Tuesday, March 18, 2008

Health Care and Mental Wellness

Political correctness is on everyone's mind these days. We over emphasize the need to not offend anyone based on race, religion, gender, and a host of other reasons. We never wish to make fun of anyone related to appearance or behavior, and to be socially bereft of feelings will make you an outcast quicker than a snowball's chance of survival in summer. But have you ever been called "crazy" or "nuts" or "insane" even in jest? However, there are plenty of people that truly are. And what about those news stories we hear about when someone has "gone postal?" Yet, in most cases, we should try to keep our feelings to ourselves when confronted by someone who truly is "looney tunes;" and instead, we should try to help them if at all possible.

Most of us try to avoid unpleasant situations when we meet somebody who is not normal by our accepted social standards. We feel awkward when we are exposed to someone with abnormal mental capabilities. Our personal radar is set off when we are around anyone who acts out of the ordinary when we are in a public setting such as a store, sporting event, restaurant or other place where crowds are gathered. We feel that there may be security or safety issues that could cause us personal harm or injury, or worse. Most of us are not sure how to handle one of these scenarios and become extremely uncomfortable when approached by someone who is "off his rocker". We have a "fight or flight" mechanism that kicks in automatically, and most of us want to choose the flight option.

Unless someone is a trained professional in the healthcare industry or is active in a security position such as police, armed guard, or military, it is unwise to attempt resolution of a situation where a mentally unstable person is making a scene. The best option is to remove yourself from the area as quickly as possible and inform someone immediately about addressing the issue. Personnel who are educated and prepared to address this type of mental health problem are best suited to help out with someone in a stressful state. Many times, the person who is causing the scene may be unaware of their actions due to a heightened state of mental anxiety exacerbated by any number of reasons.

Data gathered in the Global Burden of Disease study (conducted by the World Health Organization, the World Bank, and Harvard University) revealed that mental illness, including suicide, ranks second in the burden of disease in established market economies, such as the United States. Nearly two-thirds of all people with diagnosable mental disorders do not seek treatment according to a report issued by the Surgeon General. The World Health Organization report also stated that in developed countries, the ten leading causes of lost years of healthy life at ages 15-44 were: (1) Major Depressive Disorder, (2) Alcohol Use, (3) Road Traffic Accidents, (4) Schizophrenia, (5) Self-Inflicted Injuries, (6) Bipolar Disorder, (7) Drug Use, (8) Obsessive-Compulsive Disorders, (9) Osteoarthritis, (10) Violence.

It is pretty obvious that mental health is a major concern on a global basis. About 877,000 people die every year from suicide per their statistics. Hundreds of millions of people worldwide are affected by mental, behavioural, neurological and substance use disorders. For example, estimates made by WHO in 2002 showed that 154 million people globally suffer from depression and 25 million people from schizophrenia; 91 million people are affected by alcohol use disorders and 15 million by drug use disorders. A recently published WHO report shows that 50 million people suffer from epilepsy and 24 million from Alzheimer and other dementias.

The World Health Organization also has a huge amount of data on file addressing mental health issues. One in four patients visiting a health service has at least one mental, neurological or behavioural disorder but most of these disorders are neither diagnosed nor treated. Mental illnesses affect and are affected by chronic conditions such as cancer, heart and cardiovascular diseases, diabetes and HIV/AIDS. Untreated, they bring about unhealthy behaviour, non-compliance with prescribed medical regimens, diminished immune functioning, and poor prognosis. Cost-effective treatments exist for most disorders and, if correctly applied, could enable most of those affected to become functioning members of society. Barriers to effective treatment of mental illness include lack of recognition of the seriousness of mental illness and lack of understanding about the benefits of services. Policy makers, insurance companies, health and labor policies, and the public at large – all discriminate between physical and mental problems.

Many people try to control their mental instability by using medications. Unfortunately, when someone taking a controlled substance for mental health reasons goes off prescriptions, there can be serious repercussions. Now, it can take several weeks for patients and psychiatrists to figure out if an antidepressant is working properly. According to information released online by HealthDay News, only about 30 percent of depression patients will respond to a specific drug. Also, according to USAToday, there is no one size fits all method for treating depression. Exercise will work wonders for some, while not positively affecting the moods of others.

The USAToday article also reported this month that a person’s genetic makeup undoubtedly plays a role in what types of therapies will be beneficial, whether that is exercise, antidepressant medication, psychotherapy, and other treatments. Additionally, there exists a large body of research suggesting that exercise can impact negative moods, and can often be just as effective as psychiatric medications in treating depression. Other studies have found that when people stop exercising, they are more likely to get depressed; and that the more exercise someone got, the less his risk of having a mental health problem. The bottom line is that there is no definitive, cookie cutter answer to treat mental illness. People react differently to various medications and treatments.

Pretty scary stuff! The good news is, though, that there is a huge amount of resources available for anyone to use. A plethora of materials and information is available online, and many resources are available from local and national assistance, including government agencies and private and public mental health facilities and providers. Although mental health conditions run the gamut from mild depression to alzheimers to suicide and more, treatment is available for those who need it.

Until next time. Let me know what you think.

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