T

he human brain is a wonder. Through folds of tissue and pulses of electricity, it lets us perceive, attempt to understand, and shape the world around us. As science rapidly charts the brain’s complex structures, new discoveries are revealing the biology of how the mind functions and fails. Given the centrality of the brain to human health, its malfunctions should be a priority, separated from stigma and treated on par with the diseases of the body. We aren’t there yet, but the transformation is underway.

Mental disorders affect nearly 20 percent of American adults; nearly 4 percent are severely impaired and classified as having serious mental illness. These disorders are often associated with chronic physical illnesses such as heart disease and diabetes. They also increase the risk of physical injury and death through accidents, violence, and suicide.

Suicide alone was responsible for 42,773 deaths in the United States in 2014 (the last year for which final data are available), making it the 10th leading cause of death. Among adolescents and young adults, suicide is responsible for more deaths than the combination of cancer, heart disease, congenital anomalies, respiratory disease, influenza, pneumonia, stroke, meningitis, septicemia, HIV, diabetes, anemia, and kidney and liver disease.

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The treatment of mental illness has long been held back by the sense that disorders of emotion, thinking, and behavior somehow lack legitimacy and instead reflect individual weakness or poor life choices. Not surprisingly, there has been a mismatch between the enormous impact of mental illness and addiction on the public’s health and our society’s limited commitment to addressing these problems. Here are three examples of how that plays out:

  • Most emergency departments are ill-equipped to meet the needs of patients in the midst of mental health crises.
  • Most insurance plans view mental illness and addiction as exceptions to standard care, not part of it.
  • Despite an overall cultural shift towards compassion, our society still tends to view the mentally ill and those with addiction as morally broken rather than as ill.

Too often, individuals suffering from serious mental illnesses — those in greatest need of care — have been isolated and cared for outside of traditional health care, as in the asylums of the past. There, mental health care was separate from, and far from equal to, traditional health care.

Why the disconnect? Psychiatry has been hampered by an inability to observe and record the physical workings of the brain. Because of that, psychiatric assessments and treatments have been viewed as somewhat mysterious. Even today, the underlying mechanisms behind some of the most powerful and effective psychiatric treatments are still poorly understood. All of that translates into the difficulty that many people have finding help for real, disabling symptoms attributed to a mental illness or addiction.

However, just as other fields of medicine have evolved as knowledge advanced during the past century, psychiatry has also made profound gains. Advances emerging from unlocking the brain’s physiology and biochemistry are coming at a time when mental health care is being integrated into traditional health care. The potential has never been greater to finally bring psychiatry quite literally under the same roof as the rest of medicine.

The Ohio State University Wexner Medical Center, where I work, offers an example of this kind of transformation. Now celebrating its centenary, the Ohio State Harding Hospital was founded as the Indianola Rest Home by Dr. George Harding II, younger brother of President Warren G. Harding. It was created as an asylum that provided quiet, nutrition, and a focus on spirituality.

Today, the hospital can address mental health issues as effectively as it treats trauma or cardiac arrest. This shift is occurring nationally, with community-involved, comprehensive mental health integration into hospitals in cities and rural communities alike.

Proven regimens for treating common mental disorders and addictions are aiding the “cure” rate and boosting public acceptance that such care works. Modern practices have the potential to improve public health and, perhaps equally important, engage families more actively in the care of individuals suffering from mental disorders and addictions.

I find it fascinating to see the commonsense approaches to treating mental illness once employed by the Indianola Rest Home increasingly being accepted within mainstream medicine. Bringing together the sensibilities and experience of the past with state-of-the-art modern medicine often makes good sense.

Will the stigma of mental illness finally fade? Better understanding of the human brain and the biological nature of the mind will help, but it won’t be enough. How we think about mental health matters. When mental health is ultimately recognized as essential to physical health, not an extraneous element of it, then we will have access to true, complete, modern medicine.

John V. Campo, MD, is professor and chair of the Department of Psychiatry and Behavioral Health at The Ohio State University Wexner Medical Center in Columbus, Ohio.

