Biases Surrounding Mental Health

Biases are known to be ingrained in the human nature. Ironically, the bias starts reflecting in our approach to an individual’s health, even if the sufferer is a loved one, as we give priority to physical health over mental health. Many of the biases regarding mental health are inbuilt or are passed on from one generation to another.

Social media has a considerable role in propagating such biases. Without proper evidence, many crimes of violent nature, such as shootings, murders, etc., are often ascribed to mental disorders. As indicated by Jonathan M. Metzl, M.D., Ph.D., and Kenneth T. MacLeish, Ph.D., in a 2015 study published in the American Journal of Public Health, most of the mass shootings in America are attributed to mental illnesses, and are often considered the root cause of violence.

The stereotype that “all persons with mental illness are violent” add fuel to the prevailing negative mindset against mental disorders. Another deep-rooted stigma regarding mental ailments is that people with some kind of mental deformity are incapable of independent living or doing competitive work. The fact that most physicians suffering from mental disorders such as depression or anxiety do not seek help, fearing that it would hinder their professional life, points at the deep-seated bias related to mental disorders.

Whether it is schizophrenia, bipolar or depression, a common perception about these mental disorders is that they are a character flaw. Depression, for example, is seen as sign of a weak-willed spirit. Also, in many instances, it is believed that mental disorders can be set right with attitudinal changes. For example, many believe that children with attention-deficit hyperactivity disorder (ADHD) need to be more disciplined and spanking is the best way to ensure that they behaved appropriately. Unfortunately, this tendency results in many with mental illnesses to be punished or discriminated against for no fault of theirs.

Implicit and explicit bias

Bias can broadly be divided into two types – implicit and explicit. It is a case of explicit bias when the individual is aware that he or she is biased against a particular person or group and uses it against a perceived threat. For example, painting all immigrants and refugees as potential sociopaths and antisocial elements is a form of explicit bias. According to Alexandra Werntz, University of Virginia and PIMH researcher, people are familiar with explicit biases, and “they are influenced by a lot of different factors, like willingness to disclose and social desirability.”

Implicit bias is, however, more difficult to understand because an individual is unaware of its existence. It is beyond the boundaries of one’s consciousness or awareness, but more likely to impact the way one behaves with regard to those with mental health disorders. For example, people showing implicit bias tend to believe that people with mental illness are helpless and negative, and should be blamed for their wrongdoings.

Determining the impact of bias on mental health outcomes

While bias is a common occurrence with regard to mental health, discriminatory behavior because of inbuilt prejudices could have a negative impact on the diagnoses and treatment. Past studies have indicated that many mental health professionals continue to endorse negative biases about mental illness.

Apart from the lack of empathy, a constant stigma surrounding mental disorders can result in increased anger and an unwillingness to help the patient in need. It was observed that the attitude of the health care professionals toward mentally ill patients reflected “paternalistic approaches.” While there was an element of empathy involved, in most instances it was believed that patients with mental disorders were incompetent.

Mental disorders are treatable

Whether it is a depression or an anxiety disorder or a neurodegenerative disorder, mental disorders are certainly not a character flaw. Recovery seems difficult as long as one keeps postponing the need to seek treatment. Understanding the importance of having a sound mental health can give rise to a new perspective on life that would further enhance the quality of overall health.

One Consumer’s Observations of the Mental Health Care System in America

The mental health system is a unique culture. Psychiatry itself is, unlike any other medical specialty. Mental health is an enclosed system. That means it is a world within a world. The doctors, therapists, patients, and support workers play roles. It’s a reciprocal environment. Each player in the system allows the other person the opportunity to act out his or her role. For example, the psychiatrist gives you a diagnosis that has no basis (Yes this does happen from time to time). You, the patient, having complete faith in the powers of the behavioral health system, accept this diagnosis as the gospel truth. In time, you begin to notice certain behaviors and thoughts that you believe may be a sign of your supposed illness. You return to your doctor and report these symptoms. Your psychiatrist agrees with your observations and writes them down in your medical record. He also inserts his authoritative comments to support his opinion. Therefore, both parties in the relationship are mutually validated in their roles.

When one has been playing the patient role for so long, a person begins to identify himself or herself as a “psych patient.” That’s who you are. This is the term that defines your very existence. You belong to the mental health system. Soon enough you find that every activity you engage yourself in is related to your disorder and the medication your doctor prescribed to suppress it. It’s a sad commentary indeed. It’s sadder still for the person who needlessly struggles against an undefinable defect in his or her character as if the diagnosis were the irrefutable truth. I acknowledge the fact that the unsettling scenario I am painting here is not true for every psychiatric patient.

At some point, the psychiatric patient discovers the benefits of being labeled mentally ill. There are mental health workers, such as case managers who assist the “consumer” in obtaining a free living allowance from the Federal government in the form of Social Security Disability Income or Supplemental Security Income in whatever minimal amount it may be. I will add for comfort that social security disability benefits are reported (by the government) to run dry in 2016. A consumer is often entitled to free housing, health care, food assistance, and much more. The mentally ill person may even have the right under certain disability laws to bring a pit-bull into a no-pet residential community. Technically speaking, you could even take it on a commercial airliner. The reason is simply because your therapist deemed it necessary that you have an emotional support animal (oops was that a secret?). Don’t get me wrong. I’m sure there are people who require a companion animal for their emotional health. I’m not trying to be disrespectful to those who are struggling. What I’m saying that there are incentives built into the system for many people to accept their diagnosis and play out their role.

