MENTAL HEALTH IN THE UNITED STATES

MENTAL HEALTH IN THE UNITED STATES

Researching facts about mental illness will always be of particular interest to me. In July 1999 I was diagnosed as Bipolar 1, severe. The past eight years have been a challenging and wearisome road traveled.  Years of instability were exhausted trying to find the correct combination of medications to stabilize me. I have seen the halls of numerous psychiatric wards at least eighteen times in the past eight years. Scars are permanently etched into the flesh of my wrist and forearms. Attempted suicide will forever be a part of my perplexing past. Now, finally, some stability seems to be present yet intense anxiety is still a common denominator.     

Mental disorders in the United States are widespread. An estimated 26.2 percent or about one in four adults suffer from a diagnosable mental disorder in a given year. (RC, June 2005) According to the 2004 U.S. Census residential population estimate, this figure translates into 57.7 million people. (U.S. Census Bureau Population Estimates by Demographic Characteristics., 2005) Also, mental disorders are a leading cause of people on disability contributing to people for the ages of 15-44. (Organization., 2004)

Major Depressive Disorder is the leading cause of disability in the United States and affects up to 14.8 million adults in a given year. (RC, June 2005) Major depression can include various symptoms and affect people differently. Some people have trouble sleeping whereas some will sleep constantly. Some may lose weight were others may gain. Generally a person will feel agitated, irritable, and some will feel worthless or guilty for no reason. Major depression may also include fatigue, difficulty concentrating, a feeling of hopelessness and helplessness, body aches, and suicidal thoughts.

Bipolar Disorder affects approximately 5.7 million adults in a given year. (RC, June 2005) It is a brain disorder resulting in a chemical imbalance between the neurotransmitters of the brain. Bipolar Disorder causes unusual and drastic shifts in a person's mood and ability to function in everyday life because of the severity of symptoms. Too often relationships are damaged, job or school performance is unacceptable, and suicide is possible. An elevated mood of mania consist of increased energy, a euphoric high, racing thoughts, little need for sleep, rapid talking, unrealistic beliefs in one's abilities, increased sexual drive, abuse of drugs and alcohol, and denial that anything is wrong. This can swiftly switch to a state of depression, which can include any of the above symptoms mentioned for major depressive disorder.

Schizophrenia affects approximately 2.4 million adults. (DA Regier, Feb 1993) Schizophrenia is severe, chronic, and disabling. People suffering from this severe brain disorder may hear voices, may believe others are reading their minds, controlling their thoughts, or plotting against them. They may see, hear, smell, or feel something that no one else can. They may have delusions and disorders of movement. At times there may be a loss or a decrease in the ability to initiate plans, speak, and express emotion. The cognitive deficits that are the most disabling in terms of leading a normal life are problems with attention, memory, and the executive functions that allow planning and organization.

Six million adults are affected by panic disorder. (RC, June 2005) Panic disorder is an anxiety disorder characterized by unexpected and repeated episodes of intense fear. It is accompanied by physical symptoms such as chest pain, heart palpitations, shortness of breath, dizziness, abdominal distress, tingling or numb hands, a flushed or chilled feeling, a sense of unreality, and a fear of impending doom or loss of control.

Approximately 2.2 million adults are affected by Obsessive-Compulsive Disorder (OCD). (RC, June 2005). OCD is an anxiety disorder of recurrent and unwanted thoughts and repetitive behaviors such as hand washing, counting, checking, or cleaning. People with OCD perform these repetitive acts in an effort of preventing the obsessive thoughts or to alleviate them. However performing them only provides temporary relief and not performing those acts increases their anxiety greatly.

One of the problems that concern me today is the stereotypes that exist concerning mental illness. The history of social psychiatry has taught us that cultural conceptions of mental illness influences whether or not someone may seek help, the stereotypes given to mental illness, and the kinds of treatment we create for people suffering from a mental illness. Recent research shows the stereotype that people suffering from a mental illness are dangerous is on the increase. Also, the stigma attached remains detrimental to the lives of people with mental illness. (BG Link, 1999)

In the 1950s, Shirley Star, a pioneer of social psychiatry, conducted the first nationally representative study of these issues to show the public image of mental illness as follows:

Mental illness is a very threatening, fearful thing and not an idea to be entertained lightly about anyone. Emotionally, it represents to people a loss of what they consider to be the distinctively human qualities of rationality and free will, and there is kind of a horror in dehumanization. As both our data and other studies make clear, mental illness is something that people want to keep as far from themselves as possible.

In a more recent study the public's view of mental illness as a "fearful thing" was much like Star's original study. People were presented with different scenarios each with a different form of mental illness. Even though there was no mention of violent behavior, the percentages of people believing that violence was somewhat or very likely lead researchers to the conclusion that public fears were out of proportion with reality. Empirical research of violence consistently shows that only a minority of people suffering from mental illness become violent. (BG Link, 1999)

By comparing the two studies, it showed that the perception of dangerousness has increased rather than improved since the 1950s. Even though effort has been made through public education it has been focused on the nature, causes, and treatment of mental illness. To rid the stereotype of dangerousness it is going to have to be addressed directly. We need to communicate the real association between mental illness and violence, which is more than likely to be toward the person actually suffering from the mental illness.

Another factor found in the studies is that people simply want to keep a social distance between themselves and the mentally ill. One possible reason is that the symptoms signify undesirable personal attributes that people would rather avoid. Also, the same symptoms are the ones that seemed to generate fear that the person will act violently. Therefore the studies suggest some part of people's unwillingness to intermingle was an inflated fear that symptoms lead to violence.

Accomplishments have been made in educating the public about mental illness since the 1950s. The public seems better able to identify the illnesses and the causes of such mental illnesses. However, simultaneously we still find the connection of mental disorder and the perceived likelihood of violence and this perception coupled with social distancing. If the symptoms of mental illness continue to be linked to fears of violence, people with mental illness will be negatively affected by rejection, by a refusal to seek help because of stigmatization, and by exclusion through fear-based responses.

BG Link, J. P. (1999, 09). Public conceptions of mental illness: label, causes, dangerousness, and social distance. Retrieved from American Journal of Pubilc Health: http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1508784&pageindex=1

DA Regier, W. N. (Feb 1993). The de facto mental and addictive disorders service system.Epidemiologic Catchment Are prospective 1-year prevalence rates of disorders and services. Archives of General Psychiatry. , 50(2): 85-94.

Organization., T. W. (2004). The World Health Report 2004: Changing History, Annex Table 3: Burden of disease in DALYs by cause, sex, and mortality stratum in WHO regions, estimates of 2002. Geneva: WHO.

RC, K. W. (June 2005). Prevalence, severity and comorbidity of twelve-month DSM-IV disorder in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry , 62 (6): 617-27.

U.S. Census Bureau Population Estimates by Demographic Characteristics. (2005, June 9). Table 2: Annual Estimates of the Population by Selected Age Groups and Sex for the United States: April 1, 2000 to July 1, 2004 (NC-EST2004-02) . Retrieved from Source: Population Division: http://www.census.gov/popest/national/asrh/