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Tuesday, January 18, 2011

The Arizona Tragedy and the Stigma of Mental Illness

Statement by Jacob Berelowitz, LMSW
Executive Director, Talk Therapy Television

The recent tragic events in Arizona have once again generated nationwide discussion about our approach to mental illness.  Some groups are pushing for laws that make it easier to force involuntary psychiatric treatment on individuals with mental illness.  However, as others have pointed out, Arizona is one of the easiest states to involuntarily commit an individual, yet nothing of the sort happened.   

In another area, advocacy groups are taking this opportunity to highlight the lack of adequate mental health care services in Arizona and throughout the United States.  There is no question about the need for more services, however due to budgetary concerns, on the federal and state levels, cuts continue to be made to these services.  It is important that these conversations continue as they shape the views of our nation on these important topics and ultimately affect the way mental health care services are delivered.  However, one has to wonder if other factors could be of equal or greater importance in preventing this sort of tragedy from happening again and improving the state of mental health in the United States.

A recent study conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that in 2009 less than 4 out of every 10 individuals with a diagnosable mental disorder received any mental health care services.  However, the lack of available services is not the only reason for this lack of care.  Many individuals don’t seek out treatment because they are afraid of losing their jobs if word of their condition came out.  Others have little understanding of what mental illness is; leading them to A) never recognize the illness and suffer needlessly for years, or B) wonder how they could possibly be helped by psychotherapy or medication.

Not all of the facts have yet come to light in the particular case in Arizona, but it appears that Mr. Loughner’s need for mental health treatment was identified by college officials who encouraged him to seek help.  While mental health services have been recently cut in Arizona, had Mr. Loughner (or his parents) sought out help, if not at a local clinic then even in the emergency room, it is likely that he would have been identified as an individual in need of treatment and would have begun receiving help.  The college officials knew that he needed help, his parents knew that he needed help, yet it seems that he never did seek it out.  Why?  Not because there were no services available.  That is a valid issue, but not something that would prevent someone from making initial contact with an emergency room or mental health clinic.  The key here, in my opinion, is lack of understanding of mental illness and its treatment options and the strong stigma that surrounds mental illness.

Perhaps some good can come out of the tragedy that happened in Arizona this past week.  The public conversation has turned, albeit temporarily, to the topic of mental illness.  The challenge now is twofold: keeping this dialogue and discussion going for as long as possible and focusing on the issues that can truly improve the number of individuals that receive quality mental health care.  Perhaps, in addition to talking about the need for more services and debating the merits of involuntary psychiatric treatment, we might also focus on the core of the problem; lack of education and stigma.  

The U.S. Surgeon General’s Report on Mental Health in 1999 said it best “Stigma impedes people from seeking help for fear the confidentiality of their diagnosis or treatment will be breached.  For our nation to reduce the burden of mental illness, to improve access to care, and to achieve urgently needed knowledge about the brain, mind and behavior, stigma must no longer be tolerated.”

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