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    Happy July 4th

    Meg H
    11:49 AM (7 minutes ago)

    to Roz
    Hi Roz….here’s a piece I wrote on my FB page I thought you’d enjoy…
    Wednesday May 31 2017…for many years I’ve always advocated to have mental health embedded within all primary care clinics for just this reason.Taking care of people is complicated and knowing the demons they may be carrying helps uncover many of the medical issues they bring to us.This is absolutely essential to all health care. In 1985-1986 a Psych-Mental Health Nurse Practitioner (Roz Reynolds) and I developed a small medical clinic within the confines of then SE Mental Health here in Portland. We had a $6000 budget, I purchased my own EKG machine and saw mental health patients 1-2 times a week for basic care and preventative care. Planning their care within their own clinic with their advocates, social workers and therapists surrounding them allowed us to truly deliver good care. I had a cardiology friend of mine read all the EKGs because many of the mental health drugs create EKG changes and need to be closely monitored. All in all it was a truly successful program but we couldn’t get enough funding to keep it going. I’m still an advocate of having mental health and health care finally shake hands and begin working together.

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  • John,

    I’m a theoretical scientist with new models of both behavior and intelligence. Both models are bizzarely elegant, and appear to have, NO EXCEPTIONS. For reasons you will probably understand already, these new models remain unacknowledged by mainstream academic interests.

    I have started to self-publish on Kindle, but looking at the human suffering alone, I ought at some point, to make a bigger fuss about these models.

    Let me know if you want to connect, or search Kindle for ‘The drive for Mastery’.

    Regards,
    mark martens
    accidental scientist

  • “When a patient goes for a medical appointment the physician assesses the patient’s risk factor for disease by documenting the family history of things like heart disease, diabetes, colon cancer, etc., so that preventative measures and treatment options for maintaining optimum health can be recommended. Conversely, the psychology profession has invested itself so deeply in attempting to “normalize” the dysfunction of family estrangement/alienation that it has become taboo for anyone to admit anymore that having a history of family estrangement is a major risk factor for developing a variety of both physical and mental health disorders. It should be mandatory for every physician and mental health provider, especially including pediatricians and all those therapists who treat children, to inquire about and document the patient’s family history of estrangement/alienation.” ~ Anue Nue

    “• Cutoffs are common experiences—prevalent, sometimes embarrassing, and thus an elephant in the therapy room.
    • Cutoffs are extremely damaging even though people often tell themselves the other person is expendable. They induce involuntary suppression of feelings.
    • The aftermath of cutoffs can include depression, devastation, dismay, shock, isolation, as well as work problems and physical/psychosomatic issues.
    • Cutoffs, even decades old, are not always clients’ presenting problem; however, they often surface in the course of therapy..
    • Clinicians often fail to identify cutoffs in their clients’ lives, or encourage clients to explore what happened, and to consider taking steps towards reconciliation. The author’s hypothesize reasons for therapists’ hesitancy and suggest ways to overcome it.” http://books.wwnorton.com/books/978-0-393-70704-5/

  • Thank you. Your article should be made more available to a greater audience of those willing to read and understand your concepts.
    Public perception leads to silence and secrecy by sufferers including myself.

    • After reading this article, light bulbs just shined simultaneously; people who suffer from mental health disfunctions are all too embarrassed to seek help, due to the stigma that follows. The enlightenment through this article as to the possibilities of why, is my reasons for agreeing with you Ian. Acknowledgement leads to better understanding.

  • Once I read that the brain has a lymph vessel through the sinuses, and brain inflammation causes depression. After trying all the bone broth diets and supplements and multiple antidepressents that never helped. I pulled out my NetiPot and targeted biofilms. 6 weeks later I knocked the infection out of my sinuses and blood poured out of my nose. Not long after, I drove down the street acknowledging I actually felt *joy*! I am no doctor, just a science major, and I strongly believe depression stems from sinus infections. I wish all of you to be well!

  • Stigma of mental illness will fade once psychiatrists stop assigning fancy labels to people (labels originating from DSM classification). In addition to the label, patients are often told that they have is a “long-term condition.” We need to remember that these labels are given in the absence of any brain differences between normal people and people who are considered to be “mentally ill.” The current practice of labeling only benefits pharmaceutical companies that have an excuse to come up with various pills for numerous “disorders,” even in the absence of any brain differences.

    We should also always remember a MAJOR assumption that is made in these types of articles. Because mental activity is CORRELATED with brain activity, an assumption is made that it is the organ brain that has to be treated. Yet, studies have consistently shown that it is various mind-states that are continuously changing the structure of the brain (this is the well known phenomena of ‘neuroplasticity’). So, what people who are highly distressed (considered as “mentally ill”) need is hope, support and other interventions such as training in mind-calming activities (like mindfulness meditation) – definitely not fancy labels and drugs.

