Bipolar 2 From Inside and Out

Posts tagged ‘mental health education’

On Stigma Fighting and Political Advocacy

Lately, I’ve noticed a trend in mental health circles. It’s a question of philosophy on some levels. What should we, as people concerned about mental health, mental illness, and society, be doing with our time and energy?

The two choices boil down to fighting stigma and political advocacy. They each have their motivation and their adherents.

The stigma fighters (including the organization Stigma Fighters) maintain that the way to make things better for the mentally ill is to erase the stigma that surrounds mental illness (particularly serious mental illness, or SMI). And there’s no doubt that there is stigma. The mentally ill are feared and blamed for violence in society. They do not get jobs or lose jobs because of their conditions. They hesitate to enter treatment for fear that friends or family will find out.

While mental illness is no longer the “secret family shame” that led to family members being “put away quietly,” kept locked in the attic, and never mentioned, many families do still find that mental illness – in themselves or their loved ones – is something to hide. Something not to discuss in polite company. Something to ignore the existence of.

People who fight stigma usually do so with information and education. Celebrities – even the British royal family – speak openly about conditions such as bipolar disorder, depression, anxiety, eating disorders, OCD, and other of the more common diagnoses. You undoubtedly have heard the PSAs on television that explain that mental health is important and that seeking treatment is not something to be ashamed of.

Are the stigma fighters making a dent in the stigma? It’s hard to say. At least they seem to have opened a conversation about mental health, mental illness, treatments including medications, mental illness among men, suicide, and other problems we face.

Still, the political advocates say, all that stigma fighting has done nothing to increase the number of psychiatric beds available or the number of psychologists caring for rural populations, the homeless, or people with schizophrenia and other psychoses that are foreign to most people’s experience. What we need are people who will bring up these and other issues with legislators and influencers at the local, state, and national levels; who will present proposals that may do some good in increasing access and funding; and who will advocate for improvements such as training for first responders in how to address mental health concerns.

And it’s true. All these things – and more – are needed. We may debate the wisdom of involuntary commitment or compulsory medication, but they are certainly topics that need to be explored if a consensus is ever to be reached. Most people in the mental health community admit that the system is broken and needs to be fixed – or possibly re-thought from the ground up.

Where do I stand on this debate? I feel that one or the other is not enough. It’s not an either/or situation. It seems to me that unless there is some real progress made in fighting stigma, the voting public and the legislators will not understand the realities of mental illness, the need for change, and what needs to be done to fix the system. Unless we engage in spreading information and changing people’s minds about what being mentally ill means, support for policy changes will be thin on the ground. And unless we come up with some solutions that people understand and support, nothing will change.

Myself, I work mostly in the stigma fighting camp. I don’t have the political acumen, contacts, and energy that real activism takes. I know it is vitally important, but it is not something I can do very much or very well.

What I can do, through my blogs and my books, is help with the information and education, spreading the word about mental health and mental illness, and helping alleviate the stigma that accompanies them. I also intend to start looking for opportunities in my writing to comment on the larger societal issues and proposed solutions and help with education about them as well.

To solve the problems surrounding mental illness, we must all do what we can, and what we do best.

What Schools Are – and Aren’t – Doing About Mental Health

I believe that mental health education belongs in schools. I’ve written about that (https://wp.me/p4e9Hv-Jw). There’s good news about the subject and there’s less-good news. I’ll let you sort out which is which.

First, two U.S. states are now required by law to include mental health in their curriculum – New York and Virginia.

New York’s law mandates teaching the subject as part of the K-12 health curriculum, which has only two other specifically required topics: alcohol, drug and tobacco abuse and the prevention and detection of certain cancers. According to the law, the new education requirements seek to “open up dialogue about mental health and combat the stigma around the topic.” Free resources for New York schools, such as teacher training, are available online. These include lesson plans, though schools and teachers are free to design their own curricula.

In Virginia, mental health education is required only in grades 9-10. Huffington Post reports that the legislation came about “after state Sen. R. Creigh Deeds (D-Charlottesville) saw that three high school students had researched, developed and presented the proposed legislation, which struck close to home for the legislator, who had lost his son to suicide in 2013.”

Indeed, those laws are good things, though one could wish that the other 48 states would take note and do likewise. They are, of course, not forbidden to teach mental health education, and many do, especially around the topics of drug and alcohol prevention and suicide prevention. Some of them even require education on those two topics, along with bullying. Many of these efforts are sincere, significant, and even life-saving, but it is worth noting that bullying and student suicide are events for which schools are at risk of legal liability. One might wonder whether that has influenced the laws, rather than supporting more comprehensive mental health education.

Contrast the U.S. experience with England, where all secondary school teachers and other school staff are being given training that will help them identify mental health issues in children, including depression and anxiety, self-harm, and eating disorders. This is thanks in part to Prince Harry’s openness about needing counseling to help him deal with the death of his mother, Princess Diana, which happened when he was 12. The Prime Minister has said that the prince’s disclosures will help “smash the stigma” regarding mental illness and the need for getting help.

“The programme is delivered by social enterprise Mental Health First Aid (MHFA) England, backed by £200,000 in Government funding,” notes the Telegraph, “and will be extended to primary schools by 2022.”

The campaigns around the mental health mandate, especially those featuring Princes William and Harry, have focused on the need for Britons to abandon their “stiff upper lip” image and to accept that men can and do need to seek help for mental difficulties. While that is indeed a vital message, one hopes that girls and women do not get left behind in the efforts.

What about U.S. states where mental health education is not a fact of life?

For schools in the U.S. that have not mandated mental health education, the National Alliance for Mental Illness (NAMI) has developed resources that can help districts, schools, teachers, and families address the problem through the NAMI Parents & Teachers as Allies program of training.

They have also developed a presentation for students called NAMI Ending the Silence, “designed for middle and high school students that includes warning signs, facts and statistics and how to get help for themselves or a friend.” These programs are offered free to schools and communities. For more information, go to https://www.nami.org/Learn-More/Public-Policy/Mental-Health-in-Schools.

For a more DIY approach, youth.gov (https://youth.gov/youth-topics/youth-mental-health/school-based) recommends that schools “partner with community mental health organizations and agencies to develop an integrated, comprehensive program of support and services.” Among the actions they recommend are for schools and partnerships to:

  • develop evidence-based programs to provide positive school climate and promote student skills in dealing with bullying and conflicts, solving problems, developing healthy peer relationships, engaging in activities to prevent suicide and substance use, and so on.
  • develop early intervention services for students in need of additional supports such as skill groups to deal with grief, anger, anxiety, sadness, and so on.

In other words, for schools to spend the time and energy to do for themselves what the state and national governments are unwilling or unlikely to do.

To me, this is one of those times when a national curriculum makes sense, or at the very least a mandate in every state. Mental health education should be comprehensive, freely available, easy to access, and scientifically accurate for all schools and schoolchildren. The education this would provide and the statement it would make would be invaluable. Drug and alcohol, bullying, and suicide prevention are just a start, but a start that many states have not made.

 

 

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