May is National Mental Health Awareness month and given the significance to our profession and patients, I thought I would use this month’s message to highlight it. Mental illness is so common that all of us either have struggled with it personally or know family members or good friends who struggled with one or more kinds of mental illness.
It is certainly common in our patients; around half of all patients admitted to the medicine service at any given time have a documented mental illness.
Although we don’t often think of it this way, mental illness can be fatal. There are over 38,000 U.S. suicides every year and 25 times that many suicide attempts. Over 90 percent are a result of mental illness.
It is estimated that more than eight million U.S. adults have suicidal thoughts in any given year – nearly four percent of the adult population! Suicide is the 10th leading cause of death for all ages in the U.S. and physicians, particularly female physicians, are at high risk for suicide.
I think the most dramatic form of mental illness is schizophrenia. It affects about one percent of every community around the world. The estimated prevalence in the U.S. is 2.4 million people. This is not an illness anyone brings on themselves because they fail to follow medical advice or engage in activities known to be risky, like smoking or drinking alcohol.
Their brains simply don’t function correctly. This should not be surprising; the human brain is remarkably complicated. Despite the fact that this is a biologic disease, the stigma persists and the shoddy treatment our society too often provides continues unabated. We need to treat people with schizophrenia compassionately like any other group of patients with a debilitating disorder.
Major depression is the leading cause of disability for Americans ages 15-44 and affects almost 15 million adults in any given year. It is a major risk factor for suicide and as such we should manage it like the potentially lethal disease it is. Bipolar disorder is significantly underdiagnosed, but still recognized in nearly six million adult Americans. Anxiety disorders are remarkably common and will affect 40 million U.S. adults this year.
These are biological disorders that people struggle to overcome. We need to approach them as such and get these individuals the help they need. The good news is that for many patients there are helpful treatments available – if they seek help. But that is a phenomenally hard step for an individual to take. Regrettably, almost all mentally ill adults and adolescents go out of their way to hide their affliction and delay seeking help.
A decade ago I was burned out and suffering from depression and like almost everyone else waited far too long to seek help. The delay in seeking treatment increases the challenges patients face and likely increases the risk of death for some. This delay will not improve until society begins to view mental illness as a disease and not a character flaw. The group to lead that change must be us, the medical staff, and the time has come to educate patients, peers, families and friends about the collection of diseases known as mental illness.
Michael Ivy, MD
Chief Medical Officer