    Regarding the first sentence of this article – I would say the ‘human MIND is the wonder’ – without our thinking, we wouldn’t know how the organ brain works (let alone know that an organ that we label as a brain even exists!). According to the following article published in Nature, the universe is immaterial — mental and spiritual:
    “The Mental Universe” by Henry, R. C. (2005). Nature, 436, 29.

    So, let us not lose sight of the many assumptions we make when it comes to the mind and the brain.

  • PEOPLE ARE BEING FORCED TO USE DEATH AS THEIR ONLY OPTION LEFT TO STOP THEIR PHYSICAL PAIN ,SINCE THIER MEDICINE HAS FORCIBLE BEEN DENIED ACCESS TO,,,VIA SOME SHRINKS,SOME DOC’S THINKING THEY HAVE THIS 6TH SENSE THAT THEY HAVE A RITE DECIDE HOW MUCH ANOTHER HUMAN BEING IS IN PHYSICAL PAIN,,,THATS WHY WHAT U DEEM SUICIDES HAVE SKY-ROCKETED,,WHEN NOT LOOK AT ALL SUICIDES FROM 1990 THRU 2000,,,THEY WERE DOWN BY 5 %,,5,000 PEOPLE CHOOSE NOT TO USE DEATH BECAUSE THEY HAD ACCESS TO DOCTORS WHO KNEW THEIR PATIENTS AND GAVE THEM MEDICINE TO LESSEN THAT PHYSICAL PAIN,,,,EVERY SINCE DR.GOVERNMENT,THE DEA GOING AFTER MANY LEGITIMATE DOC’S ,,DOCTORS IN FEAR OF THEIR LISCENCE BEING YANKED,IE,,UNABLE TO FEED THEIR FAMILY’S,,THEY WILL NOT TREAT ANOTHER HUMAN BEING W/THE MEDICINE THEY NEED TO LESSEN PHYSICAL PAIN TO FUNCTION IN LIFE,,U KNOW,,,MAYBE INSTEAD OF JUMPIMNG ON THE ARROGANT TRAIN OF SHRINKS WHO THINK THEY HAVE RITE TO DECIE WHO DIES,WHO FORCIBLE LIVES A LIFE IN FORCED PHYSICAL PAIN,OR SIMPLY BEING A DOC OR SHRINK WHO THINKSTHEY HAVE A RITE TO DECIDE WHO IS IN ACTUAL PHYSICAL PAIN,,WHICH IS LITERALY IMPOSSIBLE TO DTERMINE,,,MAYBE,,,U SHOULD SPEND OUR MONEY ON WHAT IT MEANS TO BE A HUMAN BEING IN FORCED PHYSICAL PAIN,,,FOR YOUR ,”RESEARCH,STUDIES,,,ARE NOT TRUE SCIENCE,,FOR TRUE SCIENCE U MUST BE ABLE TO REPEAT YOUR RESULTS AT LEATST 3 TIME USEING HUMANS,,,NOT RATS,,,BUT SINCE SOME INSIST ON BEING JUDGE ,JURRY,,AND EXECUTIONER WHEN IT COMES TO HUMAN LIFE,,,MAYBE START STUDYING TRUTH,,WHY HAS THE SUICIDE RATE SKY ROCKETS,,RESEARCH HOW MANY OF THOSE HUMAN BEINGS WERE JUST DUMPED BY DOCTORTS OR HAD THEIR MEDICINE LESSEN TO IN-EFFECTIVE DOSAGES,,HOW MANY DID USE DEATH TO STOP THEIR PHYSICAL PAIN??!!!!BUT NOOOOOO,,,,U DON’T WANT THAT TRUTH PUT OUT,,DO U??!!FOR IT WOULD PROVE THAT YOUR E.B.M. IS JUST A FORM OF GENOCIDE ONTO THE MEDICALLY ILL,,U SHRINKS ARE PUTTING US BACK TO DARK AGES OF PENNHURST,WAREHOUSES FULL OF CRIPPLES IN PAIN,SANATIERIUMS FULL OF CHRONIC PHYSICAL PAIN HUMANS SCREAMING OUT WINDOWS,OR WORSE YET,,AS I JUST READ ,,PUTTING A MAN IN 4 POINT RESTRAINTS BECAUSE HE WAS IN SEVERE PHYSICAL PAIN…….WHEN HUMAN BEINGS THINK THEY HAVE THE RITE TO MAKE OTHERS FORCIBLE ENDUR PHYSICAL PAIN,,ITS CALLED TORTURE,,,ITS CALLED PSYCHOPATHICAL IDEAOLOGUY,,,,,HITLER COMES TO MIND,,,,,,FOR OBVIOUSLY YOUR E.B.M IS NOT ABOUT THE HUMAN BEING W./25-30,000 MORE DEAD,IE,,YOUR SUICIDES,,ITS NOT ABOUT HUMANECARE IS IT!!!ITS ABOUT MONEY,,AND HOW MUCH YOU SHRINKS CAN FILL UP THE REHABS,THE PENNHURST , THE DAYS OLD,,,JUST MAYBE IF ANY ONE OF U GUYS AT STANFORD WOULD STOP BEING SOOOO ARROGANT,,,AND REALIZE,,WHAT U HAVE DONE W/UR E.B/M. IS KILLED OTHER HUMAN BEINGS,,SAY TO YOUR SELF,,,MY GOD,,WHAT HAVE DONE??!!AND START LOOKING TO FIND THE TRUTH,,AND NOT TO PROVE SOMETHING,,WE HUMAN BEINGS IN PHYSICAL PAIN WOULD STOP HAVING TO USE DEATH AS OUR ONLY OPTION TO STOP PHYSICAL PAIN BECAUSE OUR MEDICINES HAVE FORCIBLE BEEN DENIED ACCESS TO,,,,, THAT IS TRUTH,,,,,,,,maryw

