Monday, January 17, 2011

The pursuit of happiness...

Recovery refers to the process in which people are able to live, work, learn, and participate fully in their communities. For some individuals, recovery is the ability to live a fulfilling and productive life despite a disability. For others, recovery implies the reduction or complete remission of symptoms. Science has shown that having hope plays an integral role in an individual’s recovery.


Resilience means the personal and community qualities that enable us to rebound from adversity, trauma, tragedy, threats, or other stresses — and to go on with life with a sense of mastery, competence, and hope. We now understand from research that resilience is fostered by a positive childhood and includes positive individual traits, such as optimism, good problem- solving skills, and treatments. Closely-knit communities and neighborhoods are also resilient, providing supports for their members.

-This taken from President’s New Freedom Commission on Mental Health-2003

The mental health system in America is like a band aide on a levy wall that has sprung a leak. In good faith, and with responsibility to heal in mind, the system applies itself hastily and manages to only make the impression of repair before it is whipped back out into the rapids. For all its efforts, our mental health care system here in America, to say nothing of the flawed systems around the world, tends to remain impenetrable to the marginalized and those who are most likely to be in need of community based resources. When I say community resources, I don’t mean posh resorts where one can retreat to morning yoga classes and “group” after brunch. I mean community health clinics that catch the population not severe enough to be in “in-patient” care (think One Flies Over the Cuckoos Nest) and past the general inquiry to primary care physicians you see in those advertisements for Prozac meant to “grow the market” to produce more consumers of their product.
This system is expensive. A routine psychiatric visit ever 8 weeks to check on medication regimes, something that is required to maintain that treatment, can cost upwards of $300. Counseling or visits to a psychologist, someone who doesn’t work with your medications but rather covers the non-physiological treatment, will run a couple hundred an hour at a once a week recommendation. Community mental health clinics can sometimes offer services at sliding scales, based on income, or even free access to basic visits to keep you stable but not only is awareness lacking but the care given is at times hasty and not at all comprehensive. While the administration intended these clinics to be the great alternative to psychiatric hospitals (again, One Flew Over…), they leave those unable to pay for more formal care waiting weeks for appointments, little patience or help when dealing with medication assistance programs through the pharmaceutical companies and not always the best treatment experience overall. There is a palpable distress and frustration among the caregivers that only the repetitive clinic patient can pick up on. Something the administration can never know to address.

You would think mental health reform would be of much more pertinence to those who are in power. It certainly keeps coming back to shoot them in the foot. School shootings point to the failed school system and weak parental involvement; military base massacres point to the ravages of war and even the past, and recent, political assassinations can be attributed to an ailing state of mental health. While war may kill publicly, suicide claims more souls than war and general violence combined (the WHO’s last comprehensive statistical estimate on global mortality), while little is done to prevent it and there remains a huge public effort invested in both the more somaticized issues.

There is an awareness, in the back of the mind sort of way, of the linkages of “mental health” to physical health” has on “physical health”; in terms both of preventative care (i.e. financial investment) and the long term toll mental diseases and disorders can take on the body. The World Health Organization touts that there is “No Health without Mental Health”. While a commendable statement, this implies, however so correctly or incorrectly, that mental health is not a part of physical health, rather a way of gathering all the psychopathologies that exist into a neat nomenclature, devoid of negativity, stigma and inclusion. Broken into its logical form, this statement separates mental health from the truer form of health, assumed to be everything somatic, but at the same time recognizes, weakly at that, the connectedness of the two.
Meanwhile, the National Institute for Mental Health pushes for a more inclusive view of mental health that makes no distinction between neurology and mental health, i.e. a historically supported and much more somatic collection of chemical imbalances and structural abnormalities and a slightly less somatic collection of chemical imbalances and structural abnormalities that mental health comprises.
We know enough about the causes of mental health ailments to attribute psychological pathologies to brain structure abnormalities, chemical imbalances and at times just damaged tissue. The only thing that separates mental health from a truer form of health is the internalizing of psychological distress, the effect of which is a hush among the public as a response to the externalization of something so little understood, seldom publicized and all around stigmatized as mental health.