How to Manage Your Mental Illness at Work If you suffer from depression, anxiety, PTSD or another mental illness, here are some real-world tips to help you stay happy and healthy at work. by Eric Ravenscraft
Like 46 million Americans (according to
the National Alliance on Mental Illness), I regularly deal with a mental illness that has the potential to disrupt my daily life. Some days it comes in the form of an emotional breakdown that stops everything I’m doing dead in its tracks. Most of the time, though, it is quieter. It can be a haze that makes work slow, or it can stifle ideas when I need them most. Unlike many physical illnesses or disabilities, having a mental illness isn’t always visible to the people you work with. This can be a double-edged sword. On the one hand, it means you might not face as much open discrimination as someone with a more visible condition. On the other hand, when your mental illness makes doing your work difficult, to outsiders it can look as if you’re
just not doing your job well, which also makes it hard to get the support you need. Fortunately, United States law provides some protections for people with mental illnesses — just as they do for any physical disability — but they go only so far. Here, we’ll go over some of the support you can expect from your employer, but we’ll also discuss strategies you can use to get through the day, even when you’re not feeling your best.
The legal protections you have against discrimination: First and foremost, in most cases, you have the right under the Americans With Disabilities Act not to reveal that you suffer from any mental illness, so long as it doesn’t affect your ability to do your job. However, if
you need special accommodations from your employer — some of which are also protected by the A.D.A. — you may need to disclose your condition. One of your primary protections under the A.D.A. is that your employer cannot discriminate against you because of your condition. While employers have the right not to employ anyone they believe cannot perform the duties a job requires, they are not allowed to use the fact that you have a mental illness alone as a reason to discipline or terminate you. Notably, this extends to employers using stereotypes or misconceptions based on that mental illness. For example, if you suffer from depression, and your employer — lacking a proper understanding of depression’s symptoms — incorrectly believes you would be too glum or sad to take care of customers, he or she wouldn’t be able to fire you or use it as a reason to withhold a promotion. This is a stereotype and not reflective of your actual job performance. If you received repeated complaints from customers about poor service or frequently failed to show up to work, however, your employer could use this as a reason for discipline or termination.
The reasonable accommodations you can ask for: Time off or flexible work schedules. If you need time off for therapy appointments or to take care of reasonable treatment, an employer must make a reasonable effort to work around your schedule. That doesn’t mean giving you as many days off as you want, but rather things like adjusting shifts around your appointments or providing sick days when your condition is worse. A more accommodating work environment. If it is easier to get your work done with your condition when it is not loud, you can ask your employer for a quiet place to work, or accessories like headphones that let you work in peace. Special supervisory conditions. Say you have a sensory issue that makes it difficult to retain verbal instructions: You can request that your employer submit instructions in writing instead. Permission to work from home. You can request that your employer allow you to work from home, even in situations where other employees may not be granted the same opportunity. However, you must be able to perform your job duties remotely and keep up the level of work expected of you. 13
As you can imagine, the line between what counts as “reasonable” and not can become fuzzy. If having depression means you need to take a sick day every once in a while, that might be a reasonable accommodation to expect. If you frequently don’t show up to work without communicating with your employer, however, that would have a tangible impact on your job performance. For some jobs, the accommodations you need might be entirely unavailable. You might be able to request a quiet work environment if you work in an office building. If you work on a construction site, however, that might be impossible. The key word is “reasonable,” and it’s a very fudgy word. As with a physical illness, you may be required to provide a doctor’s note or other documentation to your employer in order to get the accommodations you need.
“Sometimes bosses just don’t want to deal with helping struggling employees out.”
It is also important that you ask for any accommodation you need before you’re in a situation where it could affect your work. If you don’t speak up about your needs and it affects your job performance, an employer can claim that your termination was because of your work, not your condition. It’s hard to argue if you never explained your situation or what you need in the first place.
