Today is one week since the tragedy at Sandy Hook Elementary School. It was a horrifying and an unspeakable act of violence. The terror that ripped through the community of Newtown will impact the minds and hearts of all Americans, for a long time to come. As a nation we are slowly processing the tragedy of December 14, 2012, and we are beginning the necessary discussions about how to respond both legislatively and humanly, in order that this type of woeful violence never happens again.
At Kantor & Kantor, LLP, one of the ways we’re choosing to respond is to invite discussion about the stigma faced by those suffering a “mental illness.” Specifically, we encourage you to comment on this blog or on our Facebook page, sharing how you feel stigma impacts a person’s access to treatment, as well as how we as a nation, as communities, as families and as individuals, respond to our fellow man if we learn they have a diagnosis of “mental illness.”
The national institute of mental health ( NIMH) reports that one in four adults, approximately 57.7 million Americans, experience a mental health disorder in a given year. The U.S. Surgeon general reports that 10% of children and adolescents in the United States suffer from serious emotional and mental disorders that cause significant functional impairment in their day-to-day lives at home, in school and with peers. The economic cost of untreated mental illness is more than 100 billion dollars each year in the United States. However, in 2010, the NIMH estimated that 40% of adults with schizophrenia and 51% of individuals with severe bipolar disorder receive no treatment in a one-year period. Would we be okay if 51% of cancer patients were not receiving treatment?
With such an incredible amount of people suffering with a mental illness, why is it that so many are accessing less treatment than they need in order to get well? Part of the reason people suffering a mental illness do not receive treatment is because some of those suffering will go off their treatment protocol (including medication) simply because their illness compels them to do so. But that accounts for a relatively small number of people, roughly 5%.
What about the other 95%? How much are stigma’s associated with mental illness preventing them from accessing treatment? According to H. Richard Lamb, M.D., Professor of Psychiatry, University of Southern California School of Medicine , “No problem has been of greater concern to mental health professionals, families, and people with mental illness than the stigma of mental illness in our society.” Examples of stigma people with mental illness face include: living in a family system that believes, “therapy is for wimps”; being raised to believe that, “taking medication for depression is a crutch”; and unfortunately there are still people who place stigma on receiving/accepting a diagnosis that involves the word “mental” because our society, even in 2012, still suffers from treating people differently/looking down on them if they have a “mental illness.” Who wants to be treated differently or looked down on for suffering from an illness? No one we know.
“Stigma/discrimination is one of the most important problems encountered by individuals with severe psychiatric disorders. It lowers their self-esteem, contributes to disrupted family relationships, and adversely affects their ability to socialize, obtain housing, and become employed.” (Wahl, 1999). Former secretary of health and human services Donna Shalala said, “Fear and stigma persist, resulting in lost opportunities for individuals to seek treatment and improve or recover.”
By definition, mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning. Why do we stigmatize people who suffer these illnesses? Diabetes and cancer are medical conditions that disrupt a person’s thinking, feelings, mood and ability to relate to others and daily functioning, as well. Do we stigmatize people who suffer physical illnesses? No. And we can no longer allow stigmas around mental illness to muddy our thoughts about who deserves treatment.
We need to deal with any stigmas we might hold against people suffering a mental illness and if people suffering a mental illness make us feel uncomfortable, we need to deal with that on our time, not shun the person or shame them away from treatment. Perhaps NAMI (The National Alliance on Mental Illness) says it best, “Mental illnesses are not the result of personal weakness, lack of character or poor upbringing. Mental illnesses are treatable. Stigma erodes confidence that mental disorders are real, treatable health conditions. We have allowed stigma and a now unwarranted sense of hopelessness to erect attitudinal, structural and financial barriers to effective treatment and recovery. It is time to take these barriers down.”
As we reflect upon this heartbreak at Sandy Hook Elementary School it is important to consider the core issue: according to the NIMH, one-quarter of all Americans meet the criteria for having a mental illness, and more than half do not seek treatment.
What role does insurance coverage and consistency in care play in the lives of people suffering from a mental illness?
Are people with a mental illness denied access to treatment for their illness?
Do people suffering with a mental illness suffer relapse if their treatment was terminated prematurely by the insurance company?
Are insurance companies abiding by mental health parity?
And when will the final rules and regulations for mental health parity be written and authorized?
Four long years after Mental Health Parity was signed into law by President Bush, we wait for final rules and regulations. Until those ‘rules and regs’ are issued, there is no enforcement of this life-saving law we call, “Mental Health Parity.”
These are important questions to contemplate. At Kantor & Kantor, LLP, we have many clients who have been unfairly denied access treatment for various diagnoses of mental illnesses, clients who were discharged from treatment too early, and clients who were juggled through the insurance company’s system – leading to inconsistent care (often leading to relapse and/or premature death).
As we move forward after the Sandy Hook tragedy, we must be mindful that we teach future generations that mental illness is not bad, it is not to be feared, and certainly it is not to be disregarded.
“Children have an amazing ability to grow and to learn and to be empathetic. Either they learn ignorance and hate or they learn love and compassion.” ~ Pasour