By Maddie Ward Maddie Ward (she/ her) is a first year pre-psychobiology major and aspiring trauma surgeon or critical care physician from Carlsbad, CA. She is most passionate about menstrual equity and mental health and joined UAEM because of her interest in healthcare policy. In her free time, Maddie enjoys playing the guitar or piano, singing, and hanging out with her cats. Whether suffering themselves or knowing a close family member or friend who struggles, few Americans are unaffected by mental illness. The National Institute of Mental Health (NIMH) reports that around 51.5 million Americans, or 1 in 5 American adults, live with some sort of mental illness. However, despite widespread prevalence and consequences, mental health remains one of the most stigmatized topics in the United States healthcare system. Due to a societal failure to acknowledge the severity and existence of mental illness, the stigma surrounding mental health prevents around 56.7% of people with mental illness from receiving the care they need and deserve. In part, the stigma is a product of unfounded beliefs that individuals with mental illness tend to act more violently. In a 2006 public opinion study, Harvard Medical School reports that 60% of Americans believed individuals suffering from schizophrenia were more likely to commit a violent act, and 32% believed it was more likely for those with major depression as well. Despite these misperceptions, the United States government reported only 3-5% of violent crimes were committed by those with mental illness. Additionally, people with mental illness were more likely to be victims of violent crimes. Thus, this stereotype harms those living with mental illness because it may make others less likely to reach out and support the individual. Further, an individual may be less likely to seek treatment out of fear of being ostracized. These stereotypes cloud the minds of many Americans largely due to the depiction of mental illness in popular media and entertainment. Dr. Patricia R. Owen’s study in 2012 of 42 characters with mental illness in 41 movies found most of the characters possessed delusions and violent behavior. One-third of the characters killed another person and one-fourth committed suicide. Seeing mental illness frequently depicted in this manner forms unconscious opinions and biases towards these individuals. This bias, whether implicit or explicit, also clouds the judgement of police officers. The Washington Post has tracked fatal police shootings over the past five years and found 23% of police shooting victims suffer from some sort of mental illness. Their bias is especially dangerous as they deal with individuals suffering from mental illness on a regular basis. Unfortunately, police officers are not trained to handle mental health situations, and their misperceptions about mentally ill people leads to tragic loss of lives. In many ways, this supports arguments for the defunding of the police and reallocating the funds to more community organizations promoting society’s well-being. If there were mental health care providers available to respond to emergencies, there would hopefully be better outcomes in situations of distress for these individuals. Stigma surrounding mental health impacts the care of those with mental illnesses for two reasons: fear of seeking help and healthcare workers’ implicit biases. Often, people fear reaching out for help because they do not want their feelings, emotions, and struggles to be diminished or dismissed by a professional. This fear is especially prevalent for BIPOC communities. The American Psychiatric Association released a fact sheet on mental health disparities for diverse populations detailing how minority communities are more likely to be considered disabled due to their mental disorder. Further, the sheet shared that multiracial individuals reported more mental illness than any other racial or ethnic group in that year. Many people see the disparity for multiracial individuals as a result of feeling stuck between two cultures or worlds. Despite these findings showing these communities at high risk for debilitating mental illness, the APA also reported that ethnic/ minority individuals were less likely to receive mental health services than white individuals. Reasons listed for this disparity included unavailability of insurance or full insurance coverage, stigmas specific to certain minority groups, mostly white mental health care providers with lack of cultural sensitivity and language barriers. The stigmas surrounding some minority groups lead to the misdiagnosis or underdiagnosis of certain mental health disorders. Even at a young age, the APA found minority children were more likely to end up in the juvenile justice system than in specialized care when they had behavioral issues. A study from the UCSD Department of Pediatrics found that different cultural upbringings may cause differing opinions on the severity of symptoms. This leads to an implicit bias within the DSM-IV-TR, commonly used by many professionals to classify different mental disorders and illnesses. The study found that different symptoms of depression are better indicators of having the illness for different individuals. The different weight of symptoms often goes unacknowledged by professionals leading to the under- or misdiagnosis of different conditions in minority populations whose symptoms may not be the “typical” symptoms. Additionally, minority groups might be less likely to seek out treatment or a diagnosis for their condition. This stems partially from minority individuals being unable to find a provider or therapist who can relate to being a minority. In 2015, the American Psychological Association reported that 86% of psychologists in the United States were white. While white therapists may try to sympathize with their BIPOC patients, they are unable to understand their feelings rising from the way that society treats their communities. In order for these patients to receive a higher quality of care, they need support from someone understanding their experiences. Even when getting past the many biases and stereotypes preventing many from receiving treatment, insurance continues to make the process more difficult. Some insurance plans do not have access to mental health care providers in the network forcing patients to pay out of pocket for essential care. The National Alliance on Mental Illness found the lack of provider network access along with extreme standards to qualify for the coverage are ways insurance inadequately support mental health care. Waiting for an individual’s mental health to decline enough to where they can be labeled as ill enough could be disastrous for the individual. Through the Affordable Care Act and 2008 Mental Health Parity and Addiction Equity Act, more steps are being taken towards securing care for mental illness. Nevertheless, these acts have shortcomings and loopholes. Insurance companies tend to be incredibly savvy in finding ways to reduce the amount of coverage for individuals especially when it comes to mental health care. The United States has a long way to go in providing equitable and good quality mental health care to individuals. Steps are being made on a frequent basis to combat the stereotypes and biases preventing individuals from receiving mental health care. This is seen in more social media campaigns promoting mental well-being and pushes in public schools to educate students and staff on ways to identify others suffering from mental illness. One of the most important steps we can all take as individuals is to remember to check in on our friends and family along with checking in on ourselves. Through more government support, the health care system will likely make more strides towards providing coverage for the care millions of Americans direly need. In a place where we push care for broken bones or physical illnesses, it is essential we place the same importance and focus on mental health. More mental health care will save lives and help create a better society for all.
1 Comment
3/26/2024 11:40:27 am
Interesting. As one of the yet to be determined unwitting mentally ill Medicare primary patients who were tricked into specific cognitive study projects without my knowledge, and used over and over by med students and other hopeful relatives,mpast and preset, at both UCSD and UCLA and points in-between, I feel otherwise. I feel raped by prying medical doctors who use “mentally ill” patients to experiment on.
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