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Why education on mental illness is needed

Two recent MinnPost articles (here and here) by Paul Scott in the Second Opinion blog questioned the need for a bill that would require the Minnesota Department of Education to recommend curricula that educate teenagers about mental illness. There were insinuations that it’s simply a way to have more children diagnosed and medicated and that NAMI promotes medications because it is heavily funded by the pharmaceutical industry. 

First off, NAMI Minnesota’s funding from the pharmaceutical funding is way under 10 percent. Nearly 100 percent of our board and staff have a mental illness or have a family member with a member with a mental illness. Our experiences are what drive our work, not who funds us.

Stating that mental illnesses aren’t illnesses of the brain doesn’t change the reality that so many have to face. It’s easy to dismiss the effectiveness of medications that treat depression. But have you ever seen serious depression up close? A heavy wet wool blanket that slows every movement, every thought — that makes it nearly impossible to carry on with normal everyday activities?  Have you ever had to hold your teenager who felt so hopeless about the days ahead that she would attempt to take her own life? Have you watched her vomit up black charcoal along with all the pills she took?  Do you know how hard it is to say that your son lost his life to depression and to put that in his obituary?

It’s easy to dismiss mental illnesses until you see them up close. Have you ever watched helplessly as your daughter wastes away, becoming thinner every day while still thinking that she was overweight? Have you ever sat in the emergency room with your son as he cried telling you that it wasn’t him that was trying to hurt you but the voices that told him to do it?  Have you ever tried to control your racing thoughts so that you could stay on your job another day?

Little funding for research
It’s easy to talk about the influence of drug companies and others on the treatment of mental illnesses when you have not held someone who is struggling with mental illness in your arms, when you have not faced it yourself. Finding effective treatments is difficult, mainly because there has been so little funding for research. Therapy and medications are typically the answers — and for many they work. When you are able to function again or you are able to see your loved one climb out of illness into wellness, out of the symptoms of mental illnesses into recovery — then you believe in the effectiveness of treatment. 

It’s easy to dismiss the importance of raising awareness until you’ve faced the discrimination at every turn — your health insurance, your employment and even your friends and family who simply do not treat it as a real illness. It’s easy to dismiss mental illnesses as phony and not real until it has struck someone close to you. When people with mental illnesses come together in support groups or when families come together to learn about these illnesses you can see the effects of negative attitudes and the lack of awareness towards mental illnesses. The isolation and discrimination they face is real and when you find people who truly understand what you are going through it is life changing. 

Teens need to know that these are real illnesses
So, yes, we need to help teenagers understand that these are real illnesses. Chances are good that someone close to them — a parent, a sibling, a child, a cousin, a friend — even themselves — will be touched by this illness.

And once you try valiantly to find a treatment that works, services that will help, and emotional support from family and friends — only then will you understand the need to end the discrimination and prejudice that surrounds mental illnesses.

It may be an intellectual discussion for some, but for me and for so many other NAMI members and Minnesotans, this is a real-life situation in which there are few answers and where hope is often elusive.

Sue Abderholden, MPH, is the executive director of NAMI Minnesota.

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Comments (3)

  1. Submitted by Alicia DeMatteo on 03/16/2010 - 12:42 pm.

    Many of these teens may have an opportunity in their high school career (and beyond) to help a friend suffering from a mental illness, as I did in high school. I was educated and knew the signs to look for, and my friend told me (and only me) that she had been cutting herself and hiding it from her parents.

    Thanks to our high school’s excellent health teacher, I knew this was a severe problem and she was in danger. And I trusted that teacher enough to tell her about it.

    Sorry for the “after school special” here, but it’s a good example of why we can’t treat mental health as second-class.

  2. Submitted by Paul Scott on 03/16/2010 - 04:31 pm.

    It’s unfortunate that my attempt to describe the financial support from industry for health advocacy groups, the divisions within the academy over the etiology and treatment of psychiatric disorders, and the implications these factors might create for the State of Minnesota developing awareness materials in concert with such groups, has elicited these reponses.

    For the record, I never questioned the need for attention to the mental health of students, much less called mental illness “phony.” I don’t know how long an advocacy group gets to tar its critics with that brush but it is neither productive nor fair. Nor did I question the motivations of anyone working for NAMI or those advancing the bill; As I said of the bill in the piece: “surely its heart is in the right place.”

    What the article suggested was not that members of NAMI or anyone else behind such efforts promote a given treatment or interpretation of the literature out of naked obedience to its corporate patrons. Only that there exist legitimate liabilities and controversies at the level of society and the individual associated with the use of certain treatments and the often shaky science upon which they rest, and that there is an inherent conflict of interest when an advocacy organization and medical specialty are educated and funded by the makers of those medications.

    I am happy to hear that NAMI Minnesota derives less than ten percent of its funds from the drug industry, if that is indeed the case (though the organization could surely make those figures public if it so chose and remove all uncertainty). But it remains a member of an larger organization that derived two thirds of its funding from industry last year, one whose materials it presumably shares, and one which has been named in a lawsuit for the off label promotion of Geodon, a powerful antipsychotic made by one of its biggest sponsors. Surely the Minnesota chapter should not be blamed for those events, but perhaps it should not rush forward to brush off the concerns those issues raise — at least if it is seeking to help write the way in which children of Minnesota will be taught about the nature and treatment of mental illness.

    Mostly it is unfortunate the writer can’t seem to imagine a critic who simultaneously cares about mental illness and the domination of a medical specialty by the drug industry. If that is the case, they really are shutting out important voices for their cause, because my experience has been that people who are alarmed by conflicts of interest feel as they do out of an abundance of concern for patients — out of a strong-felt sense of “first, do no harm.” I have seen the list of the many Minnesotans who support NAMI, and it is an impressive testament to the broad span of humanity that is touched in some way by mental illness in our community. Their wish to transform their pain into something bigger than themselves is clearly powerful, and Sue Abderholden is surely one such person, and I thank her for her service.

    But I would like to see the day when that admirable impulse is able to more fairly receive news of science that does not square with its public health campaign, and when it can juggle its empathy for the mentally ill with valid concerns over how it is originated, treated and described to students.

  3. Submitted by James Hamilton on 03/16/2010 - 04:46 pm.

    Mr. Scott’s articles raised legitimate questions regarding the influence of psychopharmocological drug manufacturers on course content and the limited guidance provided by the original draft of the bill under discussion. It appears that the bill has been improved, based on Mr. Scott’s second article. Ms. Abderholden’s response does not address these concerns, other than to state that her own organization’s funding by drug manufacturers is less than 10%.

    Yes, mental illness is poorly understood by many Minnesotans, perhaps even a majority. Like Ms. Aberholden, I know this through personal experience, more than 20 years experience in my case.

    But we cannot ignore the influence of drug manufacturers in developing a health curriculum which addresses the subject. This is particularly true in light of the history. We know, for example, that studies indicate most anti-depressants are of significant effect only in cases of moderate to severe depression. Yet, they are marketed as what my brother derisively referred to as “happy pills”. Recently, the pharm industry campaigned to influence Japan’s recognition of depression as a medical condition requiring Western medications, resulting in a doubling of the sale of anti-depressants. NPR recently reported on the campaing by another drug manufacturer which essentially created a market by creating a disease, ostopenia. Our schools should not become merely another marketing mechanism.

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