Transform the way we think about mental health

The World Health Organization identifies mental illness as the most disabling health condition in the world above cancer and heart disease.

Data reported by the National Alliance on Mental Illness indicates that one in four adults (approximately 61.5 million Americans) experiences mental illness in any given year and approximately 20 percent of youth ages 13 to 18 experience severe mental disorders in a given year.

Mental health issues have spent far too many years under the radar. Fortunately this has gradually changed in the past 15-20 years. Mental health has increasingly become part of the public discourse thanks to the tireless efforts of mental health advocates, family members and people who suffer from mental illness. Mental health struggles are widespread, impact many, and deserve to be treated as a priority for the overall health of society.

While better systems and services exist for those who suffer from mental health struggles; there is much more to be done. The needs of those who suffer and the systems impacted are extremely complex and defy simple solutions. With this complexity in mind, I will only focus on four areas that will contribute to positive outcomes.

The first is supporting and promoting programs that help reduce the stigma of mental illness. Rosalynn Carter, a longtime advocate for transforming views about mental health stated, 'The stigma and discrimination against mental health issues has always been so bad …(it) curtails funding for services, it hurts programs in the community, and stands in the way of getting policymakers interested in the issue.”

Stigma also stands in the way of people seeking help. Stigma creates a culture of fear - fear of being labeled, fear of losing children, fear of losing employment, and the list goes on. People will delay treatment if we aren't relentless in transforming the way we think and act about mental health problems. Mental health must be treated with the same priority as physical health.

Iowa's Department of Human Services took an important step in the direction of reducing stigma by bringing Mental Health First Aid to the state, a program like Red Cross Training, but for mental health.

While this is an important start; legislatively this kind of training or similar trainings (e.g. Stop the Stigma) need to be financially supported so that more community members such as educators, law enforcement, faith communities can have access to training that may open doors for people to get help.

Another area is early identification and early intervention. Just like a physical illness, once we get to stage 4, the illness is much harder to treat. Adopting 'B4Stage4 thinking” (a term coined by Mental Health America) allows for early engagement.

Mental illness is treatable and recovery is possible but both are compromised when treatment is delayed. Early intervention involves all of us - reaching out to a family member, friend or neighbor who may be experiencing a mental health problem, or conducting mental health screenings in doctors offices, schools and elderly services might all be starting points to get someone the help they need before it becomes critical.

Next is the availability of health insurance for all people that include mental health benefits. Before parity laws, people with mental health needs weren't always able to receive insurance benefits for mental health and substance use treatment. The Affordable Care Act and the expanded Medicaid program in Iowa have provided important access to mental health services. Continued support of these programs is vital to meet both the physical and mental health needs of the community. What is missing from much private insurance (and is at risk with public insurance) is a willingness to pay for multisystem services that address the environmental factors impacting a person's mental health struggles. Examples of these are supportive housing, supported employment and case management. Mental health struggles do not occur in a vacuum. Recovery is compromised when the treatment is limited to one aspect of the system.

Finally, the need for additional state appropriations is critical throughout the full spectrum of mental health needs. If we are serious about achieving positive outcomes then we need more access to programs that focus on education, prevention and early intervention, more resources for innovative treatment programs, crisis services, and transitional services for those leaving residential or hospital settings and moving to community based settings.

These are only four out of many areas of need. Let us learn, listen, advocate, and participate to collectively create a more effective mental health system.

l Rosemary Ziskovsky is Director of Mental Health and Community Based Services for Horizons, A Family Service Alliance. Comments: rziskovsky@horizonsfamily.org; (319) 398.3943 Ext 1405