What you can do when the law isn’t enough: In some cases, it is a good idea to talk to your employer to get accommodation. If you believe you’ve faced discrimination because of your condition, the E.E.O.C. is a good place to turn. As anyone who’s dealt with a mental illness on the job can tell you, however, the reality is often a lot messier than the law makes it seem. Disclosing your condition to your employer can be scary. You may worry that this will define you in your employer’s eyes — and worse, you may be right. Sometimes bosses just don’t want to deal with helping struggling employees out. The law requires employers to make reasonable accommodations. It doesn’t require them to like it. Even compassionate bosses might not keep your condition in mind when making budgetary decisions or deciding who to promote.
source: New York Times
With that in mind, there are a few strategies I’ve collected over the years that help balance personal needs with those of my employers: Save the repetitive, tedious work for your down days. Some jobs may require both creative and mechanical or tedious work that you can split up and work on when you’re best able to do it. If your workweek includes brainstorming pitches for a meeting and manually entering data into a spreadsheet, try to get the more creative part of the job done when you’re having a good mental health day, and save the tedious stuff for when you’re having a harder time. Seek out the work style that suits your needs best. For the last six years, I’ve had the good fortune to work from home. Before that, I learned that working in an office was harder for me based on my needs. You might prefer structure or you might prefer flexibility, but pursuing jobs that give you what you need can be better in the long term than trying to fit your needs into the spaces left over by your job. Take care of your home life. You can’t control everything that happens at work. You have a lot more control at home. If you need space to cry, scream or break down, give it to
yourself when you’re off the clock. Take care of the basic routines like food, hygiene and chores that give you a sense of stability. Avoid trying to keep up with your co-workers. It’s easy to get swept up in a corporate culture that prioritizes a certain kind of performative work. If your co-workers can sit down for four straight hours and pump out work, don’t try to force yourself to do the same. If you need frequent breaks to keep your stress levels down, that’s how you work. As long as you’re able to do the job to your own (and your boss’s) satisfaction, how you get there shouldn’t be as big a factor. The biggest lesson I’ve learned, however, is that there is no clear “right” way to do things. Sometimes what works is communicating with your boss about the specific steps you can take together to make a productive work environment for you. And sometimes it means giving yourself space to cry into your lunch for no good reason and coming back to your work when you’re ready. Both are valid and necessary.
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SAMPLE SPREADS
^ ANGÉLICA / Alex Tan ^
Let’s Talk About Capitalism and Mental Health. If you suffer from depression, anxiety, PTSD or another mental illness, here are some real-world tips to help you stay happy and healthy at work. by Lauren Martinchek
There are mornings where I’ve woken up, and the feeling of depression and anxiety at the thought of going to work was so all-consuming I actually threw up. It got so bad at one point at my old job that I lost twelve pounds over the course of a little over a week. I was down to barely over ninety pounds. Even now, working at a job with coworkers who have become like family, I still get that feeling frequently. It’s not as pronounced as it was at the previous job, but it’s become almost like a soft, constant drumbeat there in the back of my mind. What am I even doing here? The feeling of being stuck, tied to a job where you make next to nothing living in an area with little employment opportunity can literally suck the life out of you if you let it, and it’s almost impossible not to.
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We’ve all felt it. Burnout. “Burnout” has become so profound and widespread that the World Health Organization has actually classified it as a real occupational phenomenon. According to the WHO:
“Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy.
for it, mind, body, and soul. All too often we forget that as workers we have cultivated everything around us. We produce the technology, we build the roads, we take care of our sick, and we teach our young but in the end what do most of us even have to show for it? I am a certified nursing assistant at a local nursing home. My coworkers and I are devoting our entire lives to taking care of the elderly. We are some of the first people they meet when they move in, and we sit beside them, hold their hands, and whisper words of comfort and love to them as their bodies prepare to die. Not to mention the fact that we often are their eyes, ears, and voices in between. Up until recently I had a coworker who works so often and puts herself under so much stress that her doctor is worried she’s going to have a stroke. She’s in her twenties. Why should we have to work 70 or 80 hour work weeks just to be able to afford to travel once a year, or even simply put food on the table for our families?
