Why do people view mental illness as something catastrophic that requires immediate intervention?

[LOVEthroughINTELLECT]

If you read these forums enough you will repeatedly hear the echo of "The U.S. is way behind other industrialized countries in access to mental health services".

It sounds like the U.S. is a horrible place that is failing its residents miserably.

But then I remembered that many years ago I would have panic attacks. Hyperventilating. Heart racing.

I don't remember ever telling anybody about it. I know that 99.9% people in my life do not / did not know about it. I know for sure that it was never officially diagnosed and never treated.

Life went on.

Most people probably do not seek medical attention for the common cold. Nobody says that one country is horrible compared to other countries because of the common cold.

Have you noticed that the topic of mental illness and access to mental health services in the U.S. is almost never on anybody's radar until there is a mass shooting? After a mass shooting suddenly everybody is preaching the neglected-mental-health-system-in-the-U.S. sermon. The topic gets almost no mainstream attention the rest of the time.

Nonetheless, probably a lot of people who suffer from mental illnesses keep going to work, going to church, raising their children, etc.

When our national conversation about mental illness and mental health services is always about nothing but occasional socially outcast mass murderers, is it any wonder that there is not much push for reform?

 

[Locutus]

That may be an advantage, actually. I'm not convinced the automatic pathologising of every little tick and idiosyncracy is in our best interests.

 

[SkyWriting]

When our national conversation about mental illness and mental health services is always about nothing but occasional socially outcast mass murderers, is it any wonder that there is not much push for reform?

Perhaps there is not much need for reform unless there is harm of self
and others as a problem for the nation that is not being met locally.
Family, community, state, then federal levels all work together.

 

[DogmaHunter]

I think mental illnesses are still far too much taboo these days. Because of this, there's widespread misunderstanding and a big lack of acknowledgment of these conditions.

Even "simple" things like depression for example... If you get diagnosed with it and are put on sick leave for a month or so, then much of your coworkers will consider you to be a lazy bum who simply wants a month of vacation.

Also, because of this taboo and misinformation a LOT of people are not getting the care and treatment that they desperatly need. Tell somebody that you need to see a psychiatrist and they'll look at you funny.

For this reason alone, I'ld say, yes: there is much reason for a good reform and "raising awareness" in the general public.

As always with severe conditions: catching it early is the key to potentially good recovery. Nowadays, it still takes FAR to long from the first symptoms till the first doctor visit.

 

[Chris B]

"Why do people view mental illness as something catastrophic that requires immediate intervention?"

Because it's the extreme cases and failures of treatment that make the news, and that's what all-too-many people have as their source of information.

Given the nature of much of the public's view of mental illness, there is a disincentive for those with controlled or manageable conditions to speak up on such. There's still far too much stigma from ignorance and misunderstanding.

Someone who quizzed me for a survey couldn't even manage this for a physical illness:
"Do you take medication for any condition?" "Yes, for high blood pressure"
"So you have high blood pressure?" "No, my blood pressure is normal"
"But you said... " "Yes, that why I take the medication: result, normal blood pressure"

But admit to someone that you are taking antidepressants and many seem utterly unable to register even the possibility *that they are working*!

Yes, mental health and illness goes much wider than that, but in many of its aspects the biggest problem is an ignorant and ill-informed public.

 

[Armoured]

That may be an advantage, actually. I'm not convinced the automatic pathologising of every little tick and idiosyncracy is in our best interests.

Over treatment and pathologising of benign neuroses is indeed a problem. But letting people with genuinely harmful pathologies slip through the cracks is a separate but very pressing one. A statistic I only just learned; Australia has had about 50 military combat deaths since '95. We've had almost 300 returned service personnel commit suicide once they were back home.

 

[Nithavela]

You're absolutely right, if a cog in the machine is still spinning, or at least not damaging the machine when it breaks, who cares about it's feelings.

 

[Aryeh Jay]

You're absolutely right, if a cog in the machine is still spinning, or at least not damaging the machine when it breaks, who cares about it's feelings.

All in all were just another brick in the wall.

 

[jayem]

If you read these forums enough you will repeatedly hear the echo of "The U.S. is way behind other industrialized countries in access to mental health services".

It sounds like the U.S. is a horrible place that is failing its residents miserably.

But then I remembered that many years ago I would have panic attacks. Hyperventilating. Heart racing.

I don't remember ever telling anybody about it. I know that 99.9% people in my life do not / did not know about it. I know for sure that it was never officially diagnosed and never treated.

Life went on.

Are your panic attacks in remission? In some people they resolve spontaneously, and I hope that's your situation. But in others it's a significant chronic illness that can be quite distressing. Why should anyone suffer in silence? Like many other illnesses, the severity can vary. Panic disorder frequently is a co-morbid condition with other mental illness, such as depression and OCD. And patients who aren't getting professional help often self-medicate--usually with alcohol. This is common enough that any patient with alcoholism needs to be evaluated for an underlying anxiety or panic disorder.

