My Mental Health Christmas List

I am an Amy Grant fan, and one of my favorite songs is her version of "Grown-Up Christmas List". If you haven't heard the song, click here. It's okay. I'll wait.

The song makes you think. I, too, have a "Grown-Up Christmas List", with some of it concerning the mental health system.

No More Lives Torn Apart

Mental illness affects more than the person with the diagnosis. It tears apart the lives of the family and close friends as well. When mental illness first rears its ugly head, about the only thing you know is life is suddenly not okay. When life is not okay, it's hard to make sense of it all.

I blame the stigma attached to mental illness as much as I blame the symptoms. The stigma makes it hard to reach out and be open about our condition. This affects us by making us feel we're on our own--ironic considering that our families and friends suffer with us. The stigma can be just as disruptive as the symptoms.

When I was first diagnosed, my mother wanted to pull me out of college and keep me at home. I felt differently--I was attending my dream school and loved just about everything about it. This conflict put a strain on our relationship. In addition to this, some of my friends from church believed that my illness was demonic in origin. They believed that if I just had enough faith and truly wanted to get better, I would. This conflict eventually forced me out of the church, a move that cost me several friendships. My life was indeed torn apart.

That Right Would Always Win

The right thing is not always profitable. The profitable thing is not always right. This is especially true when it comes to mental health treatment.

Community Crisis and Emergency Services: Problems and Advantages, a report by Mentor Research Institute, states “There are tremendous gaps between the needs of the individual and family and the services offered by many managed care organizations and public funded crisis services. Funding for these services are often low in comparison to the demand and need. Crisis services are usually designed to serve a community and to be reimbursable as much as possible by health insurance and managed care companies. … Crisis and mental health triage centers are increasingly run by businesses that make higher profits when fewer services are provided. Services may be rationed using ‘invisible’ (unknown) and informal criteria driven by the organization’s administrative and financial goals. These criteria can override professional judgment and recommendations.”

The report goes on. “Depending on the county you live in, your insurance, HMO or health care company, the benefits and the treatment you receive can vary tremendously,” it states. “As evidence[d] by the debates in state and federal government, it is a practice in many managed care, insurance and HMOs to deny services that you may be entitled to and for these organizations to compel professionals to quietly support (or at least not protest) service delivery constraints which are based primarily on economic considerations.”

For right to always win in this situation, benefits would be what we need, as determined by the treatment team. It may not be an unreasonable demand. The Mentor report makes an interesting, if not ironic, observation. “The cost and impact of limiting and denying necessary services can be as high as 30 percent of the total health care cost. There is considerable argument that the cost of limiting services exceeds the cost of the services denied in many cases.”

My List

There are other reforms and changes I would like to see. The elimination of restraints and seclusion is one; these treatment failures often harm the patient more than they help. I remember reading about a state hospital that did this successfully; injuries did not go up and treatment improved.

Another thing I would like to see is a more comprehensive mental health court. Some people commit petty crimes, such as smoking in a no-smoking zone, because their psychiatric symptoms are untreated. In Indiana alone, 11 percent of the state’s 23,069 inmates were diagnosed as mentally ill. That's just the prison population. In Indianapolis, the leading provider of mental health services is the Marion County Jail. The prison system is the new state hospital. I would like to see more people referred to treatment and less sent to jail.

Finally, I would like to see the stigma reduced. I would like to see mental illness as acceptable as diabetes. We don't fear people with broken legs. Why should people with an injured mind be any different?

Well, that's my mental health Christmas list. Please add what you'd like to see in the comments.