“This idea of working just in order to live has become so engrained in us as a species that we hardly even bother to question it.”
When discussing this phenomenon, it would be irresponsible to do so without acknowledging the role capitalism has played in its development. As human beings we lead very fleeting lives here on this planet. Yet we spend almost our entire lives as a cog in the rich man’s machine, just so we are able to survive. This idea of working just in order to live has become so engrained in us as a species that we hardly even bother to question it. Instead, our feelings manifest themselves in other ways, like throwing up when we wake up in the morning, or sitting there at our desks feeling an overwhelming sense of worthlessness. Capitalism isn’t just about economics. Capitalism has evolved into an entire way of life for almost every single group of people on this planet, and we’re suffering
I am a human being of this planet, and I can’t even begin to describe how upset it makes me that I will probably never get to even a quarter of the places I would like to see. Even the simplest of little pleasures, like going out to eat with friends and loved ones at a restaurant is something that all too many of us can’t afford to do. We are putting everything we have in to
this economy, and burnout is simply a natural occurrence within a system that increasingly forces us to see that we are getting almost nothing in return. Burnout and our mental health within this system has nothing to do with just not wanting to work. But it does have to do with stagnant wages, exhausting hours, fewer and fewer benefits, and a system that is designed to exploit as much as it possibly can out of us and give as little as it can back in return. I love to work, but I do not want my life to revolve around it. It should not determine my value as a person, and it shouldn’t determine yours either. It is so easy to think of these things and instantly become discouraged. It’s so easy to lie there at night, consider it all, and feel like there is absolutely nothing we can do. But while capitalism may be able to destroy our mental health, it isn’t able to destroy the power of numbers. We have the right and the ability to demand better for society as a whole. It all comes down to culture and whether or not we have the willpower to change it. Hopefully, the time is fast approaching when we do.
^ Natural Beauty / Rob Christian Crosby ^
source: medium
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Globally, an estimated 264 million people suffer from depression, one of the leading causes of disability, with many of these people also suffering from symptoms of anxiety. A recent WHO-led study estimates that depression and anxiety disorders cost the global economy US$ 1 trillion each year in lost productivity. Unemployment is a well-recognized risk factor for mental health problems, while returning to, or getting work is protective. A negative working environment may lead to physical and mental health problems, harmful use of substances or alcohol, absenteeism and lost productivity. Workplaces that promote mental health and support people with mental disorders are more likely to reduce absenteeism, increase productivity and benefit from associated economic gains.
source: mental health foundation UK
^ Untitled / Daiga Ellaby ^
The Importance of Maintaining Friendships During Mental Illness How my friends helped me through my darkest moments. by Beth Romero Everything fell apart for me in 2014. I thought I had a tight knit circle of friends. I was on a roller derby team that did everything together — promoting, fundraising, practicing, and skating. When I had to quit the team because my mental health was further compromised by a leader, I discovered only a smallish number of people would actually continue to stay in touch with me and care about me despite the many hours we had spent together.
Looking back, this should have been less surprising. I had been home-schooled all 12 years, so this was my first experience with organized sports and it stung deeply. I didn’t realize that for many people these were relationships of convenience that would be dropped when they stopped being convenient. When I was finally able to drag my attention away from what I lost, I realized that there were things I had also gained. I met my
to-this-day bff, with whom I talk every week despite the 1500 miles between us. I met others who provide nurturing exchanges of care and affection. I learned to treasure these connections. Although the experience of losing friends was painful, it made me grateful for those who stayed, and it taught me the importance of maintaining those connections. So here are my reasons for maintaining friendship during mental illness. Friends stave off isolation. When you’re mentally ill, the isolation, self-imposed or otherwise, can eat you alive. In my case, my partner works 12+ hour shifts and is typically gone for two weeks at a time, during which I spend a lot of time alone with my thoughts. I’ve had to learn to create friendships outside of my relationship in order to not feel so alone. It’s been extra critical because alone time is when my demons like to hunt. When we first moved to Wyoming, I isolated myself. I both craved and feared interaction, but fear usually won out. It took me months to start trying to find local friends, and when I did, no one was as scary as I feared at first. While I still have a tendency to hermit when depressed (sometimes I simply cannot leave my living room couch, much less my house), my network of friends here has been everything. The thing is, to a certain degree, you’re always going to be alone. No one else can face your demons. But sometimes, a good friend can hold your hand while you do so, or give you the courage to lift your head once again, and that can make all the difference in the world.
