obviously ready to jump. When it was learned by the mental health coordinator that the young man had no insurance, we were assured he’d ‘only gone out there to think.’ I wish I knew what eventually happened to him. He should have been safe in a hospital.”
But it’s the stigma associated with mental illness that also keeps people from seeking treatment, and how to eliminate that stigma was a theme in the small-group discussions.
“People need to see mental health as another aspect of health,” Lukensmeyer told me in a phone interview. It should be viewed as just another health issue, like diabetes or heart attack. And it should be “taken as seriously as an errant cell in cancer.”
The issue of diagnosing and treating mental health early in young people (under age 24) was another big part of the discussion in Kansas City. The development of a K-12 curriculum on mental health, along with regular mental health screenings in the schools, were two of the most popular suggestions to increase help for youth under 18.
To get people talking about these issues is “exciting,” Lukensmeyer said. “We can do something about mental health issues in our community. We can take actions that will make a difference.”


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