How to Make a Big Difference in Mental Health -- at Little Cost

By Sue Abderholden

March 27, 2009

With the economic crisis and state budget shortfalls come increasing concerns about how to meet the needs of people with mental illnesses. How do we continue to move forward, adding on the gains made these last few years? How do we address the increasing anxiety and depression occurring in Minnesotans who cannot support their families? How do we improve the mental health system and expand access to it — with less money?

There are, of course, no easy answers. But here's one idea that could make a big difference at little cost: In terms of how we provide information to the individual and how we involve families and friends, treat mental illness like any other illness.

We know that educating a person about his or her illness, treatment options, the impact of diet and exercise, and community supports will increase the probability that the person will get better. For people with diabetes or heart disease, we wouldn't think about releasing them from the hospital or having them leave a physician's office without educating them about their illness. And the person wouldn't receive the information once, but multiple times.

But individuals with depression, schizophrenia or other mental illnesses often receive little to no information. If they are lucky, they may receive a handout or brochure about the illness. Maybe they will be given a sheet of paper with medications and dosages.

In focus groups conducted by the National Alliance on Mental Illness last year, we found that few people with mental illnesses had been educated about their illness and none had been told about the benefits of diet and exercise. Some shared how hard it had been while hospitalized to even discuss with their psychiatrist why their medications were being changed.

People living with cancer will often emphasize the importance of family and friends in their recovery. They are encouraged to have a family member or close friend with them to hear about their illness and treatment options. It's hard to take it all in when you're by yourself. It's good to have other people in the room to take down information and ask questions. It's even better to have get-well cards and help with meals when returning home.

Ask people with a mental illness if they ever received a get-well card when hospitalized, and they say "no." Meals or other supports are few and far between, as well. Families who have a loved one with mental illness typically say they've been "voted off the island" in the mental health care system. No information is provided unless there is a full-blown privacy release signed. No one encourages the individual to have someone else in the room to be his or her advocate. Little to no information is provided to the families so they understand how to help and support their loved one.

And we wonder why some people with a serious mental illness end up alone and disconnected, wandering the streets or confined to our jails. The reasons for the lack of education are numerous, ranging from old attitudes towards mental illness to blaming families for it.

This is one improvement that can be made that truly won't cost a lot of money. Let's begin by engaging the health care community to:

* Educate patients and their families about the diagnosis, treatment options and community supports.

* Involve families and friends in the healing and recovery process.

* Engage the individual in making informed decisions about treatment and medications.

* Encourage hope for recovery by inviting people to send get-well wishes and by encouraging community support.

* Understand how important families and friends of the person with mental illness can be, and encourage them to join in support of their family member or friend.