Friends give you space to process. Not everyone can afford a therapist, and while that shouldn’t be the sole use of your friendship, friends can definitely help you to process things, bringing the friendship to a new level of trust and closeness in the process. People process grief and trauma in a variety of ways. Some people use writing, some people use art, some use talking, some lift weights, and some use a mix. While my journal has been a space where I am lucky to be able to process things, talking has also been extremely useful. The thing that sets a conversation apart from the other methods is that it’s a two-way street, so a good friend can provide valuable feedback or even just validation when you’ve recounted a trauma and your feelings about it. Or maybe you weren’t able to give voice to your feelings while recounting the bare facts, and your friend can encourage you to do just that. This comes with a caveat — you never want to put more on a friend than they can handle, and you have to be mindful of their traumas and triggers as well. But if your friendship’s boundaries allow for the sharing of sensitive content for the purpose of analyzing and reframing your history into a story that empowers you, then it can be a great place to bring your troubles. And again, a conversation is a two way street. If you’re sharing your past, it’s likely your friend will be encouraged to as well. Then it’s not just you dumping your problems on your friend, but you helping each other. Processing your history together can be a great way to build a stronger friendship. 25
Friends help you to get perspective. I have a tendency to use scathing self-deprecating humor in regular conversation. On a recent trip with my friend, she gently called me out on it. “Do you realize how much shit you talk about yourself?” she asked with love and concern. I thought about it, and I explained that if I didn’t use humor to deflect, I would probably just internalize the negativity I was feeling about myself and feel much worse. At the time, it felt like the only way to handle my bad feelings about myself. The more I’ve thought about it, the more I’ve realized there are other options. While I don’t see self-deprecating humor making an exit from my life because it’s been a part of who I am for the better part of 30+ years, her question left me shaken. It echoed my therapist’s chiding that I am too hard on myself. It made me wonder what other not-so-healthy coping mechanisms I used without realizing, not an in accusatory way, but in a gentle and helpful way.
“No one else can face your demons. But sometimes, a good friend can hold your hand while you do so, or give you the courage to lift your head once again, and that can make all the difference in the world.”
Friends help you to get perspective. Sometimes all it takes to find a solution to a situation is a perspective shift, and so often that shift comes from bouncing ideas off of someone and getting their feedback. As illustrated by my story, sometimes we don’t even realize we need a solution until someone points out that things are a little off. Friends bring you joy. Joy is such an elusive thing in today’s world, especially if you suffer from a mental illness like depression or schizophrenia, which can produce consistently low moods. My bff and I have both endured some rough times, recently. We both have mental illness, and she in particular has had job woes because of the rocky employment climate where she lives — there are far more people than jobs and the jobs that are available
^ Shoes / DTS ^
tend to be lower paying. She’s found herself working two or three at a time and still barely able to make ends meet. Somehow when we talk about things, we find humor, we find light, and things don’t seem so hard. Maybe it’s because we don’t just talk about the bad, we talk about the good. And the in-between. And somehow in the process of talking about the chaos that is our lives, we begin to make sense of things. And in that sense we find joy.Just hearing each other’s voice on the other end of the line is enough to bring lightness to our days. The joy of friendship comes from finding someone with whom you can make sense of life, someone who relates to you on the same level, someone who “gets” you along with your hopes and dreams.
