Mental Illness Awareness Week energized advocates, engaged new supporters, and started important conversations about stigma and recovery. It also was an opportunity to explore the actors that often don’t—but should—play a role in how we’re addressing mental illness in this country.
“Awareness” includes spreading the word about what mental illness means, how it affects individuals’ lives, and debunking misconceptions. But mental illness doesn’t exist in a vacuum. So awareness also must be about pulling back the lens and identifying fresh ways to make changes on the institutional level. Here are six untapped professions that have the potential to be powerful allies in our work to improve our nation’s mental-health outcomes.
1. Primary-care doctors: identify and treat mental illness
Patients likely ask about their sore joints and allergies at their annual check-up. Suicidal thoughts or bouts of powerful “mood swings?” Probably not so much. That’s a huge missed opportunity—the primary-care office is exactly where those concerns should be coming up. Here’s why:
- It’s where you get all of your other routine screenings. Mental-health diagnostic surveys need to be as much a part of a preventive health-care approach as taking blood pressure or administering vaccines. Prompting may be the only way to diagnose patients who feel too ashamed to raise the issue, don’t recognize their symptoms, or aren’t aware mental illness is a treatable medical condition.
- It’s the hub of your service-delivery system. Physicians’ offices should be ready to refer to appropriate mental-health specialists, just like they might to a urologist or a physical therapist. If a patient sees multiple specialists, primary-care physicians can help coordinate between service providers.
- Mental health is physical health. If patients don’t divulge their mental-health symptoms, physicians can follow physical cues. Those sore joints I mentioned before? That actually might be a sign of depression. Sure, it could also be arthritis, but mental illness should be ruled out proactively.
The infrastructure is there, and hopefully the culture is catching up. A recent article called on primary-care physicians to integrate mental-health screening into routine check-ups and have a list of specialist referrals on hand. And there’s an awareness-raising movement on the patient side with outreach efforts like National Depression Screening Day.
2. Supervisors and employers: provide assistance in the workplace.
Yes, the workplace. You may be cringing to think about bringing up mental health with your boss or your colleagues. Bear with me! If you think about it, it’s in an employer’s best interest to keep staff healthy—healthy employees are productive employees, and mental illness is one of the most common reasons for health-related lost productivity. It can lead to long absences, difficulty concentrating, subpar job performance, and bad physical health (say it with me again, class: mental health is physical health). Luckily, more and more employers are embracing this fact and taking steps to encourage positive behavioral health.
Just recently, Amy Morin wrote for Forbes that employers should keep running stigma-busting conversations with employees about mental health and regularly encourage staff to get screenings. Graeme Cowan, who suffered from depression for many years and recently authored Back from the Brink: True Stories and Practical Help for Overcoming Depression and Bipolar Disorder, offered seven ways employers can make mental wellbeing part of their organizational culture. His suggestions include:
- Promoting healthy behavioral health by encouraging exercise and making stress-reducing activities like meditation readily available.
- Reducing stigma by talking frequently about the importance of mental health and making it clear that employees will not be penalized for seeking treatment.
- Guaranteeing employees confidentiality if they seek help.
- Making services easily accessible by maintaining a directory of referrals and resources. Cowan also suggests on-site programs like peer support groups.
Given how many hours of our lives we spend at work, and how high-stress an environment it can be, it’s in everyone’s interest to establish a culture that values and promotes—not stigmatizes—mental illness.
3. Housing policymakers: fund affordable housing with supportive services
Even though the link between mental illness and homelessness likely isn’t news to anyone, there are alarmingly few dollars being put into the programs that stop the cycle of these individuals between shelters and the streets. One approach proven to reduce recidivism is perennially underfunded: permanent supportive housing (PSH). PSH doesn’t just put a roof over someone’s head, it incorporates on-site services to treat the underlying causes of his or her homelessness.
Hyacinth’s Place follows the PSH model, serving formerly homeless women who have a mental-health diagnosis. Our on-site services include medication management, psychotherapy, and peer-to-peer counseling. The simple fact is that once our residents have a stable place to live and no longer are operating just in survival mode, they’re empowered to tend to their minds, bodies (remember how mental health is physical health?), and souls.
4. Employees of the criminal-justice system: decriminalize mental illness
This is another intersection you probably already know about, thanks in part to investigations, mounting media coverage, and calls to action by law-enforcement and other public figures. As a Cook County, IL sheriff said: “mental illness has been effectively criminalized in Illinois.”
Sending these individuals to jail is doing nothing to improve mental health in our country, but it’s pervasive. The Treatment Advocacy Center surveyed states’ treatment of individuals with mental illness, and found that the number of mentally ill persons in prisons and jails was 10 times the number in state hospitals. The report proposes several better alternatives for actors across the justice system–from arresting officers to judges:
- Provide intake screenings to inmates and connect them with appropriate treatment while they are incarcerated.
- Make appropriate treatment plans upon inmates’ release.
- Train law enforcement to identify and respond to mental illness.
- Give formerly incarcerated individuals outpatient treatment.
- Make reforms in the court system to find alternatives to jail for non-violent offenders.
The good news is that more jurisdictions are starting to adopt some of these strategies. And as incarceration rates reach epidemic levels, the call for action is being framed as a civil-rights issue, especially in the wake of the tragic death of a man with schizophrenia in solitary confinement.
Mental Illness Awareness Week and Domestic Violence Awareness Month overlap, which is apt, because DV and mental health are strongly connected. Survivors don’t just live with physical injuries, it’s estimated that at least 60 and up to 90 percent have a serious mental-health issues. But these emotional scars aren’t as apparent, and so too often go undiagnosed. Common psychiatric conditions include depression, anxiety, panic attacks, substance abuse, and posttraumatic stress disorder. And we can’t forget that emotional abuse should be considered as real a form of domestic violence as physical abuse. In addition, kids who witness DV often have long-term psychological damage. Simply put, survivors need mental-health screening and access to treatment. The reverse is true too: mental-health providers rarely screen for domestic violence, despite the close link.
6. Teachers and principals: provide mental-health services in schools
Half of mental-health disorders being before the age of 14, but only 20 percent of children withdisorders are diagnosed and receive treatment. Given how much time students spend at school, educators can play an invaluable role in changing those statistics both through earlyintervention and prevention. Educators who have a solid understanding of children’s mental-health needs can identify early warning signs of mental-health conditions, promote positive behavioral health, and collaborate with families and mental-health specialists. Some steps that the education system can take to improve children’s emotional development include:
- Train educators to identify symptoms of mental illness in children and intervene early.
- Promote curricula that incorporates positive behavioral health.
- Invest in a staff of mental-health professionals.
- Have on hand referrals to community mental-health services.
Emotionally healthy children have better physical health, academic performance, and social skills, preparing them to lead productive and successful lives after graduation.
These professions are far from the only ones that we should be involving when searching for ways to improve mental health in our country. Social- and economic- justice advocates and nursing-home caretakers, for example, can also be valuable allies. As an organization that not only is a mental-health service provider but also that works with our residents, community leaders, and neighbors to break down stigma, Hyacinth’s Place will be making efforts to forge new relationships that break down silos year-round.