There are case managers and outreach workers that will go to court with you, and advocate on your behalf before the judge when you run afoul of the law. They will help the mentally ill with all of their personal affairs. What a bargain! Run out and tell all of your friends about it. Let the government take care of you. It makes being a psychiatric patient seem so much more attractive. Why wouldn’t anyone want a psychiatrist label to them disabled? Again, I’m being sarcastic to make my point that people, who are improperly labeled with a DSM V diagnosis, run the risk of becoming dependent on the mental health system for their needs.

This kind of social welfare encourages people to give up their ambition and motivation. It instills the idea that living a marginal existence is sufficient. I, for one, believe in the greatness people can achieve for themselves and the world by applying themselves.

Remember this. Once you get into the mental health system your chances of getting out are slim. There are a number of reasons for this. Primarily because the psychiatrist or psychologist has you convinced that you have a serious medical problem, which you can’t handle yourself. We all know that’s ridiculous. Many people manage their depression and anxiety remarkably well without the use of psychiatric medications. If Ativan calms your nerves and helps you function, then that’s great. On the other hand, I have seen plenty of people become addicted to sedatives. These drugs are unsafe. I wouldn’t put your faith in the safety of the anti-depressants either. I think the pharmaceutical giants are quick to point that out as a result of the numerous class action lawsuits filed against them.

Some blame can be placed on the pharmaceutical companies for this unnatural drug dependence. As I was writing this article, I surfed NAMI’s website (National Alliance for Mental Illness) and noticed “In Our Own Voice,” a public education program, is funded by a grant from Eli Lily. This is the pharmaceutical giant that manufactures psychiatric drugs like Prozac, Zyprexa, and Cymbalta. I gather (without too much mental effort) that Eli Lily’s generosity is a publicity campaign to make them look like one of the good guys in the mental field, and as a result, boost sales. As I surfaced the Internet, I found that NAMI has been receiving their fair share of criticism for their questionable association with pharmaceutical companies. I will not say NAMI is immoral or unethical. That would be too easy. If Ely Lily offered me thousands of dollars, I would have to seriously consider taking it. Sometimes the decision to cross the line depends on one’s real life needs. Other times it just has to do with making a buck. There is no denying that this kind of corporate misconduct adversely affects the mental health system and exacerbates the suffering of its consumers. Again, I know some people require the assistance of the pharmaceutical companies and the psychiatric community. The screening process for prescribing these medications is a big part of the problem. That’s because there is no adequate process in place for dispensing these potentially dangerous drugs.

Society itself contributes to this dysfunctional culture. The general attitude of the public is “As long as they are not bothering us you can do what you please with them.” This gives the mental health providers even more authority to do as they please. And so the psychiatric patient is stripped of his or her rights. As I see it, a psychiatric patient is a human being without respect or dignity. You can call my words dramatic if you like.

It may seem as I am playing the blame game and the taking on the victim role. Allow to clarify the role of the patient in the mental health system (those like myself). I will be the first to admit that the informed psychiatric patient is the one who is primarily responsible for his or her unfortunate situation. We have to accept our role in the system. No one can twist your arm behind your back, and say, “Go see a therapist about your anxiety.” At least that’s true in most cases. When you reflect on why you did it, you will say, “It seemed like a good idea at the time.”

The worst thing a mentally ill person could ever do, is telling someone about his or her condition. As soon as you do, the other person looks at you differently. An automatic flash goes off in the person’s brain, “Oh God. Here we go. His illness is acting up.” This attitude is especially noticeable in the face of a mental health professional, your family members, and closest friends. It’s a universal reaction. From the moment you reveal your secret, everything you do will be blamed on your illness. The ways in which you express yourself as a normal human being will be measured against your supposed disorder. If you are frustrated about something, the people in your life will conclude, “His meds aren’t working.” When people think you cannot hear them, they will gossip amongst themselves, “Oh he’s a psych patient. That’s why he looks agitated. That’s part of his illness.” This attitude is quite common. It comes from a lack of understanding. How could a person know, unless he or she has personally experienced it.

If you should attempt to verbalize your rights as a human being, the mental health provider will proceed to have you committed to a psychiatric hospital against your will. The patient can be held for an indefinite period of time until a clinician decides the person has come to his or her senses. The mental health professionals can essentially do whatever they want with you because no one is going to speak out against them. In Massachusetts, psychiatric patients must retain a specially trained lawyer to represent them before a mental health court in order to be released. This is where we are in 2013. I’ll bet most of you reading this article didn’t know how our behavioral health system works. We are still in the dark ages.

The only time the state of the mental health system is brought to light is when a patient commits suicide or kills someone. Then there is a public uproar and the psychiatrist or therapist are blamed or in some cases sued. In their defense, no doctor can control the behavior of their patient in society. That is not their job as I see it. The mental health professional cannot be held responsible for the actions of their patients, unless they were grossly negligent in some way. We are free and sovereign human beings. In the United States, people are generally allowed to operate freely without undue interference from others. The American attitude is “No one has the right to tell me what to do.” It’s a slightly different story if the patient states that he or she intends to commit suicide or kill someone. Then the call to duty is activated.

John Backster is an advocate for the mentally ill and an activist for reform in the behavioral health system. Mr. Backster believes that the over reliance on medication as a primary treatment for psychiatric illness has led to a decline in the quality of mental health care nationwide. He is employed as an advocacy speaker for the National Action Committee for Mental Health Care Reform. He considers himself an activist for the rights of the mental ill. Mr. Backster is dedicated to bringing awareness to the alarming deficiencies that exist within the behavioral health care system. His goal is to curb the over-reliance on dangerous pharmaceutical drugs as the preferred treatment for patients with debilitating psychiatric disorders.