particular went above and beyond. We sent each other readings of books we enjoyed. He sent me so much good, soulful music. He sent me stories he had written. We talked about all of the things that bothered me, however petty or traumatic, because at the time I was a raw wounded thing and everything hurt constantly. He never made me feel judged, especially when I told him I wanted to end things. Or when he guessed that I did, and I confirmed it. Instead, he made me promise him that if I got to the point that I felt I had to end things, that I would call him first. And if I couldn’t reach him, I had to wait until the morning. He saved my life, more times than he knew. Even if I was too depressed to make the call, I knew, I just knew that I couldn’t do that to him. Not after all the time he had invested in me, in our friendship.
Friends keep you safe. For all of the above reasons and more, friends keep you safe. Suicidal ideation is a feature of many mental illnesses, and while even the best of friendships may not be able to eliminate it entirely, being anchored to people who care about you can help you to remember why you want to make it through a particularly bad night. During one of my darkest periods of depression, I had a friend who checked in with me nearly every day. I was lucky enough to have a few people who checked in with me regularly, but this friend in
He made me feel like a Worthwhile Person. Writing this makes me happily weepy because in a volatile time he made me feel like maybe things wouldn’t always be so bad. The fact that he took the time to do this speaks so much to the wonderful and caring person that he is, and this article is a big shout-out to him. Maybe not every friendship will be so dramatically lifesaving, but you’ll never find those kinds of connections if you don’t try and if you aren’t open to them. And you should definitely be open to them, because they can change your life for the better.
“There may be no relationship more affected by mental illness than the intimate relationship between partners.�
^ Untitled / Youssef Naddam ^
How Mental Illness Affects Romantic Relationships Half of all adults will experience a mental health condition in their lifetime. by April Eldemire, LMFT
Nearly half of adults experience a mental illness at least once in their lifetime. Research and practical experience tell us that mental illness can cause a person to have decreased quality of life, decreased productivity and employment, and even impaired physical health. A mental illness—including post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, and alcoholism—can also affect a person’s relationships. There may be no relationship more affected by mental illness than the intimate relationship between partners. The good news is that it’s possible to be in a healthy, loving, and long-term partnership
with someone who has a mental illness. If this is relevant to you, be aware of the unique challenges you and your partner may face, and utilize resources and strategies that will help you grow and nurture your relationship. 3 Ways Mental Illness Can Affect an Intimate Relationship The following issues are common within couples affected by mental illness. No two relationships are the exact same, so it’s important to take into context your unique relationship so you’ll be able to identify where you may need additional guidance.
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Shame, guilt, and resentment. Having a mental illness is hard enough, but the stigma associated with mental health conditions can add an extra layer of stress for both partners. The person with a mental illness may feel shame, embarrassment, or guilt about their condition. They may try to hide their symptoms or fail to seek the help they need. Meanwhile, their partner may feel confused or frustrated by their inability to help. In some cases, a person with depression or anxiety may find it difficult to follow through with household tasks, have limited emotional availability, struggle to maintain employment, and lack the desire to socialize. For their partner, these behaviors and challenges can put a strain on the relationship which may lead to feelings of disappointment, rejection, and disconnect.
“People should feel empowered to seek help if they or their loved one is struggling with mental health.”
Intimacy problems. Having a mental
illness can make a person disinterested in sex—either as a result of the condition itself and/or as a result of their treatment. (Decreased libido is a common side effect of antidepressant medications.). Many people with mental health conditions may feel inadequate and have performance anxiety and low self-esteem. For both partners, this can lead to a decreased opportunity for bonding and result in unmet needs.