    • you obviously need to find a good mental health counselor
      1) WHY are you in chronic pain?
      2) WHY do you refuse to find & utilize self help strategies to alleviate your pain on a daily basis?
      Stop relying on meds to reduce pain. you are black & white drama queen.

    • TO ,”susan?”,, U KNOW NOTHING OF MY MEDICAL HISTORY,,YOUR NOT A DOCTOR OF PAIN MEDICINES,YOUR CERTAINLY NOT MY DOCOTR,,,,,yet,, U SEEM TO FEEL U HAVE RITE TO DECIDE MY TREATMENT,,MY MEDICAL HISTORY IS ALSO ,, NONE OF YOUR BUSINESS,, it leed to my very very basic question for u and PLEASE!!! ANSWER IT,,, cause no-one ,”like’ u,,,has ever answered it,,,Now brace yourself,,,here come some truth now,,,,,,Since it is physically impossible for you or anyone to physically feel the physical pain of another,,,,WHY,,, do u think u have the rite to decide how much I/anyone is to suffer in physical pain from medical conditions that are physically painful,,,,what gives u that rite,,to force another human being to be IN agony from physical pain??For ,,’if” u are capable of seeing past your ——-,,,,,that is the flip side of your comment,,For u type here telling me I should not take MEDICINE,,AND a mental health something,,,w/out knowing 1 millimeter of my medical condition,,soo u r telling me to ,”talk,” to stop my physical pain,,,,thus denying me timely effective medical care to lessen that physical pain,,,,soo I ask u,,,,,why do u think u have the rite to force ANY human being to be in agony from denying them effective medical care to lessen their physical pain from physically painful medical conditions,via the use of thee MEDICINE,, opiates,,,????please answer??!!!!!MARYW

    • Mary . you sound very ANGRY. Thats why I KNOW you need to find a good mental health psychotherapist. You can howl all you want, but
      you need to stop “blaming ” & start LOOKING into your serious denial about your addiction problem…. pretty obvious. but sadly addicts are often self righteously blaming THEIR OWN refusal to get addiction help.
      Also. they stamp their foot @ the unfair universe instead of getting busy helping themselves.
      ITS OBVIOUS listening to you & the 1000 other junkies also in denial !
      l

    • Susan,

      You are doing nothing but further stigmatizing everything this article says we need to stop stigmatizing. Your response shows a complete lack of empathy, or even willingness to understand the suffering of another human being.

      Calling someone an “addict” and “junkie” without understanding their condition, their life, and their own experiences of their illness… it’s repulsive. We need to move away from this stigma and start by treating people with respect, listening to them, and supporting them.

      You’re the self-righteous one because you have no idea, nor show any willingness to understand, what Mary has been through in her life, and yet you throw crude labels and advice at her as if you know what she needs.

      Please, try to do better.

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