Recently I spoke at a "Stop the Stigma" seminar in Des Moines, Iowa and Teresa shared these facts and insights about mental illness. She did a great job with them! So, I asked her for permission to share them with all of you. They are sobering facts and statistics and so important to understand. NAMI is a great organization and has helped many families and individuals. If you are not familiar with your local chapter of NAMI I encourage you to check it out and become a member.
My name is Teresa and I am a volunteer for NAMI - the National Alliance on Mental Illness of Greater Des Moines.
I am the parent of two adult children with serious mental illness.
Mental illness typically strikes young people between the ages of 15 and 25 – a time when they are trying to establish their independence, searching for a career, looking for a marital partner, and establishing themselves as an adult.
One half of all lifetime cases of mental illness begin by age 14, three-quarters by age 24. Despite effective treatments, there are long delays – sometimes decades – between the first onset of symptoms and when people seek and receive treatment.
Approximately 12 years ago, my daughter was 15 and my son was 25. They each had their break with reality within 30 days of each other. My son was in military service and my daughter was just entering her sophomore year in high school.
We all experienced a profound sense of loss when the diagnosis of a serious mental illness was made, one which others find difficult to understand, since it is an illness that is stigmatized and one for which many mistakenly believe there is no hope for recovery.
Mental illness struck our family full force in the face. It was a turning point for our family. No more assuming everyone had good health. No more assurance of what the future would bring. In the beginning, you are in a state of shock, feel completely overwhelmed, and isolated. You lose your center of gravity.
As a parent you wonder where things went wrong – why did this happen to my kids – how can I fix it – how can I help them to get better – how can I protect them from a world that may not appreciate them as human beings and will too often be cruel, uncaring, and sarcastic. Will there be other people who will still embrace them and love them and not blame them for their illness? Who’s going to tell me what to do next?
The first 5 years were very difficult for all of us – weathering the ups and downs, searching for the right medications, waiting for an accurate diagnosis, finding understanding medical professionals, coming to terms with the fact they would need to manage their illnesses for the rest of their lives, and rediscovering their lives could have meaning.
So they each received the label of a mental illness – another name for a serious brain disorder, a biological disease of the brain, a medical illness. The label of a mental illness doesn’t define them – never has, never will. – I admire my children’s courage to face down this illness and to manage it. We know this is an illness without blame. We know this illness is a flaw in brain chemistry, not character.
If your family is also living with mental illness, please realize you are not alone. This is an equal opportunity disease. Mental illness strikes families from all walks of life regardless of age, race, income, religion, or education. 1 out of 4 families is affected by mental illness in their lifetime.
20% of the population lives with mild or moderate cases of mental illness. 6% of the population lives with severe mental illness. Many have co-occurring mental health and addiction disorders or other medical conditions.
The President’s New Freedom Commission Report on Mental Illness stated:
- Mental disability is not a scandal – it is an illness, it is treatable, especially when treatment comes early.
- The Commission’s findings confirm that there are unmet needs and that many barriers impede care for people with mental illnesses.
- Mental illnesses are shockingly common, they affect almost every American family at some time in their life.
- It can happen to a child, a sibling, a grandparent, a co-worker.
- It can happen to someone from any racial or ethnic background.
- It can occur at any stage of life, from childhood to old age.
- No community is unaffected by mental illnesses; no school or workplace is untouched.
When treatment is not sought, the cost can be unbearably high.
- Over 50% of students with a mental disorder age 14 and older drop out of high school – the highest drop-out rate of any disability group.
- 70% of youth in juvenile justice systems have at least 1 mental disorder with at least 20% experiencing significant functional impairment from a serious mental illness
- Job stability is difficult to maintain. Poverty and homelessness are not unusual. Relationships suffer.
- Delays in treatment can lead to complicating factors of substance abuse and other health conditions.
- A report recently completed by the Treatment Advocacy Center and the National Sheriff’s Association states that in the United States there are now more than 3 times more seriously mentally ill person in jails and prisons than in hospitals.
