We are pleased that Paul John Scott was able to benefit from medication and therapy so that his anxiety and depression did not become disabling (“Mental illness: Want to talk about it?” Dec. 8). Success stories like his provide hope for others.
However, mental illnesses vary enormously in severity, complexity and duration. Some people who live with very serious forms of mental illness have not been able to find treatment that alleviates their symptoms. They struggle with the everyday activities of life and face their illness with great courage and determination. Many people with mental illnesses and their families felt Scott’s commentary oversimplified the barriers they and others face.
While the stigma surrounding mental illnesses has lessened some, making it easy for Scott to share his story, discrimination resulting from it persists in ways both big and small. People still wait too long to ask for help and to access care. People do not feel that they can disclose their mental illness to an employer. We see the poor outcomes reflected in dropout rates, high unemployment, incarceration, homelessness and suicide.
Research on how to reduce stigma does suggest that simply saying it’s a biological illness doesn’t help. The public then believes people with mental illness can’t control their behaviors and should be avoided. The “Make It OK” campaign is promoting a deeper understanding that mental illnesses can be treated, that common myths related to violence are untrue, that treatment of mental illness is effective for many, and that mental illnesses affect people from all walks of life — which is why it is so important that people share their stories.
The Make It OK campaign is about much more than reducing stigma so that people get care. It’s about making sure that people receive the support from family and friends they would for any other illness. Most people with mental illness don’t receive get-well cards while hospitalized, and their families aren’t brought hot dishes. The Make It OK campaign aims at ending the isolation many experience on their journey.
Scott also ignores the wide range of evidence-based treatments being promoted for people who experience a range of mental illnesses. Not one of us believes that taking a pill is all that is necessary to alleviate the symptoms of a mental illness. Minnesota has undertaken herculean efforts to introduce evidence-based practices in adult and children’s mental health so people, as informed consumers, can ask for the therapies and supports that will be most effective for their particular diagnosis. These practices include peer specialists, who are people with mental illness employed to help in the recovery of others, and other approaches developed by people with mental illness.
To address the sometimes devastating impact of the symptoms of mental illnesses, we also need to look holistically at the financial, social, spiritual, occupational, physical, intellectual, environmental and emotional aspects of an individual’s life.
Most troubling is Scott’s assertion that mental illness has no biological basis. Dr. Wayne Goodman, whom Scott quotes in his commentary, is head of the Mount Sinai Medical Center’s Department of Psychiatry, whose focus is on genetics and neuroscience research to create a better understanding of “molecular, cellular and brain circuitry alterations in medical disorders.” The U.S. Surgeon General in his landmark report stated that while the precise causes of mental illnesses are not yet known, “the broad forces that shape them are known: these are biological, psychological and social/culture factors.” We know that genetics, environment and biology all play a role.
The director of the National Institute of Mental Health, Dr. Thomas R. Insel, believes that mental illnesses should be viewed like heart disease, diabetes or any other chronic illness. He believes that, thanks to technology, we are on the frontier of brain research that will help not only people with mental illnesses but people with Alzheimer’s, Parkinson’s, autism and other illnesses.
Those of us who are invested in improving Minnesota’s mental health system know that there is no single treatment or one-size-fits-all solution for individuals with mental illnesses. But we support use of a range of proven therapies and wellness strategies. We know that, along with clinical research, improving mental health care also means championing equal coverage under insurance, access to housing and employment, and a supportive community. Those of us working on these issues, including people who live with a mental illness and their families, all know that mental illnesses are real illnesses that affect the body, mind and spirit and that recovery is not as simple as willing yourself to be better. It requires a variety of strategies and, most important, hope.
Sue Abderholden is executive director of the National Alliance on Mental Illness-Minnesota; Lucinda E. Jesson is commissioner of the Minnesota Department of Human Services; Edward Ehlinger is commissioner of the Minnesota Department of Health. This article was also submitted on behalf of Julie Brunner, executive director of the Minnesota Council of Health Plans; Cindy Firkins Smith, president, Minnesota Medical Association; Carrie Borchardt, president, Minnesota Psychiatric Society; Deborah Saxhaug, executive director, Minnesota Association for Children’s Mental Health; Edward T. Eide, executive director, Mental Health Association of Minnesota; Mary Regan, executive director, Minnesota Council of Child Caring Agencies; Dara J. Rudick, interim executive director, Minnesota Association of Community Mental Health Programs, and S. Charles Schulz, professor and head, Department of Psychiatry, University of Minnesota.