Nobody has mental illness by choice, just as no one would choose to have a stroke with its debilitating effects. As Milwaukee moves toward implementing new mental healthcare models, and all the policy and program decisions that go along with that, it is important for us to collectively understand mental illness as a disease. It is an illness to be treated not unlike a broken leg, asthma or even cancer.
Because it has been cloaked in a stigma of shame, which blames the individual, it pushes people with mental illness into the fringes of our community and interferes with access to care. The science of mental illness has come a long, long way in the last 50 years, but its value is diminished by the shadow cast by stigma.
The stereotypes have become so ingrained — with predominant representations of people with mental illness as dangerous, unpredictable, responsible for their own illness — that those who have the disease begin to self-stigmatize. They often anticipate rejection, hide their symptoms and refuse to get treatment, isolating themselves from family and friends, believing they will never recover. Stigma too often denies the person with mental illness the kind of support they might expect if they were dealing with diabetes or heart disease.
Just as in other diseases, although the exact causes may not yet have been pinpointed, there are effective treatments for mental illness. People in Milwaukee can and do recover, are able to manage symptoms and go on to lead fulfilling lives, but only if they seek treatment and have the support of their families, friends and the wider community. We see success stories in Milwaukee every day, but not enough of them.
Conditions that fall into the mental illness category appear to stem from both underlying biological malfunctions and environmental factors. Research shows personal trauma, biologic insults to the brain, genetics and aging can all lead to mental illness.
We need to create a better understanding of the wide range of causes of the disease and the considerable range of treatments now available.
About one in four American adults, and 20 percent of young people between the ages of 13 and 18, experience an episode of mental illness in any given year. Those statistics from the National Institute of Mental Health should be alarming to everyone in our community, not because of fear of the person who has the disease, but because about half of those illnesses go untreated.
Symptoms of serious mental illness most often begin to emerge during adolescence. However, there is typically a 6- to 8-year gap before the person begins treatment. Earlier diagnosis, better access to care, and more control over medication can help the person with mental illness manage symptoms, restore health and live successfully in our community.
Today, there is a significant movement in the mental health community toward integrated care, which combines physical health and behavioral health services. Not only is this a better, coordinated approach to promoting the individual’s overall wellness, it also goes a long way toward reducing the barriers caused by stigma.
A person who is experiencing symptoms of mental illness is more likely to visit a medical clinic that provides primary healthcare, where he or she can also receive mental health services, than a clinic that provides mental health treatment alone. As Milwaukee looks to refine its mental health care delivery system, this model should be adopted to both improve care and reduce stigma.