The risk of codependent behaviors. Codependency is an unhealthy relationship pattern that manifests as one partner enabling another person’s poor mental health, addiction, and/ or coping strategies. The partner of a person with mental illness may start to derive their self-worth from the degree to which they are “needed” or how much they are able to “take care of” their loved one. In extreme cases, codependency can increase the risk of abusive behaviors, including manipulation, name-calling, and other unhealthy dynamics. Knowing how to distinguish the need to encourage and support from the co-dependent nature of managing the other person’s symptoms will help. Having a partner affected by a mental health condition can be navigated in a relationship if both partners have the skills and awareness to cope and communicate through these challenges. source: psychology today
This is why a paradigm shift is needed: People should feel empowered to seek help if they or their loved one is struggling with mental health. Mental illness is not a character flaw nor a moral issue. Yes, people need to be held responsible for their actions and behaviors— but they also deserve context, understanding, and support so they can learn how to manage their well-being, heal from past trauma, and honor their partner’s experience. Helpful Tips for Partners
Commit to excellent self-care. By taking good care of your physical and mental health, you’ll be better equipped to support each other and your family. Beneficial acts of self-care include regular exercise, healthy eating, a consistent sleep schedule, journaling, and doing hobbies and activities you enjoy.
Seek professional help. Use whatever resources are relevant to you and within your means. Both couples counseling and individual counseling may be appropriate.
Educate yourself. Learn about the condition together. This helps you gain a better understanding of it and clues you in to how the symptoms manifest in your marriage or partnership.
Practice your communication skills. Speak openly and honestly about your feelings, needs, and concerns. Use “active listening” skills like seeking understanding, asking clarifying questions, and using engaged body language (eye contact, a gentle touch, and interest).
Have realistic expectations. You can’t demand that someone change who they are nor expect them to meet all your needs at all times; this is true for all relationships. Equally, you shouldn’t have to violate your boundaries in order to maintain the relationship. Find a way to compromise and grow so both of you feel safe and supported.
source: World Health Organization
Globally, an estimated 264 million people suffer from depression, one of the leading causes of disability, with many of these people also suffering from symptoms of anxiety. A recent WHO-led study estimates that depression and anxiety disorders cost the global economy US $1 trillion each year in lost productivity. Unemployment is a well-recognized risk factor for mental health problems, while returning to, or getting work is protective. A negative working environment may lead to physical and mental health problems, harmful use of substances or alcohol, absenteeism and lost productivity. Workplaces that promote mental health and support people with mental disorders are more likely to reduce absenteeism, increase productivity and benefit from associated economic gains.
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Reducing the stigma of mental illness with digital treatment options by Alyssa Place
Mental health has become a global epidemic, and employers are quickly becoming aware of how important it is to provide resources for workers who may be struggling. “We’ve gone through an evolution from where mental health wasn’t being addressed at all within the workplace to a point today where there is a far higher level of awareness,” says Ken Cahill, CEO of SilverCloud Health, a digital mental health company. “But we have to move from that to providing an actionable plan and a solution within the workplace.” One in four people will be affected by a mental health disorder during their life, and 450 million people have mental health issues, according to the World Health Organization. The financial drain on the workplace is staggering: mental illness accounts for $194 billion in lost revenue per year due to increased healthcare costs, lost productivity and absenteeism, according to the National Alliance on Mental Illness. Partner with a TPA that knows how to get wellness incentives 67
done There’s a lot for self-insured businesses to think about and keep track of, such as employee health programs. SPONSOR CONTENT FROM “People aren’t being given the toolkits to help them handle the key challenges that are there in life,” Cahill says. “Those [challenges] will leak into the everyday work environment.”
“Despite the growing number of people living with mental health disorders, finding accessible and affordable treatment is often a barrier to getting help. “ Despite the growing number of people living with mental health disorders, finding accessible and affordable treatment is often a barrier to getting help. Two-thirds of people with mental disorders never seek treatment from health professionals, according to WHO. “The level of acceptance around mental health is improving, but the system is getting worse — our access to mental health professionals, psychiatrists and others is getting worse,” says Michael Thompson, president and CEO of the National Alliance of Healthcare Purchaser Coalitions. SilverCloud hopes to ease the burden through their benefits platform, treating mental health needs through online modules, journaling and coaching.