- Because of poor overall health care, statistics show that persons with severe mental illness live on average 25 years less than the general population.
Out-dated beliefs and mis-information – or the lack of information – have created an aura of fear
and that fear has fueled a cruel stigma that is devastating to the ill person and to their families and friends.
The stigma of having a mental illness prevents many from seeking help.
So to me - the most shocking thing about mental illness is how little people know about it.
Did you know mental illness is more common than cancer, diabetes, and heart disease?
Did you know the treatment success rate for mental illness is 70-90%? This is a better success rate than for heart disease – which is 41-52%.
There is the myth that “positive mental attitudes can prevent mental illness”. Has a positive mental attitude ever prevented a brain tumor? Epilepsy? Parkinson’s? They are brain disorders, too.
There is the myth that if you only “tried harder” or prayed long enough or had sufficient faith, you can overcome a severe mental illness. This further reinforces to the ill person what a failure they are for having a mental illness. It further internalizes the myth that only the weak would fall victim to such an illness.
Persons have been stigmatized by a false association between violence and mental illness that has been promoted by the news and entertainment media. In fact, most persons with mental illness never behave violently, and the vast majority of those people who do behave violently are not mentally ill. Research shows that people with mental illness are much more likely to be victims than perpetrators of violent crime (2.6X more likely to be a victim than the general population).
There is the myth that separates serious mental illnesses from the physical illness category. This is tragic. This split fuels the fires of denial, inhibits treatment and promotes discrimination in insurance coverage, housing, employment and access to services.
The first time the Surgeon General addressed mental health was 1999 – just over 10 years ago.
In the 1999 report, the Surgeon General said:
“Our society no longer can afford to view mental health as separate and unequal to general health. It is a misconception that mental health or mental illness is unrelated to physical health or physical illness. In fact, the two are inseparable.”
If you have a vision disorder, the organs of the body affected are the eyes.
If you have a hearing disorder and are deaf, organs of the human body affected are the ears.
The pancreas is an organ of the body. A disorder of the pancreas is called diabetes.
Mental illnesses are brain disorders. They are not defects in someone’s personality or a sign of poor moral character or lack of faith. They certainly do not mean that the ill person is a failure. Chemical imbalances in the brain, from unknown or incompletely known causes, are much of the reason for symptoms of mental illnesses.
Mental illnesses are like other organ diseases in which body chemistry changes. The abnormal chemistry of mental illnesses affects brain function the same way that too little or too much of other body chemicals damage the heart, kidneys or liver.
A heart attack is a symptom of serious heart disease, just as hearing voices, mood swings, withdrawal from social activities, or feeling out of control are common symptoms of a mental illness.
There are many points on the continuum of wellness, and different degrees of recovery that can be reached with medication, therapy, and a strong support system.
Mental illnesses might more appropriately be called –
- A neurological brain disorder
- A brain disease
- A physical illness
- A medical illness
An irreversible consequence of mental illness is suicide.
In America more than 34,000 Americans die by suicide each year, outnumbering homicide deaths by almost 2 to 1. If 34,000 Americans had died by any other tragedy or any other disease – it would be considered a public health crisis.
Suicide is the third leading cause of death for people ages 10-24 years. Every month 330 young people complete suicide – that’s like a jumbo jetliner crashing every month. More than 90% of those who die by suicide have a diagnosable mental disorder.
Suicide rates have increased in the military. From 2005 to 2009, more than 1100 active duty service members committed suicide – an average of 1 suicide every 36 hours. The Marine's suicide rate has more than doubled over the last three years, surpassing the Army's as the worst in the military.
Male veterans are twice as likely to die by suicide as compared with their civilian peers in the general US population.
In Iowa, an average of 328 Iowans (nearly 1 every day) have died of suicide each year since 2001. The number of homicides averages 50 per year in comparison.
