Mental Health Awareness Month is Insane
It is Mental Health Awareness Month. That is insane. We’re just gladhanding one another, while avoiding the real diagnosis: We’ve been so pathetically behind bringing people up to speed on recognizing and treating scourges like depression and anxiety that there is a massive epidemic of suicide gripping the nation, while hospitals and outpatient clinics remain fractured to the point of absurdity in delivering treatments that can save lives—like IV ketamine infusions, transcranial magnetic stimulation, expert psychopharmacology and high-level psychotherapy.
The fact is that while we talk about “awareness,” any individual in the United States struggling with symptoms of mental illness should be “aware,” of this: You will need to take immediate charge of your own treatment, in order to defeat the symptoms plaguing you. Unless you have lots of money to spend and great motivation to find a psychiatrist worthy of spending it on, no one will serve in the role of dedicated director of the care you need.
Why? For one thing, the number of well-trained mental health professionals—and here I mean, experts, not hacks—is woefully inadequate to meet the need. Psychiatrists have been coerced into being “medication visit” doctors who profit from seeing 30 patients a day, 15 minutes at a time, and who routinely fail to see patients as entire people who need a comprehensive approach to healing their disorders. The same is now true for psychiatric nurse practitioners. That leaves the gripping, intellectually and emotionally demanding work of deciphering the psychological roots of discontent, anxiety or delusions like paranoia to psychologists (some of whom are also now empowered to prescribe medications at the drop of a hat) or mental health counselors, some of whom have no more than a high school education and a modicum of training, thereafter.
Secondly, mental health professionals turn out to be passive go-along-to-get-alongers, not incisive self-starters. If you don’t ask about the newest ways to treat your depression or anxiety or attention-deficit disorder, they will probably take the path of least resistance and not bring it up. It’s less work, frankly, to refill your medicines and lend an ear to listen to your suffering, than to do what is needed to defeat that suffering.
Thirdly, mental health professionals turn out to be scared of anything new. That’s right. Scared. While oncologists might embrace the “right to try” law that makes experimental drugs available as a last-ditch option to cancer patients with dire prognoses, psychiatrists won’t even routinely embrace the use, for instance, of ketamine, which has proven miraculous in defeating mental illness. They have been far too slow to lobby for the use of psilocybin, despite the fact that it can be life-saving. And they have been too frightened to push back against the DEA on being completely free to use opiates like the pain reliever Tramadol to treat depression, even though it works in a huge percentage of cases.
Fourth, no political will really exists to change all this. If it did, you wouldn’t have insurance companies dictating lengths of stay for patients in inpatient units (which they do) and you wouldn’t have them lobbying emergency room clinicians to send patients on the edge of life and death back home because they “contract for safety.” Imagine how well it would go over to have insurance companies sending cardiac patients home, unless they were likely to die within the next 24 hours. That’s what will be happening, in emergency rooms all over America today.
The truth is that America doesn’t deserve to observe a Mental Health Awareness Month because we won’t really lift a finger to save lives devastated by mental illness this month or any other month. We could win the whole battle, but we won’t even join it.
Dr. Keith Ablow
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