I was fairly young when my grandfather was diagnosed with depression. I didn’t understand how he could be so sad when he had such a large, loving family and a seemingly happy life. To some extent, I blamed my grandfather; I didn’t understand what was really happening was a chemical imbalance out of his control. As a society, we still don’t really understand, and many of those who are struggling hide their true selves away to avoid questions and judgment. The recent story of the contrast between a young athlete’s happy life as depicted by social media and the mental illness that led to her suicide is a perfect example. It’s time to really start addressing societal norms and acting on warning signs to behavioral health disorders.
If you search “stigma” on Google, you’re helpfully provided with a definition at the top of the search results: “a mark of disgrace associated with a particular circumstance, quality, or person.” You also get an example, and the one that’s supplied is sadly relevant: “the stigma of mental disorder.” One of the biggest barriers to people seeking help for their behavioral health care needs is the role that stigma plays in their lives. It is what leads people to believe that they are responsible for their own illness or keeps them in denial about it. After my grandfather’s initial diagnosis, it was rarely ever spoken about again, and certainly never by him. We are not yet comfortable speaking freely about mental health disorders.
It is especially unfortunate that the stigma of mental illness is so great, given how prevalent it is. One in four Americans will be affected by a mental health disorder in any given year, and many more will have a family member affected. According to the National Alliance on Mental Illness (NAMI), serious mental illness costs the US $193 billion in lost earnings per year. Furthermore, Colorado recently published a report (PDF) that shows our state ranks poorly on a number of behavioral health measures. Most notably, Colorado has the fifth highest suicide rate and the second highest rate of non-medical use of prescription pain relievers in the nation.
In any given year, it is estimated that 60% of people in need of mental health care will not seek treatment. Unlike our response to a broken leg, mental illness is often considered a health issue that can wait or is merely a sign of weakness—something that may fix itself. The Affordable Care Act requires health plans to provide mental health and substance treatment, so potential access to care is improving. There are also several Colorado initiatives aimed at increasing access to mental health care, such as the Colorado State Innovation Model, which aims to integrate primary care and behavioral health care, and the Denver Foundation’s Colorado Health Access Fund, which is a funding opportunity focused on increasing access to behavioral health care. Now, it is imperative that patients realize that access.
The path to recovery for those suffering from mental illness or substance use is often long and requires the support of peers and professionals. Similarly, Colorado’s path to a better mental health system will likely be long and require the effort of many dedicated individuals and organizations. My hope is that somewhere along this journey we find acceptance and openness to end the stigma and reach out for help.