Question meaning of 'mentally ill'.
Journalist should bring the same questioning attitude to issues of mental health that they bring to the defense budget or a host of other topics. But that doesn't happen often enough.
By accepting the fuzziest of contentions and surrendering their skepticism, journalists do no favors to the mentally ill in desperate need of a media willing to ask tough questions on their behalf.
Take, for example, the term "mental health." Eighteen years ago, when I was a social worker, the term had not become what it is now: a catchall phrase that covers absolutely everything and ends up meaning practically nothing.
This reached its apex in the recent surgeon general's report, which attempted to remove the admittedly unjust stigma of the mentally ill by saying just about everyone has mental problems at some point in their lives.
That's true. But lumping together those who suffer from schizophrenia or bipolar disorders with those suffering from poor self-esteem minimizes and even demeans the seriousness of chronic mental illnesses.
Hype aside, the report fell short of its billing.
The report blames private insurance companies for not giving clients the same access to mental health care as they do for medical care without pointing out that the federal government does the same thing. In the 1990s, the government stopped allowing Medicaid funds to be used to pay for mental health institutions with more than 16 beds. Between 1990 and 1997,40 state hospitals closed, nearly three times as many as closed between 1970 and 1990. Fewer public institutions means fewer places to care for the mentally ill who may need occasional inpatient treatment but can't afford the exorbitant rates of private hospitalization.
The most disturbing aspect of the report, however, is that it lumps together alcoholism and drug addiction as just another mental disorder. This has become a trend. Many mental health clinicians have zero training in addiction. Yet they assume that chemical dependency is a symptom of some underlying trauma that needs to be treated with conventional therapy such as individual counseling. They want to deal with the wound before addressing the addictive behavior.
There is a problem with this. Most addicts and alcoholics would give anything to hear that the problem they face isn't really drinking or drugging, but their unique pain. It enables them to avoid the central issue, which is the need to stop sniffing, snorting, gulping, or injecting. Such an approach makes it far less likely that they'll recover and more likely that they'll die drunk.
An even more difficult issue is the topic of the mentally ill who also are substance abusers. For example, of the 283,800 prisoners the Bureau of Justice Statistics says have spent time in a mental hospital, more than half were under the influence of drugs or alcohol when arrested.
The trend in mental health is to minimize or misinterpret the problem of addiction that is central to so many issues in our society. Nationwide, 63% of juvenile delinquents reported using illegal drugs on a regular basis. Nationwide, five children die every day from abuse and neglect; statewide studies show that as many as 70% of parents who abuse and neglect their children are substance abusers. A 1998 study compiled by the Bureau of Justice Statistics said that more than half of criminal offenders reported that they were under the influence of alcohol or drugs at the time they committed their crimes. We can't build enough prisons to fix this problem. On/e baby born addicted to drugs can cost one million dollars; a child born with fetal alcohol syndrome may cost hundreds of thousands in special education costs alone. Mental health disorder? Please. We are in the middle of an epidemic of addiction, and we aren't dealing with it.
Editorial writers can sort through mental health issues by doing what they do best: asking hard questions. When your state mental health officials come into your office to tout the latest program, ask him or her these questions:
* Show me the supporting data that indicate how and why this approach works.
* What are your specific goals? What are you trying to do?
* How will you know you are making progress?
* How will you define success?
* If you judge treatment to have been successful with a client, at what point is that measurement taken? When a client has left treatment for 48 hours? A week? Six months? A year?
* Who is going to be accountable for the success or failure of this program? What evaluations will you do to determine its success or failure?
* If the mental health system is working, why is the percentage of inmates with mental illness rising? What is failing in the community mental health system?
Reporting on mental health issues requires that we demand specifics. Not generalities. Not pabulum. Otherwise, money and lives will be wasted on feel-good approaches that do nothing to solve the real problems.
NCEW member Maura Casey is associate editorial page editor for The Day in New London, Conn. She spent three years as a counselor in a homeless shelter before she, became a journalist. Her e-mail address is email@example.com
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|Article Type:||Brief Article|
|Date:||Jun 22, 2000|
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