Beating the Mental Health Treatment Stigma

May 7, 2008— -- "…one flew east, one flew west,

one flew over the cuckoo's nest."

So starts the famous book chronicling our mental health system in the 1950s, best known for Jack Nicholson's portrayal of a sane but wild inmate in the Oscar-winning film adaptation. This pop culture phenomenon featured every possible psychiatric condition and outcome, including schizophrenia, depression, bipolar disorder, use of mind-altering medications, forced lobotomies and suicide.

In my professional lifetime, people who had serious psychiatric diseases like schizophrenia and manic depression frequently ended up in asylums like this one.

Jump forward to the mid-1990s and the movie "A Beautiful Mind," which focused on the true-life story of John Nash, a schizophrenic who won the Nobel Prize in economics.

How was this possible? For him, it was a supportive work environment and a strong marriage.

Nash's story truly fits in with this year's Mental Health month theme — "Get Connected." Having a good relationship with family and co-workers is an important part of that connection.

Mental Health Treatments Have Evolved

Mental health has come a long way in the past generation. We have seen amazing advancements in the treatment options psychiatrists like me now utilize when treating patients.

In the 1950s, doctors began prescribing a new type of medication for patients with severe mental health issues. These antipsychotic medications gave us more choices and helped us better understand brain chemistry. The brain is a very complicated organ and we're just beginning to understand it. About one percent of the population has bipolar disorder, which causes dramatic mood swings with periods of normalcy in between. Schizophrenia affects 1 percent of the population as well. People with this disorder may hear voices, become paranoid, and go through periods of agitation and withdrawal.

I have a cousin whose son is schizophrenic. For years, the father and son had a terrible relationship; family members were embarrassed to have mental illness in their midst, and the son did not get proper care.

I finally told my cousin, look, schizophrenia is very much like diabetes, a genetically determined chemical imbalance in the brain. There are medications that can regulate this. Treat your son just like a diabetic. If he starts acting crazy, don't get involved in his craziness — send him to the doctor to get more medicine.

Well, this advice changed this young man's life. He went to a doctor, received the appropriate medication, which he now takes regularly. He has not been hospitalized since and has rehabilitated his relationship with his father and is an active member of the family. Years ago, this simply would not have been possible. He could have ended up in the cuckoo's nest for the rest of his life.

A Growing Acceptance

While we'll never understand precisely how each person's brain chemistry works, we have seen amazing advancements in treatment.

As we recognize Mental Health Awareness Month this month, I want to remind Americans just how far we have come. Newer medications are more effective and have fewer side effects. Parents take it for granted that they can get an Adderal for their child's Attention Deficit Hyperactivity Disorder, or that they can take a pill to treat depression or panic disorder. That has not always been the case.

Mental disorders are the leading cause of disability for people aged 15 to 44, and many people suffer from more than one disorder at a time, according to the National Institute of Mental Health. Now, people no longer have to suffer in silence. They can have a real life, complete with job, family, friends and hobbies. All thanks to the remarkable progress in treatment.

Mental health in the elderly population is a growing concern also. A recent study at Texas A&M Health Science Center that was published in the Journal of the American Geriatrics Society found that doctors spend little time discussing mental health issues with older patients and rarely refer them to a therapist, even if they show symptoms of severe depression. People over 65 make up 12 percent of the U.S. population, but accounted for 16 percent of suicide deaths in 2004.

Medications and treatment advancements have truly changed the face of mental illness. And each new generation of medications offers people more opportunities to live relatively ordinary lives, if they are closely monitored by a psychiatrist and if they take their medications.

Still, mental health is the stepchild of healthcare. This year's "Get Connected" theme for Mental Health month recommends staying connected to family and friends, your community, and your doctor.

I would like to add another category — get connected to the many types of treatment that are available today and can benefit individuals with one or more mental health conditions. It is worth the time and effort to find the right treatment for you.

Dr. Richard DeVaul, Professor of Psychiatry and Family Medicine at Texas A&M University, has many years of clinical and academic practice as a medical psychiatrist. He is the Founder and Creator of the Leadership in Medicine Program at the College of Medicine, Texas A&M Health Science Center.