There’s an entire graveyard of first-drafts of this piece sitting somewhere in the dusty virtual archives of CWR, but after eluding me for so long (and I mean months, people) I finally think I’ve got this complicated and multifaceted post down.
Let’s get right to it.
Mental Disorders Are Partly Your Fault
See this comic?
As much as it’s making a good statement about the way we treat mental illness (and we’ll touch more on that in a second), the simple fact of the matter is that the idea that mental illness is something that just “happens” is wrong. The comic asks us “Would you really tell someone with a broken hand to just ‘get over it’?”. To which I say, “No, but I would yell at him for not wearing cast or for trying to punch through cinder blocks.”
Mental illness is a horrific situation which we still don’t know a whole lot about, but that doesn’t mean we can fall into the easy mistake of thinking we’re helpless victims. Just in the same way a person on an all-cheese diet probably shouldn’t be surprised at having constant digestive issues, a person who knowingly and willingly exacerbates his or her own condition or goes into a situation where they’re going to be more vulnerable shouldn’t be too surprised when things start going bad. I’m not saying that a person prone to depressive episodes should constantly avoid any possible trigger, but that person should be aware of his or her own condition, the risks involved, and be actively engaged in their own treatment or recovery.
There’s No Such Thing As Preventative Care
In spite of that, we do need to understand how complicated the situation is. As of yet, we’re severely lacking any kind of preventative mental health care in this country (and indeed, in most countries). The acceptance of the very existence of mental illness is comparatively new, and as far as a comprehensive infrastructure goes, most folks are out of luck.
Whenever flu season rolls around we get flu shots. To fight the spread of major contagions we get vaccines (the sane of us, anyways). To combat against most everything else we practice decent hygiene, proper dieting, and keep ourselves in relatively good shape. All of this, more than anything else, is the cornerstone of of a healthy, functioning society- prevention rather than cures.
We simply do not have an equivalent on the mental health side of things. Our perspective of the situation is either you have a healthy mind or you’re ill- there’s somehow no progression or middle-ground. Obviously there are certain things out of our control here- plenty of mental illnesses are formed over a long time by environmental factors and there’s no easy way of addressing that.
For the most part, though, it seems the closest formalized preventative mental health care comes to us in the form of inspirational and confidence building self-help books.
Well There Is, But It’s Gotta Be Under The Table
As mentioned above, we really don’t tend to respond to a problem until it’s way too late. Insurance won’t provide basic mental healthcare until there’s an actual disorder present. By then, of course, things are already way out of hand.
The DSM-V, the be-all-end-all diagnostic criteria for mental illness, has become less a guide for doctors and more of a menu for insurance and pharmaceutical companies who influence the language of the text to bend the odds in their favor. While obviously this back-room dealing needs to be addressed in and of itself, perhaps the greatest challenge in modern application is the large number of clinicians out there who are diagnosing folks who don’t meet the criteria for a disorder with one. It’s viewed often as necessity in providing some sort of lifeline to folks while there’s still a chance- think of it like doctors diagnosing people with cancer so they’ll be able to prescribe allergy medication.
As you’d expect, it’s crazy, sloppy, and tends to blur certain legal lines.
All that is just to say that…
We’ve Got No Mental Health System
We really don’t.
There’s no comprehensive system for addressing mental health issues, and certainly not any system for addressing the sheer scale of what we’ve got going today. A huge part of this again seems to be the interference of the insurance industry, meddling (if not out-right dictating) the terms and conditions of mental disorders. Naturally my solution to this would be the overthrow of the whole cancerous Capitalist system, but that’s just me.
Obviously we’re going to have to start making some changes.
We teach first aid. We know CPR. A person on the street can tell you the symptoms of a heart attack or a stroke or even how to set a broken bone. What do we have for mental illness except a bunch of images in movies and on TV of lobotomy patients?
What if we did mental health check-ups on the same regularity that we do physicals? What if we followed the example of some countries and provided sick days not simply for physical issues but for mental stress as well? What if we had a basic understanding of how our own minds work? What if we were taught from our first day of school how to withstand the onslaught of tricks used by advertisers?
We need to have a society who can see behavior and tell you “Hey man- that doesn’t look right…” or “You don’t sound so good…”.
And we’re getting better, don’t get me wrong, but we still have a long way to go.