Stigmas and stereotypes lead to inadequate mental health care
While those struggling with other chronic illnesses are seen as fighters and survivors, patients with mental illnesses are told to get over it and move on.By Maggie Labarta Special to The Sun Mental illnesses and substance use disorders are brain disorders, which for some are chronic and disabling. In addition to the symptoms of the illness, many people battling mental illnesses and substance use disorders have also found themselves isolated, shamed, ridiculed and criminalized. Their journey to recovery is made more diffi cult by these stigmatizing responses; recovery is not easy and it must begin with a sense of hope. The sense of hope can come from all kinds of places and people, but it has almost always come up in the many conversations I have had with people who are successfully managing their mental illnesses. Hope is the shift that these people ultimately need to overcome the illness and its effect on the body, mind and spirit, including the stigma that so often follows. Right now, Florida has the chance to provide that hope to millions more. Mental illnesses and substance use disorders touch all of us. With one in four having a mental illness, and one in 10 a substance use disorder, not a single person is unaffected: Even if we have not struggled with a mental illness ourslves, we all know someone who has. Treatment works — most mental illnesses can be treated just as effectively as the physical illnesses our health-care system deals with every day. But usually, those with mental illnesses end up receiving inadequate care. Why? The culprit is stigma, a societal response that other illnesses do not engender. Yes, mental illness and addiction can sometimes produce bizarre or disorganized thought and behavior, problems controlling emotion and difficulty functioning in ways society deems appropriate. For most, the suffering is silent and internal, but the extreme cases are what people remember, and TV and movies rehash over and over again. These inaccurate stereotypes paint patients within the mental health system as frightening, depraved or willfully deviant. Whereas those struggling with other chronic illnesses are seen as fighters and survivors, our patients are told they should get over it, move on with their lives. These illnesses have routinely been left out of insurance coverage, or less well reimbursed (until that was forced by parity legislation). They have been relegated to social services or criminal justice, rather than embraced within the health-care system. Like our patients, the system of care has been stigmatized — isolated and devalued. Because of that, investments in research and treatment have been woefully inadequate: Florida has been 49th in funding for the last several years, leaving many without access to needed treatment. But that could begin to change this year. The Department of Children and Families has made it clear that to stop child abuse and neglect, parental mental illness and addiction must be identified and treated. The Agency for Healthcare Administration has required Medicaid Managed Medical Assistance plans to provide better coverage, and have sufficient numbers of providers, than was previously the case. The criminal justice system has acknowledged that many incarcerated people should be in treatment, not prison or jail. And the legislature discussed bills in this session designed to modernize and add resources to the mental health and substance abuse treatment system. Right now, the system is underfunded and teetering on the brink of crisis. It is not broken, as some have said, it has been under-resourced and neglected for years; yet it provides great service t o those who can get in. It lacks capacity and support. The legislature could help turn that around, bring the system to solid ground and provide hope to patients whose recovery is entangled within a neglected system that threatens to drag them down with it. Now is the time to raise our voices in support of those whose illnesses have been treated like bad decisions, and whose lives have been devalued. We can no longer neglect the system designed to support them. If Florida believes their lives matter, now is the time to prove it by supporting the system designed to give them access to hope and recovery. But this doesn’t just come down to the legislature; it is also about every person who has ever known someone struggling with a mental illness or substance use disorder — meaning, it comes down everyone. Maggie Labarta is president/ CEO of Gainesville-based Meridian Behavioral Healthcare.