Copyright 1999 The Denver Post Corporation
The
Denver Post
December 26, 1999 Sunday 2D EDITION
SECTION: SCN; Pg. E-11
LENGTH: 1240 words
HEADLINE:
Making Strides Report may help mental illness lose its stigma
BYLINE: By Claire Martin, Denver Post Staff Writer,
BODY:
The surgeon general's report on mental health
may change the way people think about mental illness, and prompt
health maintenance organizations and insurers to cover mental
illnesses as broadly as they cover physical illnesses.
But
not overnight.
'I think it's going to take many reports, and many
public service announcements, before people see mental illness
as something that's as normal as a physical disease,' said Mary
Ann Watson, a private pscyhologist and professor of psychology
at Metropolitan State College in Denver.
'Today, when we hear
the phrase 'mental illness,' most of us picture someone wandering
homeless, talking to the gods. But that's a fraction of the entire
range of mental health issues that include people I think of as the
'walking wounded' - people functioning fairly well, but with
day-to-day conflicts that could benefit from meeting with a
therapist, or medication.' The surgeon general's report, issued earlier this
month, blamed social stigma and lack of funding as the main reasons
why existing resources fail millions of Americans who need
help resolving temporary or chronic mental disorders.
1 in 5
diagnosed
Every year, nearly one in five Americans is diagnosed
with mental illness, from temporary depression to schizophrenia.
But the combination of a general view that mental
illness is shameful, and constrained health
coverage, prevent two-thirds of those diagnosed from seeking
treatment.
Many health maintenance organizations do not
cover or severely restrict their coverage of mental
health treatment, including therapy sessions and
medications. Even health maintenance organizations
that do cover depression and other mental disorders
often limit how often a patient can see a psychologist, and schedule
counseling sessions 6 weeks or more apart.
Will the report change that?
It will, predicts physician Margaret Cary, regional
director of the Colorado Department of Health & Human Services.
'Remember, the first surgeon general's report on smoking
took a while to lead to the tobacco settlements,' she cautioned.
'I'm not directly comparing that, except to say that this
is the first step in an ongoing attempt to talk about the
importance of diagnosing and treating mental illness. There's a group
of people who feel that if you're a good person, a strong
person, then you wouldn't have a mental health problem. That's like
saying if you're a good person, you won't get pneumonia or high
blood pressure. This is about looking at mental illness as
another illness, not a character flaw.'
Carol Jean Garner, a
board member of Consumer Centered Services of Colorado, a
patient-advocacy group, is guardedly optimistic about how the report
may change services for people with mental illnesses.
'We
have to remember, with one in five people being treated for a mental
illness, that all of us are a moment away from being a person who has
one, or connected to someone who does,' she said.
'But I've been in the
field 20 years, and just when I think we've done all the education we
need to do, I'll find we're just getting started. The stigma is much
less now, but we need to look at people as people, not as patients or
clients. That's hard, because mental illness is not easily
understood, and there's a great deal of fear associated with it.'
Many mental and behavioral health professionals believe
that the exhaustive report - the data was drawn from more than
3,000 studies - will help dispel lingering myths about straitjackets
and insane asylums. It encourages Americans to speak up if
they recognize symptoms in themselves or others.
While the
report does not argue that health insurers and businesses should
cover mental illness as thoroughly as they cover physical
disabilities, mental health advocates believe that its authority may
help persuade Congress and state legislatures to make that happen.
Optimism for change
Peter Van Arsdale, a researcher at Fort
Logan Mental Health Center, is optimistic that the report will change
how professional mental health therapists, counselors and others
think about preventive measures.
'In the report, Dr. (U.S.
Surgeon General David) Satcher takes a public health approach, and
when you apply that to mental health and mental illness, that
suggests you'll be looking at ways to intervene and prevent
disabilities,' Van Arsdale said.
'I'm kind of excited about the implicit
preventive approach. I think that's going to benefit a lot of folks.'
Van Arsdale represented Fort Logan at last summer's
meeting of the Western Pyschiatric State Hospital Association, where
he saw a preview of the report.
Undiagnosed and untreated,
mental illness can be expensive and dangerous, Cary pointed out. The
transition from grief to clinical depression and, ultimately, to
suicide or criminal behavior can be fatally swift. Mental illness can
exact a severe cost, in more ways than one.
In 1990, direct
and indirect expenses related to mental illness cost more than $ 150
billion annually, Cary said, and that cost has climbed over the
years.
Charles G. Ray, president of the National Council
for Community Behavioral Healthcare, said Cary's estimate is
too conservative. Besides direct expenses - medications
and intervention programs - mental illness contains hidden
costs, including lost productivity and wages from people who can't
do their jobs, in maintaining an increasingly large penal system
that contains a substantial population with mental disorders, and
in paying for medical procedures that treat physical
conditions related to mental illness.
'To people who aren't
familiar with the system, it looks like it costs a lot of money to
invest in prevention and education and intervention, but if you put
the dollars into that, in the long haul you'll spend less money,'
said consumer advocate Garner.
'If you spend money upfront, then in the
long run, you won't be putting money to house people in hospitals and
other institutions, where they'll require more services for a
longer term, and the people may be reluctant to be compliant with
a system they don't trust.'
And improving services isn't
always expensive, she pointed out. One of the newest, and most
popular, mental health services introduced in Colorado this year is
the Warm Line - a telephone resource for people struggling with a
problem that's difficult, but not life-threatening.
Common
experiences
The Warm Line is staffed by people who have been treated
for mental illnesses, and trained by certified mental
health professionals to counsel others. Like support groups whose
members are united by their common illness, the Warm Line is
successful because callers tend to trust someone else who's shared
their experience.
'The Warm Line is a way to diminish a
potential crisis, to access help immediately,' Garner said.
'If you can reach someone when they're depressed,
that depression may not end in suicide, which is an enormous problem
in Colorado, especially here on the Western Slope. We have
the state's highest suicide rate, especially among the elderly.
The sooner you intervene, the more likely you are to prevent it.'
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