Sunday, January 23, 2011

The link between financial trouble and mental illness

Going through one of the worst economic sagas in U.S. history has thrown the country into two types of depressed states: a financial one and a psychological one.

Both have been devastating to our national identity, unity and priorities. The financial one is debated openly and spoken of in the media daily. The psychological one, however, is still closeted from our national discourse, still approached with social stigma as the dirty little by-product of the recession, only to be discussed after a national tragedy.

But, after the events in Tucson, secret it can no longer be. A recent government report found that 20% of Americans had some form of mental illness in 2009. Let's read that again: 1 in 5 Americans suffers from mental illness, including depression and anxiety. Undetected, these conditions lead to alarming rates of suicide or other violence.

The recent surge in those staggering statistics reflects two types of economic side effects. First, the rise in mental health disorders has increased as economic certainty has deteriorated: joblessness, crippling debt and home foreclosure. Second, the problem is only exacerbated when those with newly-developed or pre-existing illnesses can't seek treatment because they don't have health insurance due to unemployment.

A vicious, vicious cycle. A true great depression that has its sights set on our young people, like Jared Lee Loughner. According to a government report, the American youth population, ages 18-25, had the highest level of mental illness at 30% - almost 1 in 3 young people.

According to a government report, the American youth population, ages 18-25, had the highest level of mental illness at 30% - almost one in three young people.

Loughner's troubled mind and depression-based joblessness were recently analyzed by the Wall Street Journal after the paper discovered and printed his online postings: "The online-forum messages exhibit a growing frustration that, at 22 years of age, Mr. Loughner couldn't land a minimum-wage job and was spurned by women. By May 15, he wrote, he hadn't had a paycheck in six months. A month later, he wrote that he had submitted 65 applications, yet "no interview."

I would never go insofar as to say that Loughner was depressed only because he didn't have a job as, of course, that simplifies a deranged, complex killer. Nor would I, even for a moment, suggest that he would have sought help even if he did have the access to mental health care or a more stable economic situation. But, the postings highlight the idea that, for whatever reason, employment or otherwise, he didn't get the help that he needed.

How quickly we forget the similar ramblings of desperation from Seung-Hui Cho, the Virginia Tech shooter, who expressed extreme hatred for "rich people and elitists" in a letter to NBC News, stating that "this did not have to happen." We later found out via a temporary detention order obtained by ABC News that a psychologist wrote that Cho's "affect is flat and mood is depressed."

The Washington Post editorial page this week asks "could more have been done?" on a campus level in the three-and-a-half years since the Virginia Tech massacre. The article concludes, "psychiatrists say that it is nearly impossible to predict if someone is going to become violent."

That may be the case, but violence is only the most extreme, nightmarish manifestation of mental illness and certainly not the only one to be tackled. While the human toll is clearly the most egregious, the costs run as wide as they do deep.

According to data released by St. Vincent Health, the failure to recognize and diagnose mental disorders has a huge impact on the US workforce, both for the workers themselves and the overall rate of national productivity. Untreated and mistreated mental illness costs the country $105 billion in lost productivity each year-and U.S. businesses foot up to $44 billion of this bill.

Most of the symptoms of psychiatric disorders are manifest by high school when detected by mental health professionals. Harold Koplewicz, a child psychiatrist and president of the Child Mind Institute, recently said on MSNBC, "It's our moral imperative as a society to take care of our young people. Serious psychiatric illness, 75% of it, occurs before the age of 24. So it's not unusual that we're going to see college-age kids suffering more than anybody else."

A true "lost generation," with the highest current rates of unemployment and mental illness. Yet, we are still an underserved nation, with only 34,000 psychiatrists for what has been projected as 15 million Americans in need of mental health therapy, services and assistance. The math doesn't work.

It is time to discuss a major systemic overhaul that might require another costly, but equally merited, "bailout" from Washington - one we can't afford and can't afford to live without.

In the short run, some problems can be handled at the local level, some at the state, and some at the national simply through sharing information, establishing best practices, enforcing gun registration, vigilant psychiatric profiling and a little common sense. However, long term we must look at mental health in the same light as all other treatable illnesses.

"If this young man was bleeding or wheezing or having a seizure in his classroom, we would have called 911 and gotten an ambulance," Koplewicz said, referring to Loughner. "And yet we have all of these signs and symptoms of psychiatric disorders that unfortunately both in his college and in his family and in his neighborhood, people turned away. And that's the big change that has to occur."

This is not a young problem, an old problem, a right or left or otherwise politicized problem - it is the great equalizer, the issue that, directly or indirectly, has and will affect us all.

Gone should be the days of the anti-psychiatry movement that reached a fever-pitch in the 1960s. We are all in this recovery together. Since Columbine and Virginia Tech, the economy has exponentially spiraled downward.

Our employment picture is the worst in 25 years, pensions aren't what they used to be, the equity we thought we had in our homes is kaput and the rich-poor divide is the largest it has been in a half-century.

That we have a national epidemic in mental illness compounded by fiscal depression is undeniable. It doesn't take an expert to see that there is a national psychiatric crisis that reverberates, no longer as an isolated instance of senseless bloodshed but, as a string of lethal events that traumatize and paralyze the entire nation.

Recovering from it should be handled with the same vigor that has been used to emerge from fiscal calamity, as they are both cyclical, interdependent and, more often than not, feed and fester off each other.

© 2011 CNBC.com

 
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