One Consumer’s Observations of the Mental Health Care System in America

The mental health system is a unique culture. Psychiatry itself is, unlike any other medical specialty. Mental health is an enclosed system. That means it is a world within a world. The doctors, therapists, patients, and support workers play roles. It’s a reciprocal environment. Each player in the system allows the other person the opportunity to act out his or her role. For example, the psychiatrist gives you a diagnosis that has no basis (Yes this does happen from time to time). You, the patient, having complete faith in the powers of the behavioral health system, accept this diagnosis as the gospel truth. In time, you begin to notice certain behaviors and thoughts that you believe may be a sign of your supposed illness. You return to your doctor and report these symptoms. Your psychiatrist agrees with your observations and writes them down in your medical record. He also inserts his authoritative comments to support his opinion. Therefore, both parties in the relationship are mutually validated in their roles.

When one has been playing the patient role for so long, a person begins to identify himself or herself as a “psych patient.” That’s who you are. This is the term that defines your very existence. You belong to the mental health system. Soon enough you find that every activity you engage yourself in is related to your disorder and the medication your doctor prescribed to suppress it. It’s a sad commentary indeed. It’s sadder still for the person who needlessly struggles against an undefinable defect in his or her character as if the diagnosis were the irrefutable truth. I acknowledge the fact that the unsettling scenario I am painting here is not true for every psychiatric patient.

At some point, the psychiatric patient discovers the benefits of being labeled mentally ill. There are mental health workers, such as case managers who assist the “consumer” in obtaining a free living allowance from the Federal government in the form of Social Security Disability Income or Supplemental Security Income in whatever minimal amount it may be. I will add for comfort that social security disability benefits are reported (by the government) to run dry in 2016. A consumer is often entitled to free housing, health care, food assistance, and much more. The mentally ill person may even have the right under certain disability laws to bring a pit-bull into a no-pet residential community. Technically speaking, you could even take it on a commercial airliner. The reason is simply because your therapist deemed it necessary that you have an emotional support animal (oops was that a secret?). Don’t get me wrong. I’m sure there are people who require a companion animal for their emotional health. I’m not trying to be disrespectful to those who are struggling. What I’m saying that there are incentives built into the system for many people to accept their diagnosis and play out their role.

There are case managers and outreach workers that will go to court with you, and advocate on your behalf before the judge when you run afoul of the law. They will help the mentally ill with all of their personal affairs. What a bargain! Run out and tell all of your friends about it. Let the government take care of you. It makes being a psychiatric patient seem so much more attractive. Why wouldn’t anyone want a psychiatrist label to them disabled? Again, I’m being sarcastic to make my point that people, who are improperly labeled with a DSM V diagnosis, run the risk of becoming dependent on the mental health system for their needs.

This kind of social welfare encourages people to give up their ambition and motivation. It instills the idea that living a marginal existence is sufficient. I, for one, believe in the greatness people can achieve for themselves and the world by applying themselves.

Remember this. Once you get into the mental health system your chances of getting out are slim. There are a number of reasons for this. Primarily because the psychiatrist or psychologist has you convinced that you have a serious medical problem, which you can’t handle yourself. We all know that’s ridiculous. Many people manage their depression and anxiety remarkably well without the use of psychiatric medications. If Ativan calms your nerves and helps you function, then that’s great. On the other hand, I have seen plenty of people become addicted to sedatives. These drugs are unsafe. I wouldn’t put your faith in the safety of the anti-depressants either. I think the pharmaceutical giants are quick to point that out as a result of the numerous class action lawsuits filed against them.

Some blame can be placed on the pharmaceutical companies for this unnatural drug dependence. As I was writing this article, I surfed NAMI’s website (National Alliance for Mental Illness) and noticed “In Our Own Voice,” a public education program, is funded by a grant from Eli Lily. This is the pharmaceutical giant that manufactures psychiatric drugs like Prozac, Zyprexa, and Cymbalta. I gather (without too much mental effort) that Eli Lily’s generosity is a publicity campaign to make them look like one of the good guys in the mental field, and as a result, boost sales. As I surfaced the Internet, I found that NAMI has been receiving their fair share of criticism for their questionable association with pharmaceutical companies. I will not say NAMI is immoral or unethical. That would be too easy. If Ely Lily offered me thousands of dollars, I would have to seriously consider taking it. Sometimes the decision to cross the line depends on one’s real life needs. Other times it just has to do with making a buck. There is no denying that this kind of corporate misconduct adversely affects the mental health system and exacerbates the suffering of its consumers. Again, I know some people require the assistance of the pharmaceutical companies and the psychiatric community. The screening process for prescribing these medications is a big part of the problem. That’s because there is no adequate process in place for dispensing these potentially dangerous drugs.

Society itself contributes to this dysfunctional culture. The general attitude of the public is “As long as they are not bothering us you can do what you please with them.” This gives the mental health providers even more authority to do as they please. And so the psychiatric patient is stripped of his or her rights. As I see it, a psychiatric patient is a human being without respect or dignity. You can call my words dramatic if you like.

It may seem as I am playing the blame game and the taking on the victim role. Allow to clarify the role of the patient in the mental health system (those like myself). I will be the first to admit that the informed psychiatric patient is the one who is primarily responsible for his or her unfortunate situation. We have to accept our role in the system. No one can twist your arm behind your back, and say, “Go see a therapist about your anxiety.” At least that’s true in most cases. When you reflect on why you did it, you will say, “It seemed like a good idea at the time.”