Have you noticed that the topic of mental illness and access to mental health services in the U.S. is almost never on anybody's radar until there is a mass shooting? After a mass shooting suddenly everybody is preaching the neglected-mental-health-system-in-the-U.S. sermon. The topic gets almost no mainstream attention the rest of the time.

You may not have heard it specifically mentioned, but's a facet of health care delivery, and health insurance reform in general. Some type of single-payer health coverage is in the platform of one of the leading Presidential candidates. This is a huge national issue.

Nonetheless, probably a lot of people who suffer from mental illnesses keep going to work, going to church, raising their children, etc.

As I said, severity varies. But what's reported in the literature is sobering. This is pasted from a 2013 CDC release on depression and the workplace:

• In a given year, 18.8 million American adults (9.5% of the adult population) will suffer from a depressive illness1
• It is estimated that 20% of people aged 55 years or older experience some type of mental health issue. Depression is the most prevalent mental health problem among older adults2
• Approximately 80% of persons with depression reported some level of functional impairment because of their depression, and 27% reported serious difficulties in work and home life3
• Only 29% of all persons with depression reported contacting a mental health professional in the past year, and among the subset with severe depression, only 39% reported contact3
• In a 3-month period, patients with depression miss an average of 4.8 workdays and suffer 11.5 days of reduced productivity1
• In 2003, national health expenditures for mental health services were estimated to be over $100 million4
• Depression is estimated to cause 200 million lost workdays each year at a cost to employers of $17 to $44 billion5, 6

http://www.cdc.gov/workplacehealthpromotion/implementation/topics/depression.html

This is just depression. The stats are much worse if you include the anxiety disorders, bipolar disorder, and substance abuse.
Mental illness has a very significant adverse economic effect, not to mention how it impairs one's quality of life.

 

[Martinius]

If you read these forums enough you will repeatedly hear the echo of "The U.S. is way behind other industrialized countries in access to mental health services".

It sounds like the U.S. is a horrible place that is failing its residents miserably.

But then I remembered that many years ago I would have panic attacks. Hyperventilating. Heart racing.

I don't remember ever telling anybody about it. I know that 99.9% people in my life do not / did not know about it. I know for sure that it was never officially diagnosed and never treated.

Life went on.

Most people probably do not seek medical attention for the common cold. Nobody says that one country is horrible compared to other countries because of the common cold.

Have you noticed that the topic of mental illness and access to mental health services in the U.S. is almost never on anybody's radar until there is a mass shooting? After a mass shooting suddenly everybody is preaching the neglected-mental-health-system-in-the-U.S. sermon. The topic gets almost no mainstream attention the rest of the time.

Nonetheless, probably a lot of people who suffer from mental illnesses keep going to work, going to church, raising their children, etc.

When our national conversation about mental illness and mental health services is always about nothing but occasional socially outcast mass murderers, is it any wonder that there is not much push for reform?

Some people with what you had don't get better on their own; you are fortunate. And not all mental illnesses are "catastrophic"; the extent and severity can vary. It appears that at one time we over-reacted to emotional and mental problems, often locking people up for no good reason. Now we don't do that as much, and we may have actually gone too far in the other direction by not directing people who need help to where they can get it.

As a senior I have noted that medical questionnaires for our generation now include several questions to determine if the patient is depressed or suffering from other mental issues. I think this is important, and it could alert the doctor to problems that might otherwise go undetected.

One reason that mental illness is only in the spotlight when some terrible event occurs is because of the media and the way government works. The same applies to many other aspects of life; I have noticed that the only time something gets fixed (a dangerous road or intersection, inadequate airport runways, defective cars) is when enough people get killed to make it newsworthy. Otherwise the problem is usually ignored.

 

[Locutus]

Some people with what you had don't get better on their own; you are fortunate. And not all mental illnesses are "catastrophic"; the extent and severity can vary. It appears that at one time we over-reacted to emotional and mental problems, often locking people up for no good reason. Now we don't do that as much, and we may have actually gone too far in the other direction by not directing people who need help to where they can get it.

As a senior I have noted that medical questionnaires for our generation now include several questions to determine if the patient is depressed or suffering from other mental issues. I think this is important, and it could alert the doctor to problems that might otherwise go undetected.

One reason that mental illness is only in the spotlight when some terrible event occurs is because of the media and the way government works. The same applies to many other aspects of life; I have noticed that the only time something gets fixed (a dangerous road or intersection, inadequate airport runways, defective cars) is when enough people get killed to make it newsworthy. Otherwise the problem is usually ignored.

the squeaky wheel gets the grease.

as for societal oblivion to chronic low grade 'mental illness', it's just not unrealistic to expect the system to notice, much less cater to, every case.

