Stresslines: Treatment is
key to mental health
recovery and justice
By
Angela D. Vickers
Mental illnesses affect a
person’s thoughts, feelings,
and behaviors. When a
person’s actions and moods
change noticeably over a
period of time, people
should know enough about
common brain illnesses to
consider the likelihood
there might be a mental
illness. With the mood
disorders of depression and
bipolar, the changed
behaviors must occur for a
period of over two weeks.
Checklists are used to teach
us when to see a doctor
about a suspicious mole or
skin problem. Checklists
help people recognize a
stroke or the beginning of a
heart attack. A checklist of
the most common symptoms of
mental illness could alert a
person to the need to see a
professional.
Choosing the proper mental
health professional is often
where the real delay begins.
What professional is right
for recognizing a mental
illness problem? Most
families would think first
of encouraging their loved
one to see a “counselor” of
some type. Most people
consider a psychiatrist to
be someone who sees only
those “severely ill or crazy
people.” The general public
presumes that anyone might
need to “talk with someone”
every now and then. It is
not viewed as being as
threatening or as
stigmatizing to talk with a
social worker, a pastoral
counselor, a family
therapist, a school
psychologist, or a clinical
psychologist.
However, too many people
dangerously delay needed
medical treatment, while
trying to “talk away”
biochemical problems found
in common mental illnesses
through counseling sessions.
Missed diagnoses are often
the result of people
avoiding an assessment by a
psychiatrist. Some avoid
this medical doctor out of
shame. People fear the
discrimination, including a
possible loss of employment,
that comes from being
labeled as a “mental
patient.”
Many citizens simply cannot
afford to visit a specialist
like a psychiatrist. Due to
a lack of parity, health
insurance policies often do
not cover mental health
treatment the way other
illnesses are covered.
Insurance companies may have
restrictions and barriers to
easy access to a
psychiatrist. Many policies
exclude mental health
coverage. Most people cannot
afford to pay for a
psychiatric evaluation, the
often expensive daily
medications, and their
follow-up doctor visits.
Many seeking treatment for
their behavioral issues are
receiving ineffective
nonmedical treatment. Many
lay counselors working in
churches lack the training
to recognize mental illness
symptoms. They are untrained
about the possible deadly
consequences, through
suicide, of not referring a
person to a needed medical
professional. Untreated, or
improperly treated, mental
illness gets worse. The
faith community encourages
medical help for cancer and
heart disease. Many faith
communities associate the
symptoms of mental illness
with a person’s relationship
with God. Symptoms are
viewed as sin. The illnesses
worsen without proper
medical treatment.
Talk therapies, without
more, are often not
sufficient to correct
biochemical problems in the
brain. Sure, the person may
feel better after an office
visit. Therapist and patient
often discuss the patient’s
past and find someone to
“blame” for the patient’s
problems. The person’s
confidence is often boosted
by having someone special
with whom to talk on a
regular basis. However,
recovery for some people
with mental illnesses
requires more.
Peer support groups like the
Depression and Bipolar
Support Alliance —
www.dbsalliance.org — have
been successful for years in
helping people recover.
Participants all see their
individual psychiatrists and
take medications for their
brain illnesses. The peer
support groups are not
professionally led. Group
leaders have received
training in facilitating and
are knowledgeable about
mental illnesses. Some
counselors in substance
abuse treatment and anger
management programs are not
knowledgeable about mental
disorders. Many providers
with mental health training
never studied psychiatry and
the medical model of
understanding behavior. Peer
groups offer a sense of
compassion, accountability,
and encouragement. A big
plus is that they are free
and confidential.
The report of President
George W. Bush’s New Freedom
Commission on Mental Health,
Achieving the Promise:
Transforming Mental Health
Care in America, 2003, noted
that much mental health
treatment in America is 15
to 20 years behind the
latest medical research and
medical knowledge. A delay
in receiving needed medical
care can decrease a person’s
chances of recovery. By
delaying recovery, improper
treatment can put a patient
at risk of substance abuse,
acts of bad judgment, and
even suicide. In conditions
like schizophrenia, bipolar,
major depression, and many
anxiety disorders, it is
well accepted that “best
practices” show that
medications are routinely
needed to restore, and
maintain, proper chemical
levels in the brain.
Trying to discipline away,
punish away, or even reward
and praise away symptoms of
major mental illness is
ineffective and
inappropriate. If these
treatments had been
effective, we would not have
a mental health crisis. The
added stress of improper
treatment can make brain
illness symptoms worse.
Many in the legal community
and the media do not seem to
understand the vast
difference in education and
in treatment styles between
a psychologist and a
psychiatrist. Most talk
therapists and psychologists
are liberal arts majors in
college. After college,
therapists study for an
additional two or four
years, depending upon which
type of degree they were
pursuing. These nonmedical
mental health providers did
not study the biochemistry
of the brain. They did not
study genetics. They studied
behavior changes, when using
therapies such as behavior
modification. They based
their treatment on the
studies and teachings of
others in the field.
Psychiatrists are scientists
and medical doctors who
understand how behaviors,
energy levels, sleep, and
eating patterns are often
tied to brain chemistry
changes. The way a
cardiologist looks at a
person’s heart and how it
affects health, a
psychiatrist looks at the
brain and how it affects
behavioral health.
A psychiatrist first
receives a college degree as
a science major, studying
chemistry and biology. Then
he or she goes to medical
school for four years of
graduate study. The person
must receive a doctorate
from the medical school
before he or she can pursue
a psychiatry residency. The
studies include genetics, so
they can track illnesses
like mental illnesses, which
are inherited, by noting
symptoms in relatives.
Information about suicides,
suicide attempts, substance
abuse, and violence in
family members can assist
physicians in diagnosing a
patient.
Psychiatrists understand how
the brain affects thoughts,
feelings, and behaviors in
those persons who have
inherited certain brain
illnesses. Psychiatrists
observe the changes in the
chemical levels in the
brain. Psychiatry
understands how these
changes affect a patient’s
behaviors, thoughts, and
feelings. They adjust levels
that are either too high, or
too low, using medications.
When the brain chemical
levels return to normal, the
brain is restored to health.
When the brain is well, the
psychiatrist observes that
the thoughts, feelings, and
behaviors of the patient
return to normal.
The talk therapists and the
medical doctors should have
a complimentary role in
patient recovery. After the
psychiatrist has the patient
stabilized and recovering,
the therapist can help the
person understand his or her
behaviors, and to decrease
stress which may trigger
episodes of illness. Since
psychotropic medications can
take a month or longer to
become effective, therapists
can monitor and encourage
the patient who is waiting
for the medicines to kick
in. Therapists can spend the
time it takes to educate the
person about mental
illnesses. This instruction
will help explain how mental
illness symptoms were
affecting the person’s life.
The therapist can also help
their client understand how
the behaviors and attitudes
of others in their family
might also be affected by
symptoms of unrecognized
brain illness. This type of
knowledge helps a person
develop proper coping
skills. Forgiveness and
acceptance is much easier
when a person realizes that
an undetected medical
problem in the brain was the
basis for much of the
unacceptable behavior.
