One out of five Americans experiences mental illness each year; however, the majority of those who need treatment do not get it.
This is the conclusion of the first-ever US Surgeon General’s report on mental health which was released by Surgeon General David Satcher in December 1999. That there are so many of our nation’s citizens suffering from mental disorders is a rather shocking statistic to most people but, equally shocking, should be the relatively small number of persons being treated for their disease. Mental health professionals and mental health advocates are hoping that the Surgeon General’s report will result in at least two accomplishments. First, that the publicity surrounding the report’s release will result in more people who need treatment getting it, either directly by self-referral or, indirectly, as a result of someone intervening on behalf of a sick person. Secondly, that an increased awareness of mental disease will provide the impetus for a successful push for parity or equality in health insurance coverage between mental health and other health care coverage.
The stigmatization surrounding mental disorders is subtle because it reflects two extremes-the “lock em up and throw away the key” mentality and the contemporary fascination with and trivialization of everything psychological. The first extreme is illustrated by the case of William Minor, a Yale educated physician who, after a scarring experience as an army doctor in the Civil War, seems to have fallen into severe mental illness. On a trip to England he awoke one night in the throes of a paranoid delusion, rushed outside and shot a stranger walking down the street, whom he fantasized had been trying to attack him in his sleep. After being found not guilty by reason of insanity, through application of the McNaughton rule, this respected son of a fine Boston family was to spend almost the rest of his life in Surrey, England, at the Broadmoor Asylum for the Criminally Insane. What is so interesting about Minor’s story is that through peculiar good fortune he was to spend much of his life, though an inmate, making a major contribution to the completion of one of the heroic tasks of Victorian England-charting of the life and providing a biography for each word in The English language. The completion of the Oxford English Dictionary took 70 years. Minor’s life illustrates, on the one hand, the “lock em up and throw away the key” fear we all still have of mental illness, and on the other, the human potential that can so readily been lost by such an attitude.
The other extreme of stigmatization is from the contemporary trivialization of the psychological. People who suffer tremendous abuse and scarring, and may have deep-seated emotional problems, are on television talking about it as a form of entertainment. All interpersonal problems are subject to being psychologized. Everyone is an armchair therapist. Those taking Prozac and other anti-depressants are regularly the subject of New Yorker cartoons. The result of this trivialization is that one does not want to be stigmatized by having something universally regarded as petty as a psychological or emotional problem. Because of society’s contemporary fascination with the psychological and the media’s pandering to it, we lose compassion for the individual and the uniqueness of the human being who suffers from mental distress. As responsible members of a society which at once fears and mocks mental illness, it can be difficult for distressed professionals to ask for help.
The Surgeon General’s report on mental illness comes just as the North Carolina State Bar Lawyer Assistance Program has held in January 2000 its first ever Annual FRIENDS Conference on Depression and Other Mental Disorders. The timeless of the Bar’s development of a program to provide assistance to lawyers suffering from depression and other mental disorders attests to the successful history of the PALS program as well as the foresight of the PALS founders and both the current and past leadership of the State Bar.
Lawyers are at greater risk than the general population for mental illness but are even less likely to pursue treatment. Three factors appear to be responsible: first, the stigma attached to mental health disorders or those suffering from mental illness; second, how lawyers are viewed by the public and how they view themselves; and third, the nature of the legal profession.
Stigmatization has long been the bane of those who are mentally impaired no matter the severity, length, degree, diagnosis, prognosis, etc. of the impairment; no matter whether the impairment might the severity, length, degree, diagnosis, prognosis, etc. of the impairment might be a result of genetics, a physical accident, a temporary abnormality of the brain chemistry, etc. The mentally ill are too often viewed as weak or bad and in need of being “put somewhere” instead of appropriately being seen as sick and in need of proper medical care.
The lawyer is most often viewed by society and, in many instances, by himself or herself as having to be tough, ruggedly individualistic, of the Lone Ranger/hired gun type. Few people want to go out and hire themselves a “rather nice lawyer.”
The legal profession is demanding, filled at times with tension, often demoralizing, often all-consuming, and often threatening. The very nature of the profession serves as a barrier to a lawyer’s seeking of needed help or seeking to help another lawyer.
Despite the stigma and negativity surrounding depression and other mental illnesses, the FRIENDS Program is off to a surprisingly excellent beginning. A good many lawyers have self-referred to the FRIENDS Program for assistance and we have received numerous inquires and referrals by others on behalf of lawyers in need of help. Additionally, the response to our efforts to recruit a cadre of FRIENDS Volunteers statewide has been, and continues to be, very heartening. Any lawyer who is interested in becoming a FRIENDS Volunteer can obtain an application form by writing to FRIENDS, NC State Bar, PO Box 25908, Raleigh, NC 27611-5908 or by calling 1-877-627-3743. Typically, FRIENDS Volunteers are lawyers who understand, through personal experience or professional training, the problems associated with depression and other mental disorders. Volunteers are trained in confidentiality and in providing peer support so that they are available to listen and share their own stories of how the dealt with a similar condition.
Author Lewis Presnall, in his book Search for Serenity, states that “in this topsy-turvy world, it’s often the lopsided man or woman who runs the fastest along life’s little side-hill.” The “lopsided,” or those who have been wounded, are often viewed today as heroes, where once they were victims of stigma. The good news is that those who suffer from mental illness can get well. The Surgeon General’s Report should be received with applause as it generates the kind of positive publicity necessary to stimulate those who are in need of assistance to seek help and, in addition, to encourage renewed efforts toward the provision of adequate health insurance coverage.
Any lawyer who believes he or she may be suffering from depression or other mental health disorders is just a phone call away from assistance (take a moment to take the short test accompanying this article). “Maturity is knowing when to go for help” and the FRIENDS Program is available to you by calling toll free: 1-877-627-3743 or 919-828-6425.
Take the test
If you or someone you care about answers yes to five or more of these questions (including questions #1 or #2): and if the symptoms described have been present nearly every day for two weeks or more, you should consider speaking to a health care professional about treatment for depression, or call FRIENDS.
|Do you or they feel a deep sense of depression, sadness, or hopelessness most of the day?|
|Have you or they experienced diminished interest in most or all activities?|
|Have you or they experienced significant appetite or weight change when not dieting?|
|Have you or they experienced a significant change in sleeping patterns?|
|Do you or they feel unusually restless or unusually sluggish?|
|Do you or they feel unduly fatigued?|
|Do you or they experience persistent feelings of hopelessness or inappropriate feelings of guilt?|
|Have you or they experience a diminished ability to think or concentrate?|
|Do you or they have recurrent thoughts of death or suicide?|
Other explanations for these symptoms may need to be considered.
by Ed Ward
Adapted from American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders.Fourth Edition. Washington, DC. American Psychiatric Association: 1994.
The North Carolina State Bar Journal, Spring 2000 Vol. 5,Tags: depression, mental health stigma Posted by