MAY 31, 2017
he human brain is a wonder. Through folds of tissue and pulses of electricity, it lets us perceive, attempt to understand, and shape the world around us. As science rapidly charts the brain’s complex structures, new discoveries are revealing the biology of how the mind functions and fails. Given the centrality of the brain to human health, its malfunctions should be a priority, separated from stigma and treated on par with the diseases of the body. We aren’t there yet, but the transformation is underway.
Mental disorders affect nearly 20 percent of American adults; nearly 4 percent are severely impaired and classified as having serious mental illness. These disorders are often associated with chronic physical illnesses such as heart disease and diabetes. They also increase the risk of physical injury and death through accidents, violence, and suicide.
Suicide alone was responsible for 42,773 deaths in the United States in 2014 (the last year for which final data are available), making it the 10th leading cause of death. Among adolescents and young adults, suicide is responsible for more deaths than the combination of cancer, heart disease, congenital anomalies, respiratory disease, influenza, pneumonia, stroke, meningitis, septicemia, HIV, diabetes, anemia, and kidney and liver disease.
The treatment of mental illness has long been held back by the sense that disorders of emotion, thinking, and behavior somehow lack legitimacy and instead reflect individual weakness or poor life choices. Not surprisingly, there has been a mismatch between the enormous impact of mental illness and addiction on the public’s health and our society’s limited commitment to addressing these problems. Here are three examples of how that plays out:
- Most emergency departments are ill-equipped to meet the needs of patients in the midst of mental health crises.
- Most insurance plans view mental illness and addiction as exceptions to standard care, not part of it.
- Despite an overall cultural shift towards compassion, our society still tends to view the mentally ill and those with addiction as morally broken rather than as ill.
3rd party payers need to understand this and make it easier for practitioners to care for our patients. A good primary care provider is adept at managing these afflicted folks. We have a huge shortage of underpaid & overworked PCP’s in this country,