Lack of services an issue of values, not money | Mental Health Matters | SierraSun.com

Lack of services an issue of values, not money | Mental Health Matters

Andy Whyman, MD
Special to the Sun-Bonanza

According to the National Institute of Mental Health (NIMH), 43.7 million adults 18 or older, or 18.6 percent of U.S. adults, experienced “any mental illness” in 2012. “Any mental Illness” is defined as a person with a diagnosable mental condition accompanied by no or only mild mental disability.

The Institute also claims that 9.6 million, or 4.1 percent of the U.S. adult population, experienced “serious mental illness” in 2012; these are persons with a diagnosable mental condition that substantially interferes with major life activities.

Overall, that’s a whole lot of people with real problems of an emotional nature.

Citing other statistics, the NIMH concludes that in 2008, just over half or 58.7 percent of adults with “serious mental illness” received treatment, and 13.4 percent of all U.S. adults obtained mental health treatment defined as inpatient or outpatient care and/or psychotropic medication.

Much of that 13.4 percent group received only medication prescribed by a general physician in a office or clinic setting.

For depressive disorders, nearly 40 percent of treatment was considered only “minimally adequate.”

Broadly translated, this means that almost half of the adult population most in need of mental health treatment don’t get it, and even for those who do, said care is frequently not optimal.

Americans should not be proud of these numbers. Imagine the outcry if half of the adult population was denied care for cancer, heart disease, or diabetes.

What’s the local impact of this sorry state of affairs? An editorial in the 7/18/15 Reno-Gazette Journal states, “Compared with the rest of the nation, Nevada ranks 49th in the nation for the number of psychiatrists per 100,00 people.”

What did the state do about it? Aside from a few minor procedural tweaks, in a negligently underfunded program, and plans for the long distant future, very little.

In California, the numbers look better, but these numbers deceive; there are 16.5 psychiatrists per 100,00 population, better than the national average. But most of them are in larger cities or communities with academic institutions.

When I last inquired, Truckee had one office-based county psychiatrist who prescribed medication for part of one day a week! Tahoe Forest Hospital had virtually no psychiatric services or coverage, a situation inviting disaster.

This dearth of services is unacceptable, and, as the Reno Gazette implies in its 7/8/15 editorial, likely contributed to recent homicidal and suicidal tragedies in the Reno area.

But try and convince those who hold the purse strings that these lives matter as much as those of theirs and yours, and you get the usual disinterested, perfunctory excuses.

And excuses they are, no matter how tight the budget claims. Don’t believe me? Check out the dollars that virtually every governmental and large “nonprofit” agency spends on travel, junkets, outings, “seminars,” meaningless meetings, fancy meals and drink, then tell me there is no money.

No, the lack of services is an issue of values, not money.

Whining and complaining about misplaced priorities and misused monies won’t change anything though. What can you do now if you or someone you know should obtain mental health care?

Here Whyman’s list:

1. If you can afford it, seek private care. Emotional problems lasting more than 6-8 weeks are generally helped by talk therapies with qualified mental health providers. And, if after 8-10 visits you’re not a bit better, change therapists.

2. If your problem fits into the severe and incapacitating category, medications are frequently helpful in addition to psychotherapies. While the vast majority of psychotropic medications are written by non-psychiatric physicians, an available psychiatrist is a better choice.

3. If you have a mental health emergency, get on the phone: If the situation is life-threatening call 911, the Washoe County Crisis Center (800-9925757), or 211 in Nevada County. If that doesn’t work, go to your local Emergency Room regardless of your ability to pay.

4. Access the Truckee-North Tahoe Mental and Behavioral Health Resource Directory, an excellent guide to both public and private mental health and substance abuse providers. See http://www.tfhd. com under “Quick Links.”

5. What to do if you’re a family member or a fast friend of someone who you believe has emotional or substance abuse issues they won’t or can’t attend to? First, talk to them. Share your thought and observations. Next, offer to help, maybe by finding a mental health provider for them, or getting them to a scheduled appointment. Don’t be timid here; People with more severe mental problems are less likely to seek help on their own.

6. If family or friend, any talk about suicide or mention, even in passing, of suicidal thoughts should be alarming. First, listen. Then make sure help is available, immediately if you feel the threat is sufficiently frightening. Being told, “I won’t do it” might not be enough. If your friend or loved one is already in therapy, contact the therapist and tell them what you know; suicidal patients may not share suicidal thoughts or plans with the therapist.

7. You can also offer serious help to people on the edge just by being present; take a walk, go for coffee, make a meal, go to a show, work on a project.

Just being there matters.

Incline Village resident Andrew Whyman, MD, is a clinical and forensic psychiatrist. His column focuses on drugs, mental health and substance abuse in an effort to raise better awareness. He can be reached for comment at adwhyman143@gmail.com.