MENTAL HEALTH & Its Economic, Societal, and Individual Costs – Part 1
Mental Health: What is it?
It has long been recognized that there is a close association between our mental health and our physical health. Achieving good psychological health without good physical health or vice versa can be challenging for any person. Comorbidity, or the co-occurrence of two or more disorders or illnesses, is not uncommon when considering mental health. Poor physical health can be a source of stress that poses a challenge to maintaining our mental health. For example, someone with a chronic physical illness may also experience depression. Poor mental health, on the other hand, can result in behaviors that sacrifice our physical health. Oftentimes, severe psychological and emotional trauma may, along with dysfunctional psycho-behavioral expressions, be manifested in the form of physical diseases such as diabetes or obesity.
Good mental health refers to a state wherein we are able to fulfill our potential. It exists when we are able to make contributions to our community and our workplace, while weathering the daily stressors that come with belonging to a community and having employment.
Usually we think of mental health as simply the absence of mental illness. But mental health or the lack thereof, is more than the absence or presence of relatively common illnesses such as anxiety, depression, substance abuse/dependence, or even the more severe forms of mental illness like schizophrenia and bipolar disorder. Good mental health also means that there is the absence of mental health problems. In other words, there are other things that result in poor mental health but don’t rise to being a true illness. For example, problems like excessive anger, poor quality or negative relationships, and workplace bullying (whether as victim or perpetrator) can all be indicators of poor mental health. At the very least, these emotional relationship problems can contribute to the development of more serious conditions. In general, the consensus is that any discussion about improving mental health needs to begin with recognizing that both mental health problems as well as mental illness need to be addressed.
It is also recognized that in order to improve mental health, we need to have a clear idea of what our goal “to improve” actually means. The traditional goal of health care has been to “cure” the health-related problem. In other words, the treatment process, in physical and psychological health care, has been to identify the cause, remove the cause or treat the symptoms, and then send the patient home, presumably problem-free. Although this model may roughly work for some physical ailments, for most circumstances it cannot be successfully applied. One reason it may be inapplicable is that more often than not, we have yet to discover the cause of the illness. Logically, if we do not know the cause, we cannot remove it. Nonetheless, we still need to treat the illness. In other situations, we may actually know the cause, such as in diabetes Type I or Huntington’s disease, but we have yet to discover a satisfactory cure. With many mental health problems e.g. emotional control problems, the inability to form positive, constructive relationships, or illnesses e.g. clinical depression or schizophrenia, there can be numerous root causes. Discovering the actual cause for any given individual’s psychological condition won’t gain us any traction in improving their mental health, since the cause is less relevant than the behavior itself.
For reasons such as these, recovery, rather than curing, has become the goal for most treatment models today. Recovery is an evidence-based treatment approach that focuses on getting the person to live, as much as possible, an independent, high-quality life where they are able to work toward successfully achieving their life goals. SAMHSA (Substance Abuse and Mental Health Services Administration) has identified the following four areas as essential components to a life of recovery: 1) Health, or being able to make choices that positively impact our physical and emotional health; 2) Home, or having a stable living space that we feel safe in; 3) Purpose, or living our days with positive and constructive activities that provide us with meaning and satisfaction; 4) Community, a life filled with relationships and social connections that we can turn to for various reasons ranging from talking about our problems with others to just spending time with and feeling connected to others. Although curing an individual isn’t excluded, recovery focuses on reducing the symptoms or even attaining full remission of the symptoms, so the individual can lead a normal life in spite of their mental health illness or problem.
Relative to taking a curative approach, assisting a client in recovery has a lower threshold for success, but is more challenging, typically due to aiming for more elusive, abstract goals. For example, things such as quality of life have a tremendous individualistic component to them. In other words, one individual, who is challenged with developing good relationships with others, may view the “good life” as being filled with many close friends, whereas another might see the “good life” as filled with good working relationships with their co-workers.
Because of the individual nature of recovery, successful practices are moving towards therapies that emphasize evidence-based treatment. It is only the client who can ultimately identify satisfactory goals for treatment and, since these goals generally occur outside of the treatment context, it is also only the client who can truly determine how progress is being made.
Clients are being asked to participate in helping to customize the treatment process, providing feedback on the process as an integral measure of the progress being made towards achieving the treatment goals.
To summarize, mental health is seen today as more than the absence of clinically significant illness. Dysfunctions in a wide range of an individual’s life can also contribute to poor mental health. The goal of treatment is to help the individual achieve a life filled with purpose, achievement, and all of the other things that we generally consider to be essential elements for living a fulfilling life. Given the idiosyncratic nature of these elements, treatment models are moving towards including the clients in determining the treatment goals as well as incorporating the client’s perceptions of the treatment progress.
Tune our next blog to know what is the World Health Organization (WHO) talking about mental health problems and illness?