In Polk County last year, there were 72 suicide deaths (more than 1 every week)
We have inadequate community services and a fragmented mental health system
We have huge gaps in the mental health workforce, treatment beds and services of all types, and funding.
Except for metropolitan areas, the entire state of Iowa is in a mental health workforce shortage area.
Without an adequate workforce, you can’t have adequate availability of services.
Iowa is 47th in the nation for the number of psychiatrists
Iowa is 46th in the nation for the number of psychologists
Iowa is in the bottom 5 states for number of inpatient hospital beds.
The population of Iowa is around 3,000,000 – as mentioned before 6% of a population will have serious mental illness – that means there are approximately 180,000 persons with serious mental illness in Iowa. We have an inadequate workforce across many professional levels. The most striking is the number of psychiatrists – there are around 140 psychiatrists in private practice for the whole state for those 180,000 people. Statewide there are around 650 beds for the needs of those 180,000 persons with serious mental illness. Those beds are full every day, 365 days of the year and people are being turned away.
In the Polk County area there is a population of around 400,000 people. With 6% of any population group having severe mental illness – in Polk County that means around 24,000 people.
There are approximately 100 acute care beds for the needs of those 24,000 people in the Des Moines area between Iowa Lutheran, Mercy Franklin, and Broadlawns hospitals.
Most people don’t know where to call if they need help – there is no one door to walk through or one phone number to reach services. Services are provided based on multiple program guidelines rather than what an individual needs are.
There is inadequate funding for a mental health system
Polk County is barred by state law (as are all other 98 counties) to raise additional funds for mental health services. County dollars are frozen at 1996 dollar levels. This inability to raise additional funds results in a lengthy waiting list for services.
Polk County has a waiting list of 650 and growing for disability services – 450 of those have mental illness – half of those are at risk of homelessness or hospitalization. Over 5000 disabled are on state waiting lists to receive waiver services – services in their home.
The state legislature promised to take care of funding any growth in the mental health system when they froze the county’s ability to fund mental health services in 1996. They have not lived up to that promise.
There has been inadequate funding for disability services to eliminate waiting lists and provide for a continuum of care. Budgets have been slashed, staff lost, beds closed, inadequate services, workforce shortages and open access to mental health medications are scheduled to be revoked in the Medicaid program.
There has not been the public outcry to fund an adequate system. Instead, persons with mental illness are being thrown away into a much more expensive alternative – one with much poorer outcomes for everyone involved.
Too often, people receive punishment instead of treatment when in need of assistance
Jail and prisons have become de facto mental hospitals. They are not structurally appropriate for patients, and the staffs are not recruited or trained as psychiatric caretakers. We build prisons instead of recovery centers.
The Iowa Dept. of Corrections has publicly stated 3500 of 8500 inmates have a diagnosable mental illness or around 40%.
In historical perspective, we have returned to the early nineteenth century, when mentally ill persons filled our jails and prisons. In the 1840’s, a reform movement, sparked by Dorothea Dix, led to more humane treatment of mentally ill persons. As a result of Dorothea’s efforts, for over a hundred years, mentally ill individuals were treated in hospitals. We have now returned to the conditions of the 1840’s by putting large numbers of mentally ill persons back into jails and prisons.
We advocate for more assisted outpatient treatment, jail diversion programs, mental health courts, and re-entry programming to divert persons into treatment. Investment needs to be made in housing and supported employment programs as well.
To put all this information in perspective –
Simply put, treatment works, if you can get it. But in America today, it is clear that many people living with mental illness are not provided with the essential treatment they need.
I’d like to end with a meditation which was composed by one of our Board members. It is a meditation for “Those Living With Mental Illness”
When I think about the unfairness of my mental illness
may I also find
the courage to reach out to others,
the memory to recall I am not my illness,
the patience to realize that difficult times pass,
the wonder of the world of which I am a part,
the joy in the simplest of things,
the satisfaction in doing a random act of kindness,
the gratification in completing a goal, however small,
the energy that comes with laughter.
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