A Check Up From the Neck Up

I just finished reading “A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction” by Patrick J. Kennedy and Stephen Fried. As a mental health and addiction counselor, I found this book right on target with the need to destigmatize illnesses of the brain. He opens with his hope that routine doctor visits will include a “checkup from the neck up.”

Kennedy bravely shared his personal experience of both mental illness and addiction. He suffered medical conditions of asthma and chronic pain from a back surgery. He was diagnosed with bipolar and anxiety disorders, and substance problems with alcohol and opiate dependence.

Kennedy was instrumental in the passage of the Mental Health Parity and Addiction Equity Act which was enacted in October of 2008. A bias exists in favor of medical care over illnesses of the brain. More than half of the people who have been diagnosed with a mental illness or addiction do not get treatment. The Act requires that insurance coverage for mental health should be no lower than coverage for medical benefits, and it can’t be more restrictive than that for medical benefits.

A friend of mine went into the hospital on Tuesday for severe back pain. After a few tests, they ruled out pinched nerves and kidney stones and found gallstones and significant anemia. An endoscopy showed a cancerous malignancy on his colon. My friend received immediate love, support and resources from his network of family and friends. Contrast this outpouring of love with disdain for someone who is diagnosed with an addiction, depression, schizophrenia, compulsive disorder or some other form of a brain illness. These people are just as deserving of compassion as cancer. And yet, their condition oftentimes becomes a family secret.

Granted, mental health and addiction are shrouded with minimization and denial, but I believe that stigmatization about these conditions contributes to lack of treatment until late stage problems exist. The Reagan eras “Just Say No” campaign reinforced the idea that addiction is a character flaw, and not a disease. Even between the two, mental illness is sometimes considered a disease whereas addiction is a moral failing. But, some would rather have an addiction problem than be characterized as crazy.

Research has improved our understanding of the brain and its function in mental health and addiction. It is imperative that we start providing brain health checkups at an early age. A certain percentage of the population will develop some form of mental illness in their late teens and early twenties. The earlier it is identified and treated, the better the prognosis. Many conditions can be prevented with a simple questionnaire that assesses for symptoms that may indicate mental illness or substance abuse. Checkups at any age can be beneficial and can be completed swiftly at a doctor’s office. And when people seek treatment, we need treatment that is accessible and affordable. The consequences of lack of treatment are dire and can lead to suicide.

Much can be done to improve research into prevention, treatment and cures. But first, we need to remove the shame, stigma and discrimination associated with mental illness and addiction. If you, or a family member, suffers from these conditions, be assertive in accessing the best treatment possible and educate yourselves regarding research on evidenced-based practices. Advocate for the best care possible.