“It’s very much about the full spectrum of care — challenges around work-life balance, resilience, sleep, financial debt, anxiety and depression,” Cahill says. “What we’re delivering to the organization is a full end-to-end solution, and everyone can access it.” SilverCloud uses techniques backed by cognitive behavioral therapy, one of the most common forms of treatment. Users start by taking a short quiz, which identifies a variety of risk factors associated with their mental health and assigns them various program modules 30 to 40 minutes in length. Users also have access to in-person coaches who can personalize and suggest other modules and features, depending on their needs. Cahill says SilverCloud can be used in conjunction with in-person therapy and other mental health treatments, but 65% of users report a clinically significant improvement in the reduction or severity of their symptoms, in line with person-toperson therapy outcomes. Currently, over 200 healthcare, payor and employee benefits organizations are working with SilverCloud. Express Scripts and Mercer Canada will soon be able to get access to the company’s digital mental health platform as well. SilverCloud is part of a growing group of digital mental health providers hoping to meet the demands of employees placing a high priority on accessible, tech-based mental health benefits. Benefitfocus includes access to Happify through their BenefitsPlace platform. The mental health app uses gamification to teach mood training. Additionally, Cisco recently partnered with Vida, a chronic care app, to offer teletherapy through its digital coaching platform. Cahill says the focus on the importance of
source: Medium
good mental health will push employers to keep fighting for these critical resources. “The reason we all hold down a job, work as functioning members of society, hold on to relationships and those kinds of things are the result of good mental health,” he says. “There’s still work to be done, but the strides that have been made are a real sea change from where we were two or three years ago.”
v Listen 1 / Danny Owens v
SAMPLE SPREADS
Too Many Americans Suffer from Mental Illness.
Here are Some Solutions: by Tom Pollock
The 2008 Mental Health Parity and Addiction Equity Act pushed insurance companies to cover mental health like other medical treatments. It was a necessary law. For too long, insurance companies have charged punitive co-pays and deductibles for mental health treatments. Yet the law is far from perfect. Its enforcement mechanisms are weak and too many loopholes remain.
Nevertheless, the real challenge with American mental health is not laws or regulations, but perceptions. Because today, fearful of the stigma that still sticks to mental health conditions, too few Americans are seeking treatment for serious health issues. As the National Alliance on Mental Illness (NAMI) notes, one in five Americans will experience a mental illness, and one in 25
< Patches / Anton Darius / Source: Unsplash
“We need a social awakening to mental health. Specifically, we must end the stigma that goes with saying ‘I have a mental health condition.’ ” Americans now live with a serious mental illness. But get this: 60 percent of adults and 50 percent of children with these conditions did not seek treatment in 2014. Racial discrepancies are also at play: AfricanAmericans, Hispanic-Americans and AsianAmericans are two to three times less likely to seek mental health treatment than whites. Imagine if those statistics applied to physical conditions? There would certainly be many visibly ill and discomforted individuals walking on our streets. As a society, we would not stand for it. We would demand action. The real challenge with American mental health is not laws or regulations, but perceptions Still, this is just the beginning of the mental health statistics horror show. NAMI also points out that mental illness has physical impacts on society. Twenty-six percent of homeless shelter residents, and 70 percent of youth in state and local juvenile systems have an underlying mental illness. In addition, 37 percent of mentally ill students aged 14 and older drop out of high school.
