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Sunday, April 28, 2013
The stigma around mental health issues is particularly illogical, because there’s no lifestyle link. With mental health disorders, no one eats too many bacon cheeseburgers and ends up with bipolar disorder, or has a two-pack-a-day smoking habit and develops schizophrenia.
So why do we stigmatize mental health patients?
There’s a long literature on this question that I’m not going to be able to contribute much to other than this thought: It was a mistake as a matter of health policy to talk about mental health differently than health care generally; to treat it as something other than what mental health care should be, simply a part of our overall health care system. After all, no state has a Department of Pulmonary and Cardiac Health.
Many, if not most, states have some type of stand-alone mental health agency. We do not have separate health insurance provisions for cancer care versus cardiac care. However, despite the best efforts of mental health parity advocates, we very much have two health insurance systems: one for physical health, one for mental health. This is a false distinction given the physiological basis of many mental health disorders.
We do not just stigmatize mental health patients. We do the same to their family members. For example, we do not instinctively question what is wrong with the parenting of a child with leukemia, but we certainly do with the parents of a child who ends up in the hospital with a mental health condition. Is it the marriage? The discipline techniques? The home environment? Perhaps parenting classes? We do not ask these questions about a kid with a heart condition.
Kids with mental health issues are an uncomfortable fit for the zero-tolerance kind of society we are building in an increasingly suburban state. Kids with mental health issues sometimes hit other kids. Kids with mental health disorders might curse at inappropriate times, even to an adult. In less enlightened times, such kids (and adults) might have been disciplined at school or hospitalized — to be sure, for far too long and under very poor conditions.
In our more enlightened but zero-tolerance era, we arrest them (or perhaps merely expel them). I’m not sure that either approach is as enlightened as we might like to believe.
In fact, three of the largest mental health systems in our commonwealth are state prisons, local and regional jails, and the juvenile correctional system. It is almost medieval that we are imprisoning those we do not understand.
The moral implications of this cruel policy aside, it is also a tremendous waste of human potential. The mental health stigma creates a societal Catch 22. Because of the stigma, mentally ill people are reluctant to seek treatment. Untreated symptoms then result in incarceration, not the needed treatment.
It was only a few years ago that Virginia ended its policy of requiring parents to relinquish custody of their mentally ill child in order for the child to receive state funding for needed services. Even then, the initial efforts (led in large part by former Roanoke Del. William Fralin) to end this cruel policy met with the most fervent local government opposition I have witnessed in 20-plus years of following the Virginia General Assembly.
It is an uncomfortable truth that Cervantes wrote “Don Quixote” in jail, that Churchill suffered from the “black dog” of depression, and that any number of very senior leaders in our society have or at least exhibit what we might politely call “anger issues.” Perhaps you have worked for one of them.
Mental health care is not a matter of a dependant population that the well among us need to simply care for. Some of our most productive and most creative people have significant mental health issues. Treating mental health conditions will allow more of our fellow Virginians to share their talents and gifts with the world — whether or not they eat bacon cheeseburgers.
Weather JournalStorm track isn't very snowy for us