 

[Locutus]

You're absolutely right, if a cog in the machine is still spinning, or at least not damaging the machine when it breaks, who cares about it's feelings.

Actually, yes. Primary subsistence societies don't have the time or resources to cater to 'feelings'. Food must be harvested, water must be carried. Not saying this is wrong or right - I make no value judgments - but it's reality. And it works, if survival and reasonable quality of life are the main aims.

 

[Locutus]

Over treatment and pathologising of benign neuroses is indeed a problem. But letting people with genuinely harmful pathologies slip through the cracks is a separate but very pressing one. A statistic I only just learned; Australia has had about 50 military combat deaths since '95. We've had almost 300 returned service personnel commit suicide once they were back home.

My field, oddly (given my pacifist inclinations), is war-caused PTSD. This is a whole other bucket of hell, which can't reasonably be equated to things like the anxiety mentioned in the OP.

 

[Locutus]

Given the nature of much of the public's view of mental illness, there is a disincentive for those with controlled or manageable conditions to speak up on such. There's still far to much stigma from ignorance and misunderstanding.

Yes, mental health and illness goes much wider than that, but in many of its aspects the biggest problem is an ignorant and ill-informed public.

I think it's simply long memory. We come from thousands of years of ignoring small ills in order to survive. The 'least' of these small ills beings those which don't impede physical labour. ie, mental health. Speaking up about them would have been seen as attempts to shirk duty. It would be regarded as self-indulgent.

I don't believe we are ignorant or ill-informed, I think we acknowledge (cave man style) that catering to minor mental health problems is a luxury.

 

[Locutus]

I think mental illnesses are still far too much taboo these days. Because of this, there's widespread misunderstanding and a big lack of acknowledgment of these conditions.

.

They are taboo, for the aforementioned wholly practical reasons. It was (and still is in some cultures) poor form to jeopardise survival of the tribe on account of 'head things'.

 

[OldWiseGuy]

We have crafted a society that drives people nuts. We are fish-out-of-water.

 

[OldWiseGuy]

As a senior I have noted that medical questionnaires for our generation now include several questions to determine if the patient is depressed or suffering from other mental issues. I think this is important, and it could alert the doctor to problems that might otherwise go undetected.

I am often asked point blank (curiously by nurses only) during routine visits to my doctor, if I have had any recent suicidal thoughts. Honestly, if I had I wouldn't tell anyone, they might take my guns from me.

 

[Martinius]

I am often asked point blank (curiously by nurses only) during routine visits to my doctor, if I have had any recent suicidal thoughts. Honestly, if I had I wouldn't tell anyone, they might take my guns from me.

They haven't asked me that one yet; how do you act when you see your doctor? Often, the nurses seem sharper and more aware of things than the doctors are.

Personally, I used to think a little about suicide when I was much younger, mostly about how, but not any more. As I have aged, life has become more precious. And I don't want to miss any more time than I already do with my children and grandkids.

They should be asking teenagers these questions, since suicide is the second highest cause of death for that age group.

 

[s_gunter]

I am often asked point blank (curiously by nurses only) during routine visits to my doctor, if I have had any recent suicidal thoughts. Honestly, if I had I wouldn't tell anyone, they might take my guns from me.

If you had those thoughts, and you answered that question honestly, you'd also be essentially locked up for a while. They'd place you under a "psychological hold," which is usually a minimum of 3 days, but is more likely until the psychiatrist assigned to you gets as much as he can from the insurance company, under the guise of, "being of no danger to self or others." You cannot leave the hospital (and you're usually dumped in the worst hospital in the area, usually a state hospital, so you're further punished by being in a rotten "hospital") on your own recognizance. Therefore, your mental "illness" really isn't an illness, it's a crime. If you only considered/planned your suicide, but hadn't taken action, it's a "thought crime." If you get caught during your suicide attempt (someone coming home when they weren't supposed to, for example), that person will call emergency services. After the person is talked down from their attempt, the person usually isn't taken to the "hospital" in an ambulance, s/he's hauled off in a police car in handcuffs. Therefore, the signs/symptoms (which suicidal ideation and suicide attempts/sucesses are) severe clinical depression isn't really considered an illness at all. It's considered a crime. Until that changes, people won't get the help they really need, since they won't be honest with their doctors.

 

[OldWiseGuy]

They haven't asked me that one yet; how do you act when you see your doctor? Often, the nurses seem sharper and more aware of things than the doctors are.

I've noticed that too. They generally aren't interested in anything you have to say about your own condition. Most likely because your observations aren't backing by peer-reviewed studies.