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MindView Director's Letter Archives
The Status of Mental Health Care - Spring 2000
A recent report from the Surgeon General of the United
States provides an overview of the state of mental health
treatment in the nation. On the positive side, the report
confirms that effective treatments are available for most
mental disorders. On the other hand, the majority of individuals
with mental illnesses fail to seek treatment when they
need it. The report addresses many of the barriers that
interfere with the delivery of mental health care to individuals
who need it.
The stigma that is associated with having a mental illness is one of the significant barriers. In its most obvious form, patients may associate having a mental illness with personal weakness. Unlike illnesses like cancer or diabetes, patients may believe that they are somehow responsible for having a psychiatric disorder. As a result, the acknowledgment that one has a mental illness can be associated with a loss of self-esteem as well as the belief that others will be less accepting of the ill person. The stigma associated with mental illness may also lead to real discrimination in finding work or sustaining relationships. In addition, families may resist accepting that members have mental illness since they believe that this reflects poorly on them. The media continues to spread the notion (in films such as The Prince of Tides and Shine) that psychiatric disorders such as schizophrenia can result from disturbed family relationships. These notions are, of course, false. Psychiatric disorders are brain illnesses that arise through no fault of the patient or the family.
The Surgeon General's report also outlines other manifestations of stigma that can interfere with patient's receiving proper treatment. Restrictions in the insurance of treatment for psychiatric disorders represent a serious obstacle for individuals who are seeking treatment. It is based on the false belief that illnesses of the brain that are manifest in psychiatric symptoms should be treated differently from illnesses in other organ systems.
Fortunately, progress is being made in all of the above areas. The treatment article by Joel Braslow illustrates one source of the stigma associated with psychiatric treatment. That is, for the first half of this century treatments for mental illness were dramatic but sometimes ineffective. The report acknowledges that in the second half of the century effective treatments have been discovered and are available for all of the major psychiatric disorders. Also, prominent individuals with psychiatric illnesses such as William Styron, Mike Wallace, and Patty Duke have demonstrated that individuals with psychiatric disorders can succeed in all aspects of their lives. Organizations such as The Alliance for the Mentally Ill and NARSAD have made substantial progress in dispelling myths about mental illnesses. Their efforts have contributed in a substantial way to recent successes in assuring parity of coverage for psychiatric illnesses. And finally, the Surgeon General's report itself will give additional impetus to all of the efforts to erase stigma.
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