May is Mental Health Awareness Month
Yes, we have made great progress in decreasing the stigma that exists regarding mental health issues and related treatment. However, we still have a long way to go. Several role models have recently “come out” in the media in an attempt to normalize mental health issues and to encourage open, honest discussion and treatment. The Duke and Duchess of Cambridge, Prince Harry and Lady Gaga for example, recently have shared their own struggles and emphasized that it is time to stop hiding mental health struggles and to discuss these issues in the same manner that we would discuss physical health issues. We all need to do our part!
What You Can Do.
Educate yourself about the possible symptoms of mental illness:
significant changes in appetite/ eating / weight or sleeping patterns
loss of interest in pleasurable activities
loss of interest in sex or sexual problems
decrease in motivation / energy / grades / work productivity
withdrawal from others and decreased social contacts
feelings of sadness / unhappiness or increased tearfulness
feelings of hopelessness / helplessness / despair
thoughts of self-harm or suicide
overwhelming feelings of anxiety / fear / rapid heartbeat / shortness of breath / sweating / dry mouth/ lightheadedness / dizziness
physical symptoms such as back pain / muscle pain and tension / chest pains / stiff neck / general aches and pains / headaches / stomach issues / constipation / diarrhea
high blood pressure
trouble concentrating / slowed thinking and decision making
increased anger / irritability / frustration / guilt feelings
self-medicating with alcohol, drugs, gambling or sex
literally hearing or seeing things that others tell you are not there
literally hearing voices telling you to do things or believe certain things
feeling as though people are out to get you, steal your thoughts, harm you in some way, broadcast to you over the TV or via some other means
Point out your concerns to others who may be struggling:
If you have concerns about someone you care about, gently point out your concerns to them. Educate as to the symptoms of mental illness and how you see those symptoms expressed in them. Encourage them to reach out for help. An option is to start with their primary care physician or nurse practitioner.
Share your own struggles with others:
If you are struggling with mental health symptoms or receiving treatment, share that information with others. This is part of normalizing the situation and letting others know that they are not alone and that it is OK to speak about their struggles and receive effective help. Once you open up and share, you will be surprised how many others will also share and may feel as though they have “permission” to do so.
Be aware of your own attitudes and judgements:
Whether you are a patient or a loved one, we all need be very mindfully aware of our preconceived notions about mental illness and related treatments. We often refer to those who have a physical diagnosis as struggling with cancer, diabetes, migraine headaches etc. We do not say that they are those diagnoses. However, we often say that people are depressed, anxious, schizophrenic etc. People are not those things. That is not their identity. Let’s change our attitudes, wording and expressions related to these diagnoses. Correct others when you hear that their expressions or their attitudes are not conducive to the goal of decreasing the mental health stigma. Encourage others to look at the positive qualities in everyone, regardless of their struggles.
Advocate for mental health reform:
Many who struggle with mental health and or drug/alcohol issues are treated as criminals by the judicial system. More and more court systems have a mental health court in place, although this is not true in general. We must advocate for the mental health treatment of those who often end up in the court system and ending criminalization of the mentally ill.
Likewise, we all need to speak with insurance carriers, local state and national mental health organizations and legislatures to educate and urge them to show parity between mental health and physical health issues.
What Providers Can Do.
Point out the symptoms you are witnessing:
Many physicians, nurses, dentists, physical therapists, massage therapists, and other providers are hesitant to share the concerns they are witnessing in their patients. I am often told that they do not want to offend anyone. This reasoning challenges the Hippocratic Oath to do no harm. It is not in the consumer’s best interest and actually promotes the mental health stigma.
Make a referral for the appropriate level of care:
Making a referral for the appropriate level of care in mental health may be the most helpful thing you can do for your patient. In addition to being aware of the above mentioned mental health symptoms, it would also be helpful to become educated about different levels of care in mental health. There is individual treatment usually on a weekly or biweekly basis or there is intensive outpatient treatment for those who need more than they are able to achieve individually. This level of care typically consists of attendance 3 days per week, 3 hours per day for approximately 7 weeks. Partial Hospitalization is even more intense, where an individual will attend 5 days per week and return home at night. Inpatient or Residential treatment involves 24 hour care for a period of time. A referral to a qualified mental health professional providing several levels of care will assist you in determining the most appropriate disposition for your patient.
Make a referral when asked to complete disability paperwork:
Many providers are asked to complete FMLA or other disability paperwork on behalf of their patients who are experiencing mental health issues or severe stress, depression or anxiety within the work environment. The best thing those providers can do is to again educate their patients about the symptoms of mental illness and refer them for the appropriate level of care. They should not be sitting at home with time off, hoping to get better. Many of them need higher levels of rehabilitative care, such as an Intensive Outpatient Program.
Know where to refer:
Have a list of centers where help can be received in a safe, comfortable setting. Check out their websites. Look at patient testimonials. Those centers and facilities should be
able to provide information regarding levels of care, improvement and success rates. Share these with your patients. Refer your patients and family members to The National Alliance for Mentally Ill for additional support.
In conclusion, please remember that many mental health diagnoses are the result of biochemical imbalances. Although those imbalances can be triggered by life stressors and poor coping skills to deal with those life stressors, those imbalances are inherent and genetically predisposed. We all have a responsibility to become educated about mental health issues and to do our part to decrease the stigma that many are prisoner to on a daily basis. Educate yourself, your patients, and your loved ones as to where to get effective help and at the appropriate level of care.
John A. Glovan, Psy.D.
Director, Health and Wellness Program