The worst thing a mentally ill person could ever do, is telling someone about his or her condition. As soon as you do, the other person looks at you differently. An automatic flash goes off in the person’s brain, “Oh God. Here we go. His illness is acting up.” This attitude is especially noticeable in the face of a mental health professional, your family members, and closest friends. It’s a universal reaction. From the moment you reveal your secret, everything you do will be blamed on your illness. The ways in which you express yourself as a normal human being will be measured against your supposed disorder. If you are frustrated about something, the people in your life will conclude, “His meds aren’t working.” When people think you cannot hear them, they will gossip amongst themselves, “Oh he’s a psych patient. That’s why he looks agitated. That’s part of his illness.” This attitude is quite common. It comes from a lack of understanding. How could a person know, unless he or she has personally experienced it.

If you should attempt to verbalize your rights as a human being, the mental health provider will proceed to have you committed to a psychiatric hospital against your will. The patient can be held for an indefinite period of time until a clinician decides the person has come to his or her senses. The mental health professionals can essentially do whatever they want with you because no one is going to speak out against them. In Massachusetts, psychiatric patients must retain a specially trained lawyer to represent them before a mental health court in order to be released. This is where we are in 2013. I’ll bet most of you reading this article didn’t know how our behavioral health system works. We are still in the dark ages.

The only time the state of the mental health system is brought to light is when a patient commits suicide or kills someone. Then there is a public uproar and the psychiatrist or therapist are blamed or in some cases sued. In their defense, no doctor can control the behavior of their patient in society. That is not their job as I see it. The mental health professional cannot be held responsible for the actions of their patients, unless they were grossly negligent in some way. We are free and sovereign human beings. In the United States, people are generally allowed to operate freely without undue interference from others. The American attitude is “No one has the right to tell me what to do.” It’s a slightly different story if the patient states that he or she intends to commit suicide or kill someone. Then the call to duty is activated.

John Backster is an advocate for the mentally ill and an activist for reform in the behavioral health sy

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Workplace Mental Health – A Series – An Overview Of The Issue (This Is Important!)

The mind and the body are inseparable. And you do want to engage the whole employee in your worksite wellness program, right?

Most worksite wellness programs today are not really wellness programs at all – they are employee health status management programs. Why do I say this? Most worksite wellness programs focus solely on employee physical health, to the exclusion of all the other dimensions of wellness.

As conceived by the modern wellness field’s founders, (Robert Allen, Donald Ardell, Halbert Dunn, Bill Hettler and John Travis), wellness is a multi-dimensional concept. The published wellness model of the National Wellness Institute includes the following dimensions: physical, social, emotional, intellectual, occupational and spiritual.

Emotional well-being is associated with numerous benefits to health, family, work, and economic status. Positive emotions and view of life are associated with decreased risk for disease, illness, and injury; better immune functioning; better coping and quicker recovery; and increased longevity. In addition, mental health and mental illness may influence physical health and biologic functioning. Positive mental health is associated with better endocrine function (i.e., lower levels of cortisol, epinephrine, and norepinephrine) and better immune response (i.e., higher antibody production and greater resistance to illness). It has also been shown to be associated with longevity.

Researchers are continuing to learn more and more about the mind – body connection. It has been clearly shown that emotions play a huge role in our physical health. There is also a reciprocal relationship between many chronic diseases and mental health. Self-efficacy, goal-setting, and problem-solving enable self-management behaviors, and these components are dependent on emotional health. On the other hand, self-management behaviors that enhance health, such as physical activity and stress reduction, can improve mental health status and quality of life. In many ways, it makes no sense to address physical health without addressing emotional health at the same time.

The absence of mental illness does not mean the presence of mental health. Growing research supports the view that these are independent, but related dimensions. Mental wellbeing are characterized by the presence of positive affect (e.g., optimism, cheerfulness and interest), absence of negative affect, and satisfaction with life. On the other hand, mental illness is characterized by alterations in thinking, mood, or behavior associated with distress or impaired functioning.

Why Address Mental Wellbeing in the Workplace?

The health of the mind and body cannot be separated. What effects one influences the other. Therefore, a healthy mind supports and contributes to a healthy body and vice versa.

Mental illness costs employers money and mental health can impact productivity and employee performance. Just like physical health, mental health can be viewed as being a continuum. At one end there is mental health and mental illness is located at the opposite end.

Mental health generally refers to the successful performance of mental function, resulting in productive activities, fulfilling relationships, and the ability to adapt to change and adversity. These domains are commonly referred to as wellbeing.

Mental illness includes diseases with classic psychiatric diagnoses, such as depression, bipolar disorder, and schizophrenia. Mental health and mental illness can be influenced by multiple determinants, including genetics and biology and their interactions with social and environmental factors.

Employers approach employee health through a multi-strategy framework. A multi-strategy framework can be applied to an employer approach to mental health as well. A comprehensive approach includes: promotion, prevention, intervention, and follow-up. It is important to recognize that mental health promotion needs to be equal in importance to the prevention and treatment of mental illness.

Today’s worksite wellness programs need to address all dimensions of employee wellness, not just physical health.

Addressing Total Employee Wellness

Employee mental health is a critical component of successful worksite wellness programs. I

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