“We’re Number One!”

Study: U.S. Leads In Mental Illness, Lags in Treatment

© Bryan Zepp Jamieson
6/8/05
http://zeppscommentaries.com/S&E/mental.htm

The most striking thing about the National Comorbidity Survey Replication isn’t that it reports that 46% of Americans have experienced mental illness at some point in their lives, or that 26% have experienced mental illness in the past year. It isn’t that those afflicted often suffer from “comorbidity” – getting two or more forms of mental illness concurrently. It isn’t even that America has far higher rates of mental illness than any other developed country.

The most striking thing about the survey is that it does NOT count schizophrenia or other severe affective disorders that usually require institutionalizing. Nor does it include organic deficits stemming from stroke, trauma, or oxygen deprivation. According to the Harvard report on Science Daily, “The survey examined four classes of disorders: anxiety disorders (such as panic and post-traumatic stress disorders), mood disorders (such as depression and bi-polar disorders), impulse-control disorder (such as conduct and attention-deficit/hyperactivity disorder), and substance abuse disorders (such as alcohol and drug abuse).” Chances are good that a significant number of respondents were able to conceal mental problems from the researchers, and another sizeable group that had suffered such problems in the past would state, often sincerely, that they had never been so afflicted, either out of simple denial or for fear of being stigmatized. Given that these disorders most frequently have transitory episodes in children and adolescents, it’s entirely possible that a lot of people have either forgotten the incidents, or dismissed them as being part of the emotional Sturm und Drang of adolescence. Finally, the survey didn’t include two segments of the American population where mental illness is concentrated the most: in the prisons, and among the homeless. So the number of 46% is, if anything, very low. Chances are a substantial majority of Americans have experienced mental illness.

There are two bits of good news in this. First, the percentage of mentally ill in America seems to have leveled off in the ten years since the last survey. While still extremely high, it isn’t worsening at the frightening rate that it did over the previous decades. And the second is that most episodes are mild enough that people remain functional through them, and the symptoms usually abate within three months.

As awful as the American medical system is, it pales in mediocrity next to the way mental health care is administered in this country. It is, frankly, at a level that many third-world countries would find embarrassing and disgraceful. The report notes that most forms of mental illness first appear by age 14, but that on average, they don’t go and get treatment until age 24. Further, the state of the treatment facilities in the US as a whole is, to put it mildly, lacking. County psychiatrists may have a work load of hundreds of patients, and be able to devote, at most, one hour a month per patient. Between overwork and underpay, the positions attract two types: idealists, and incompetents. And this is a system that does not nurture idealism.

A lot of people seek out alternative treatments, with varying degrees of efficacy. As a result, you see people trying to cure alcoholism by taping magnets to their foreheads, or severely depressed individuals treating their depression with crystals on a chain. A lot of people go and see their local priest, who is about as well equipped to deal with mental illness as he is to treat cancer. He’ll moo religious noises at the sufferer about how he must be strong, keep his hands off his private parts, trust in Gawd, and to remember that bad thoughts are Satan’s domain. This doesn’t help most people very much.

I saw a couple of people today who are, respectively, a retired psychologist and a practicing psychiatrist, and I asked them both for opinions on the survey results. Neither was particularly surprised, or even really seemed to consider it news. One felt that it might be a result of people feeling they had lost control of their country, a tempting premise, but one that doesn’t correlate directly. The fact is the climb in mental illness leveled off at just about the same time that things started to seriously go to hell for Americans. The other noted that societal pressures were higher, but cautioned that frequently, episodes didn’t have an external cause, or any cause at all that they could determine.

Fair enough. I was thinking about one type of mental illness (and another one not counted in the survey) that had exploded in frequency over the past 15 years – autism. Recent research had suggested that it might actually be caused by an auto-immune reaction in the brain itself. A friend of mine who I’ve known about ten years has always maintained that there was a link between vaccinations and both autism and auto-immune disorders such as lupus, rheumatoid arthritis, and exczema. To him, the news that autism might share provenance with these other AI diseases would be one more piece of a growing library of evidence against broad-spectrum vaccinations in the very young. We’ve known for years that affective emotional disorders can stem from exposure to heavy metals and other toxins. How much mental illness in America is due to our increasingly high-tech pollution?

But a lot of behavioral problems stem from imperfect interactions with society, with individuals in general, or from belief systems that are in conflict with perceived reality. I believe that fundamentalism is a mental illness (and again, not counted in the survey, although it strongly tends toward a comorbidic, if not causative, role with other mental disorders) and that it places strenuous demands on an individual who has not firmly shut out the outside world so as to not allow it to challenge his belief system.

Of course, the biggest problem is that the culture itself is completely irrational. Parke Godwin, the satirist, once noted that America’s behavior to other nations, a combination of strutting, preening arrogance and cringing, paranoid fear of rejection, would get a neighbor down the street locked up if he behaved that way. And Heinlein once remarked that a man with all his screws tight in this society would get locked up.

I considered examples of the irrational, illogical, and flat-out contradictory demands this culture places on individuals: the tyranny of the American workplace, where workers are punished for weariness and watched constantly; the insistence of fundamentalist churches that utter nonsense is literally God’s truth and in order to accept it, one must reject endless reams of evidence; the examples of “heroic behavior” presented as expected behavior by the cultural media; the insistence that arguing that the people’s government should represent the people’s interests is somehow unpatriotic, a view fostered by an administration hag-ridden with ideologues and a complicit and lazy media; and I realized that this essay could run to 1,500 pages or more.

So let’s just say that the culture is utterly cracked, and it is the efforts to conform to the demands of that culture that are causing so many people to break down emotionally.

People sweat, defecate, have sex urges, entertain doubts, resent being monitored, don’t want Jesus crammed down their throats, want to be like John Wayne and Steven Siegal and can’t. Americans are taught that apologies are signs of weakness, when they are actually signs of strength. Young girls want to be like Mary Kate Olson and starve themselves to the point where their sex organs don’t mature, in order to be good women. Entertainment, that most human and socializing of pastimes, is in the hands of large, faceless, impersonal corporations. Pious hypocrites have positioned themselves as the national avatars of morality. Our media, our lifeblood of social information, agrees with the government that white is black, black is white, good is bad, and tyranny is freedom from freedom.

We live in a culture where being human is increasingly frowned upon, where standards are both beyond the reach of people and disgracefully tawdry all at the same time, and where, more and more, people are punished and reviled for just being people.

Other cultures at other times have followed similar courses, and it might be a good idea to get off this particular merry-go-round while we still can. The rest, unchecked, have inevitably led to mass deaths and the death of the society that spawned this type of mass psychosis.

This is not good. Let’s think about a different approach to being sane in a crazed culture.