Health care’s final frontier: Our mental wellness

By DAVE CELONE
By Dave Celone

The COVID-19 pandemic has sent us a clear message. Our mental wellness is the next frontier in health care. Couple that with the understanding that our physical health and our mental health are inextricably intertwined, and we have a recipe for future health care success. Treat the mind, and the body will improve. Treat the body without treating the mind, and treatment will take longer or be less successful. It’s time to come out from behind the looking glass and peer into ourselves and others with eager curiosity about our mental wellness.

What do the novel coronavirus and mental ill health have in common? Well, for starters, nearly everyone is susceptible. One of every two people will experience a mental health issue in their lifetimes. One out of five will experience a mental illness this year. Look around you. Someone in your family is at risk of mental ill health. Or someone with whom you work. Or a friend. Or someone in your neighborhood. Or, sorry to say, you.

We’re all in this together. If we want to leave mental ill health behind, we’ll have to begin speaking openly about mental wellness as crucial to our overall health. We should talk about our mental health when we see a doctor for a physical health visit. It took a massive public communications effort to convey the ill effects of COVID-19 and to educate people to wear masks and get vaccinated. People have now felt the tug of isolation-related depression, anxiety, and PTSD as a result of the pandemic in greater numbers than ever before. As unfortunate as this may be, it opens the door to a new understanding that mental wellness must be taken seriously. Now, even as many countries are on the verge of leaving their masks behind, we still have a long way to go to leave the stigma of mental illness behind us.

The economic benefits of mental well-being are beginning to be recognized in the workplace. In the United States, mental health and substance misuse costs businesses $80 billion to $100 billion annually. The Lancet Global Health suggests that for every $1 spent on scaled-up treatment for depression and anxiety, there is a $4 return in better health and productivity. That’s a 400% return on investment. It won’t be long before businesses large and small begin investing heavily in mental wellness programs for employees. Many have already begun, and 2021 is purported in human resource circles to be the year mental wellness in the workplace finally receives the attention it deserves.

Mental ill health remains highly stigmatized in our culture. Only when we become comfortable discussing our mental well-being openly and without judgement will we begin the process of achieving true wellness — physical and mental — and discover a widespread social and personal healing process that’s desperately needed in this post-pandemic world.

The time is ripe now that so many people from all walks of life have been impacted personally by the pandemic’s social isolation. Leaders of industry and governments were forced to stay home with their families, learning that being apart from their passionate and ambitious colleagues brought sadness, depression, and loneliness. Many suffered directly from the novel coronavirus and needed hospitalization. Others faced stark days questioning their own worth. Still others wondered whether their lives would ever return to normal. For many, they feared the unknown for the first time. Even the strongest felt the pull downward of a near-complete social, economic, and psychological inversion.

Mental wellness sits at the intersection of cultural beliefs, neurobiology, and behavioral health, with illnesses like anxiety disorder, depression, PTSD, bipolar disorder, eating disorders, and substance misuse among the most private and hidden of disorders. They are hidden because the general perception is one of impairment in such a way as to make the owner of the disorder a social pariah. The culprit here is a fear of self-exposure. Yet, a broad swath of society (50 percent or more!) has or will experience a mental illness.

Fear. That’s the common ground shared by COVID-19 and mental ill health. Until we overcome our fear of the unknown assailant, we’ll never triumph. With COVID-19, getting the word out to people broadly in as public a way as possible was crucial. Wear a mask and you, your family, and friends will be safe. Get vaccinated and you’ll help protect yourself and others. It was a public information campaign that normalized a new disease in everyday conversation. It became exciting to see who would develop a vaccine. Finding a vaccine and getting it approved was akin to the first time we landed on the moon. And when people got vaccinated, they celebrated by placing their own personal photos on social media. Local, national, and international media coverage was non-stop. Whether people believed the virus existed or not, or that masks or the vaccine were effective, at least they had no fear talking about the pandemic openly and without shame or embarrassment.

