Editor's note: This story was originally published in Health Care Quarterly, a magazine about Southern Nevada's health care industry. Stories in Health Care Quarterly were submitted by doctors and their affiliates.
The stigma of mental illness is a paradox; it’s all around us but creates a blanket of anonymity that keeps sufferers unseen and often untreated for months, years, decades or sometimes a lifetime.
Although people suffering from mental illness are more likely to seek help today than they were 10 years ago, this stigma often shames many into silence.
Kevin Morss, regional vice president of WestCare Nevada, has worked with the mentally ill for years. During his time at WestCare, a community-based nonprofit that provides responsive human services and behavioral health care programs in 17 states and two U.S. territories, he’s spoken with hundreds of people who needed help, but before finding WestCare they weren’t sure where to start. According to Morss, the bias and challenges facing the mentally ill haven’t changed much over the years but have been decades in the making.
“There’s this very real fear of being ostracized if you have a mental illness,” he said. “Of people thinking you are weak and don’t have it together. That has to stop. Seeking help for mental illness doesn’t make you weak. It makes you strong.”
Erin Kinard, area director for WestCare Nevada, said that the evolution of treatment and awareness will be the key to changing the problems within the health care system so that the mentally ill have access to quality care in a timely manner.
“Early intervention and education are all key components of a successful mental health care plan,” she said.
Different types of conditions affect various demographics.
Depression and ADHD are common issues among teens and children, although in youths younger than 12, it can be difficult to have a definitive diagnosis. Even a decade ago, people were generally diagnosed by their primary care doctors, who, according to Morss, aren’t always equipped to recognize and treat these conditions as are specialists and case workers who deal with it every day. Conditions such as anxiety and mood disorders are often treated before a definitive diagnosis can be reached.
“There has been this tendency to just throw medication at an issue instead of doing investigative case management,” he said. “Medication is a tool, but it won’t solve everything. Today, I think we are seeing a lot more psychiatrist referrals, and fewer doctors are immediately assigning depression as the go-to cause when any number of symptoms emerge.”
Recent statistics estimate that 1/3 of the homeless population has some form of mental illness and do not have the ability or presence of mind to seek out services designed to help their situation. The solution? Resources dedicated to finding people on the street who need help but are unable to ask for it. According to Morss, society’s mental health woes will only dissipate when people collectively start to seek change.
“Society as a whole should care about mental health because it affects everyone,” he said. “If we don’t treat those suffering with mental illness on the front end, many times those same patients end up in prisons and hospitals. Treating the issues in the beginning is more cost effective in the long run.”
Kinard said that while there are a host of issues that contribute to mental illness, she believes that society as a whole has become more violent in the past several decades, with wars and episodes of street brutality. These exacerbate conditions that may have been manageable or dormant before the volatile cocktail of an underlying condition is paired with something like post-traumatic stress disorder.
“We see it in a lot in our veterans, some of whom had no mental health crises before being deployed, but many of whom had an underlying anxiety, depression or similar condition to contend with,” she said. “When these heroes come home, their condition has been intensified by these issues that we know for a fact is in direct correlation with the person’s state of mental health wellness.”
While the perception of mental illness as something to be afraid or ashamed of is not as prominent as it was in years past, the stigma of admitting you need treatment for a condition still exists and prevents some from seeking assistance. One of the most prominent adult mental illnesses is schizophrenia, which, according to Kinard, is perceived as a disease that creates serial killers.
“Pop culture has had a lot to do with that,” she said. “It depicts folks with schizophrenia as ax-wielding murderers who hear voices and cannot function in society. That’s just not the case.
“Actually, with the right medications and treatment plan, people suffering from this disease can lead healthy, normal lives.”
It can be difficult to track patterns of mental health for children who are under the age of 13 because the brain is still developing, and concerns may not pop up until later. Children who are developmentally challenged may display behavioral problems, but true signs of emotional or mental instability may not manifest until they are older. Older children may suffer from depression, anxiety or bipolar disorder. Some of these issues can be situational while others may become chronic. Signs in early adolescence include: out of control or criminal behavior; drug or alcohol abuse; and attempted suicide.
“One of the first signs that something may be wrong is that your child is acting in a manner that is uncharacteristic for that child,” she said. “This is especially true with children who are in middle and high school. Perhaps there are things going on at school that he or she doesn’t want to talk about. If that distress is being internalized, parents will see it in behavior changes.”
“The signs are many and varied,” Kinard said. “But no matter what the signs may be, I know that the system in general can be very frustrating. The most important thing I would say to a parent who is watching a child suffer is that you have to expect that the right kind of treatment may not be quickly pinpointed, but don’t give up. Push. Push the doctors, and advocate for your child until there is a breakthrough that will lead to healing.”
According to Kinard, the key is to get your child talking. If mental illness is allowed to fester then it can become a silent epidemic. But the more these issues are discussed, the safer the child feels discussing their struggles, which makes them feel less alone.
“If a kid knows that a parent understands and can be an advocate, that same child is less likely to attempt suicide or engage in risky behavior,” she said. “Remember that it’s not the fault of your child, it’s the illness. Be caring and compassionate and don’t stop. Don’t give up.”
Amanda Llewellyn is an account executive with the Ferraro Group.