Improving Mental Health : More complex than you think

Whenever we hear of someone succumbing to mental illness, especially suicide , the knee-jerk response is often  " if only they just got help" . The public often hears that mental health issues is ‘ a chemical imbalance that can be easily corrected with  medications or a few counselling sessions. This is not a complete or fully accurate statement. Both mental health illness and the mental health system is way more complex.  Just like with any physical ailment, there are a variety of reasons why mental health can be difficult to treat both individually and globally.

Included is a diagram of all factors that influence mental health ,

First , issues within the mental health system has less to do with providers and more to do with reimbursement and policies. Here are some examples

  1. Psychiatric services do not generate the revenue of other hospital services, as a result hospital administrators do not invest in sufficient inpatient psychiatric beds or psychiatric medical teams. 
  2. Often mental illness is encountered in school, the criminal justice system or emergency rooms yet there is no real transitional plan to get follow up in the community once released from these settings  
  3. Growth of pharmaceutical industry plus cuts in federal funding and philanthropy resulted in closure of mental health hospital and beds that could provide long term care to poorly functional individuals 
There are social issues beyond stigma, which include 
  1. housing instability
  2. lack of social networks or support 
  3. community violence 
We often forget the impact of holistic factors, like the impact of environment, exposure to nature , light. Will someone living on a tree-lined block with neighborhood parks feel the same as someone in blighted neighborhood filled with abandonment and decaying buildings. What about impact of violent music and movies? What about diet, nutrition and exercise?

Finally , there are individual reasons why mental illness may persist. 
  1. Not all psychiatric conditions are equal. Personality disorders do not respond to medication like mood disorders ( anxiety or depression).   
  2. Self treating with substance or alcohol which aggravates mental illness 
  3. Underlying medical conditions can complicate mental illness, that are difficult to treat or change like traumatic brain injury, dementia or intellectual disability    
 When we acknowledge and address more of these factors,  we will be more successful. As clinicians , researchers, mental health advocates , and public health professionals, we have to start thinking out the box, and applying a truly holistic approach to address mental health.

Dr Isable
Health Empowerment for All. 


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