In each of these cases, we see the possibility of better lives imprisoned in a mental health abyss. These statistics testify to an ongoing American tragedy. But at its hardest edge, America’s mental health crisis is also existential. According to NAMI, 90 percent of suicide victims had a mental illness before they took their lives. Suicide is now the third leading cause of death those aged 10–24. The correlation between mental health treatment and untimely death is transparent. Thus, so is our national responsibility. After all, if reforms could save just 10 percent of these lives, surely they are worth our energy. So what should be done? A few things. First and most important, we need a social awakening to mental health. Specifically, we must end the stigma that goes with saying “I have a mental health condition.” As someone diagnosed with obsessive-compulsive disorder, I understand this quandary personally. It is hard to admit to friends — let alone acquaintances — that you have a mental health condition. And in large part, 73
“We need a social awakening to mental health. Specifically, we must end the stigma that goes with saying ‘I have a mental health condition.’ ” that’s because our society continues to regard mental health as somehow taboo. That said, there’s a simple way of addressing this issue: discussion. By broaching into the statistics that show how many Americans suffer from mental health problems, and how many lives these problems are degrading, we can bring mental health out of the shadows. Public figures can play a key role here. Just as George W. Bush used his struggle with alcoholism to inspire other sufferers, public figures should be encouraged to come forwards and talk about their own mental health challenges. Former British Prime Minister Tony Blair’s former chief spokesman, Alistair Campbell, offers a stellar example here. Campbell makes frequent high-profile speeches on his own mental health struggles. The crucial point is that these discussions don’t simply de-stigmatize mental health issues, they guide others to treatment options. And in some cases at least, those treatment options need not be expensive.
Whether it’s Alcoholics Anonymous, Narcotics Anonymous or Cognitive Behavioral Therapy, participatory mental health groups improve many lives.
Second, we need to fill gaps in coverage. While the federal government is improving enforcement mechanisms for the 2008 Mental Health Act, we need to make more insurance plans cover more mental health issues. These discussions don’t simply de-stigmatize mental health issues, they guide others to treatment options. Consumer pressure is the best mechanism for this ambition: there are enough sufferers out there! Autism treatment options for children represent an especially concerning problem. As of December 2015, 43 states and the District of Columbia required insurers to provide autism coverage for children in health plans. But seven other states did not. Republicans and Democrats should work together to close that gap. The American Medical Association should also prioritize mental health treatments in the
same way as its British equivalent. It could, for example, expand grants for psychiatric physicians in training. At present, too few mental health professionals are available. As with primary care physicians, mental health treatment shortages are especially problematic in rural areas. Third, while we retain our exceptional medical research efforts â&#x20AC;&#x201D; critical for developing new mental health pharmaceuticals â&#x20AC;&#x201D; we must also ensure that U.S. pharmaceutical companies export their drugs at higher prices. This will reduce cost discrepancies that U.S. consumers pay for mental health focused pharmaceuticals in contrast with Europeans.
The understanding here is simple: if mental health related pharmaceuticals are cheaper, more Americans will be able to purchase those drugs to improve their situation. Sadly, Obamacare immorally raises the costs of health care rather than reducing them. None of this is to say that addressing our mental health crisis will solve every major social issue. We must not assume, for example, that improving mental health treatments would solve homelessness. Regardless, this is a task worth our attention. Just as cancer does not discriminate between Democrats and Republicans, neither do mental health conditions. This issue affects individuals regardless of class, race or creed. In bipartisan spirit then, we should work
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source: High Foucs Centers
Millions of Americans experience the symptoms of mental illness every year. The National Alliance on Mental Illness (NAMI) estimates that 43.8 million adults in the United States deal with a mental illness annually. Around 10 million people suffer from a mental illness that severely interferes with major life activities. Sadly, [nearly] half of these mental illnesses go untreated, leaving adults and children unnecessarily suffering from symptoms. The reasons people donâ&#x20AC;&#x2122;t seek treatment are vast. The stigma and shame around receiving treatment can keep people from getting help. Poverty or embarrassment can also keep someone from asking for help. It may be difficult to find a therapist you like. Many medications for depression, anxiety, and other mental illnesses have undesired side effects. Mental illnesses often isolate people and make it difficult to keep searching for solutions. Unfortunately, some people give up without finding the right combination of therapies.
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