Can you imagine if we’d been afraid to talk about COVID-19? Or find a way to counteract the novel coronavirus? We’d be dark, huddled masses, succumbing to an unseen foe. It would have been like the days of the Bubonic Plague (Black Death) back in the 14th Century. At that time, there was no rational explanation for it, though today, we know it was spread through the air and via rats and fleas. Back then, people simply died. They expected to die. Today, we know we can take preventive measures, and our scientific and medical research infrastructure’s curiosity-seeking professionals discover cures every day. Gone are superstitious beliefs of the plague being transmitted through the dying looks of an infected person. Or talk of bloodletting or bathing in rosewater as cures.

Today, we also hold out hope for a triumph over cancer. A cure may well be right around the corner. The dark days of fearing to tell people you or a loved one had cancer? Along with the stigma associated with it? Thankfully, those day are behind us. Now there’s surgery, chemotherapy, radiation and myriad other treatments that extend and save lives. The same is true for HIV and AIDS. For polio. For smallpox. For a host of viral and bacterial infections that once caused severe illness or death.

Now, it’s time to address the next looming health problem in our society: our mental wellness. The stigma that exists is of our own creation. It is a stigma of the mind as being ill versus the absence of stigma when the body is ill. Why must the mind be such an anomaly? It is part of us, we are part of it. We inhabit both. The mind and the body are interconnected so closely as to be almost one. Physical health is needed for mental health. Mental health is needed for physical health.

The only way we’ll ever make progress is to begin talking about mental ill health, reporting on it, getting it into the news and social media streams on a regular basis. Can you imagine if every major news outlet reported statistics about daily suicide rates in each country, province, state, and city each day? Just like novel coronavirus infection and death counts. And that we celebrated as suicide numbers dwindled?

Similarly, can you imagine how we would begin to triumph over mental ill health if statistics about people completing successful treatment for depression, anxiety, PTSD, eating disorders, or substance misuse were in the daily news cycle? We’d be talking openly about treatment mechanisms, where the best treatment outcomes were occurring, and who had the best therapies available for certain illnesses. It would become a race to find cures, be they therapeutic or pharmacological, naturopathic or neurologic, holistic or some new treatments yet-to-be discovered. It would be exciting to be a leader in treating mental wellness on a large scale with a personal touch. Sort of like landing on the moon, or discovering the vaccine for COVID-19.

Yes, the next health care frontier is the mind. The mind remains the great unknown. It is deeper than the outer reaches of galaxies in how little we understand it, but so close to home because we each own it. But if we allow ourselves to fear the unknown, then we’ll never understand it. If we let the unknown continue to lurk in the shadows it will remain undiscovered and undiscoverable, untreated and untreatable.

Until we do address our mental wellness in the public forum, openly and without reservation, people who need help will remain out of reach due to the shame of being stigmatized, and they’ll forgo seeking help before a crisis moment occurs. Talking about mental wellness has immediate positive benefits. That person you’re speaking with to learn how they feel emotionally, whoever it may be, young or old, rich or poor, male, female, or otherwise gendered, whatever their race or national origin, may finally feel comfortable reaching out to a therapist or substance misuse counselor. Your words, our words, of encouragement that normalize mental ill health will positively impact others and our society.

Let’s hope for the day when talking about a therapist will be as commonplace as recommending a cardiologist, oncologist, or orthopedist. It would be a whole new world if everyone who talks eagerly about how their latest knee replacement allowed them to get back to walking or playing with their children or grandchildren would speak similarly about how their mental wellness therapy helped them get out of bed in the morning with a spring in their step, ready to approach the day.

Here’s a suggestion: be courageous. Let your guard down when you next speak with a friend, relative, or co-worker. Tell them how you feel, for better or worse. I mean how you really feel emotionally, in the moment. Are you happy, sad, stressed, lonely, afraid depressed, anxious, excited, worried, relaxed, nervous, fulfilled, ashamed, fragile, hopeful? Let them know. Tell them why. Then ask how they feel. Let’s see what you get.

Dave Celone of Sharon, Vt., is director of development & community relations for West Central Behavioral Health, one of 10 community behavioral health centers in New Hampshire, with clinics in Claremont, Lebanon, and Newport. Dave may be reached at [email protected].