Mental Health Rant

The more I thought about the Goldfarb the more upset I became. Watching the video over and over didn't help.

Many people who believe they do not have issues with mental health (whether they do or not is another story) consistently downplay the significance of mental illness in our society. This attitude is not often actually put into words by educated people. No one who knows better says "They should snap out of it" or "It's their own fault anyway." But we feel that way sometimes anyway.

I work with people with mental illness every day. Still with all my experience, exposure and education I sometimes catch myself transmitting the message "Why can't you just knock it off?" and even when it's not directed right at the patient (maybe it's in a venting session with a co worker) it's always a harmful stance to take. It perpetuates a myth that all people are always in control of how they behave. They are not*.

Shutting down funding for Mental Health programs is like ignoring that people have arms.
("Hello, we are a hospital that only treats anything NOT having to do directly or indirectly with your arms.")
So is the practice of insurance companies denying authorization for mental health services.
("This insurance policy does NOT cover your arms. Sign on the line.")
What would you think if you went to a country where that was the case? You'd probably come to the conclusion that arms are not valued. They are considered expendable. People in that country for some reason just really don't need to worry about arms. For some people, it's because they have never had problems with their arms. So there'd be a lot of fine, two armed people. But then there'd be a ton of people with one or no arms just from minor injuries like broken fingers or infected lacerations.
Denying mental health services sends the message that this entire branch of medicine is less legitimate or important than others.

This is a dangerous message for health care companies and the state government to send because American society in general these days already sends very mixed messages about mental health. On one hand, we are more educated and comfortable about mental health than ever. Characters on popular TV shows have therapists, women are no longer diagnosed with 'hysteria,' when they cry, and men are encouraged to share their feelings with their wives**. On the other hand, women and men alike are feeling the pressure to save face. Think about how much the media harped on Hilary for crying when her polls were down. No one wants to see you break down when times are tough. People are expected to power through and write a book about it, produce some angry music, or create a stand up routine. Anything less is unacceptable. And yet... Oprah continues to have a tv show.

Depression, personality disorders, mood disorders, it's all neurological. It's physiological. It's very, very real. Whether the help is medication or therapy or a group or a program help is needed.
Providing mental health services is imperative for successful preventative health care. People who feel safe and happy drink less, smoke less, do fewer drugs, commit fewer crimes, and reach higher levels of self actualization. To go back to the arm analogy, what do you think will happen to all those people with disabled or missing arms? They will have to be supported even more by the people who do have arms.

I know you can't fix this. You can't re open the Goldfarb. And the money is just not there. But please try to be aware of how you view mental health. Our minds are amazing. I love my brain. If you are blessed with one that works well for your purposes please don't pollute it with bias against minds that need some help. And maybe do some thinking about how to fix these problems.

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* If you want to fight me on this I will probably ask you to meet me at 10 Shattuck Street in Boston. We can stand next to the preserved skull of Phineas Gage and have it out.
** Ugh. Ugh. Ugh. I apologize to my queer readers for this incredibly hetero sentence, but my writing is limited by my scope of experience. I would definitely welcome some guest writing on the subject of Mental Health in the Queer Community if you have some thoughts to share.

One Step Forward, Two Steps back for low income Mental Health

A short time ago I wrote about MGH's decision to put a substantial amount of funding towards a collaboration between the Department of Mental Health and Boston Healthcare for the Homeless.

This article today in the Globe brought some disheartening news: because of the state's budget cuts the Goldfarb is shutting down. Surely some of the clients from the Goldfarb will be able to get mental health services from BHCHP, but not all of them. This is terrible news for those clients, but also for society in general. Crime rates WILL go up, and public morale will continue to fail.

Hope Realized

Today this article from White Coat Notes showed up in my Google alerts. MGH is going to provide a TON of funding for the Department of Mental Health to work more closely with BHCHP.

This is great great news for BHCHP.

Because I believe firmly in holistic approaches to healing, I don't think that health care for anyone is truly complete without a mental health component. Even in the absence of a DSM-IV diagnosis, every one of us has the potential to have spiritual, mental, and emotional disturbances in response to a physical ailment. When these are ignored, well being suffers.

It is especially important in the homeless population to have mental health care due to the fact that mental illness can cause and/or perpetuate homelessness. The prevalence is outstanding, and without proper programming the most we can do in many cases comes down to short term fixes or harm reduction.

Bob Taube is quoted in the above blurb as saying that this move by MGH is going to "revolutionize the way we practice medicine," and I couldn't agree more.