World Mental Health Day is observed on October 10th every year, with the overall objective of raising awareness of mental health issues and mobilizing efforts in support of better mental health.
Globally, more than 300 million people suffer from depression. Depression is the leading cause of disability worldwide, and is a major contributor to the overall global burden of disease. More than 260 million are living with anxiety disorders, the sixth largest cause of disability. Many of these people live with both. A recent WHO-led study estimates that depression and anxiety disorders cost the global economy US $1 trillion each year in lost productivity.
Over 800,000 people die from suicide every year. 75% of suicides occur in low and middle-income countries.
Closer to Home: Mental illness will hit half in the USA
· Lifetime prevalence of at least one mental disorder: 48%
· 12-month prevalence of at least one mental disorder: 26% (more than 54 million Americans)
· For the one in four who have a mental illness this year:
Ø 40% will have mild symptoms;
Ø 37% will have moderate symptoms: including suicidal thoughts or gestures.
Ø The remaining 22% will have serious symptoms: suicide attempt with serious lethality intent, work disability or substantial limitation, an impulse control disorder with serious repeated violence, complete break with reality.
The Ugly Truth About Stereotyping the Mentally Ill
Universally, most people can relate to feeling sad, nervous, and experiencing grief at times in our life. We’ve all seen news reports or watched psychological thrillers about a maniac on a crime spree, with the underlying cause of his violence being a psychotic break or he was a victim of childhood abuse. As a society we want to conclude people like Las Vegas gunman, Stephen Paddock, was severely mentally ill. We all want to believe we are different and incapable of “madness”. Not always.
Sometimes we even make jokes about people being crazy; whacko or nuts; even though we know that we shouldn't.
Yes, you have all had some exposure to mental illness, but do you really understand it? People, by nature, fear what they do not understand. Mental illness is grossly misunderstood not only by the sufferers; but by the community at large, including law enforcement. This misunderstanding inevitably leads to misconception and results in stigmatization (stigma is defined as a mark of disgrace).
The stigma of mental health/illness in the field of law enforcement is twofold. First off, law enforcement officers are as susceptible to mental illness as is anyone else. Secondly, officers interact daily with mentally ill individuals in the community. Not only does an officer need to overcome an internal stigma, he/she must possess accurate knowledge of mental health and illness when dealing with citizens, victims, and/or suspects who have mental disorders. This is extremely significant considering that approximately 9% of all law enforcement emergency dispatch calls are related to a mental illness crisis. Misconceptions can only be corrected by educating yourself about mental health and illness.
Mental illness is most accurately defined as a health condition, a disease of the brain, that changes a person's thinking, feelings, or behavior (or all three) and that creates distress and a difficulty in functioning.
Some Reality Checks for Law Enforcement Officers and Supervisors:
Ø Neither your bulletproof vest or your duty weapon can protect you from mental illness. Mental illness knows no age, gender, ethnicity, age, or profession. As a cop, you are as susceptible to mental illness as anyone else; maybe even more so.
Ø Your chances of having a mental illness, this year and within your lifetime are significantly higher than of having a heart attack. Yet, you get a physical, chest x-ray and EKG annually. You take your prescribed medication for your cholesterol and high blood pressure daily. You change your diet; you exercise more and do whatever else your doctor tells you to decrease your odds of developing, heart disease.
Ø What are you doing to prevent and/or treat mental illness in yourself, your workplace and within those you close to you? It is time to get rid of the stigma of mental illness in your own head and within your department. The Badge of Life suggests that all law enforcement officers voluntarily participate in an annual mental health check. http://www.policesuicidestudy.com/id35.html
Mental Illness and Substance Abuse Treatment
· Only 40% of people who have ever had a disorder received professional treatment.
· Only 20% of people who have had a disorder within the past year received professional help.
· The average individual delays seeking mental health treatment for years (6 - 8 years for a mood disorder and 9 - 23 years for an anxiety disorder).
· Stigmatization is the #1 reason people with a mental illness do not seek treatment.
· Most people decide to weather it out; "things will get better when [fill in the blank]."
Realty: Early identification and treatment of mental health disorders is paramount to recovery. Mental illness and substance abuse are treatable disorders, and with the appropriate treatment the success rate is extremely high. Medications, individual/group/family therapy, and support groups (especially in combination) are the treatments of choice. Psychotropic medications will help rather than hinder your on-the-job performance in law enforcement. "Any effect on reaction time by antidepressant medication is miniscule compared to the profound impairment of cognition, information processing and survival-oriented decision-making caused by untreated depression" (Dr. Bill Lewinski, Force Science News). If you do not respond to a prescribed medication, inform your doctor; he/she can adjust the dosage or change you to a new medication.
Keep in mind; you do have the right to strictly confidential mental health treatment with a provider of your choice. Consider this before your department mandates a fitness-for-duty psychiatric assessment. You also have the right to receive treatment in the least restrictive environment available.
This is what you can do today if you believe you could benefit from a mental health check-up or treatment: make an appointment with your primary care physician, ask for a referral to psychiatric specialist through your insurance plan, contact your EAP, call a hotline, find an online support group, go to a forum, or reach out to someone you trust. If you are concerned about someone else, convey your concerns and provide them with support and resources.
25 Tips to Improve and Maintain Your Mental Health
If you have no symptoms, or your symptoms are mild, you can still benefit from a mental health wellness plan. World Mental Health Day is the perfect time to start.
1. Treat yourself well; you deserve it. Value yourself. Work on building your self-confidence.
2. Maintain a healthy work/life balance.
3. Eat a balanced diet and drink sensibly.
4. Incorporate exercise into your daily routine.
5. Learn to deal with stress: develop coping skills.
6. Learn ways to cope with negative thoughts. Positive thoughts can change the negative.
7. Identify and deal with moods. Find safe and constructive ways to express your feelings of anger, sadness, joy and fear.
8. Set priorities. Do what you can as you can.
9. Set realistic goals, professional and personal.
10. Plan your day in advance. Don't put off until tomorrow what you can do today.
11. If you feel overwhelmed, break large tasks into small ones.
12. Break up the monotony. Alter your routine, try something spontaneous.
13. Postpone important decisions until you feel mentally healthy.
14. Make time for family and friends. Surround yourself with good people and stay connected to others. Close relationships are important for good mental health and overall well-being.
15. Enjoy hobbies. Discover activities you truly enjoy and develop interests that can become lifelong.
16. Daydream. Close your eyes and imagine yourself in a dream location.
17. Share and enjoy humor.
18. Keep your brain alive. Learn something new.
19. Collect and reminisce about positive emotional moments.
20. Quiet your mind. Meditate, pray.
21. Do something for others. Volunteer.
22. Use your voice. Challenge discrimination and stigma whenever and wherever it happens.
23. Confide in someone. Reach out to someone you trust.
24. Allow yourself to give and accept support. Relationships thrive when they are "put to the test."
25. Get professional help when you need it.
Remember, if you interact with 16 people today, statistically 4 of them will be suffering from a diagnostic mental illness. One of those four will be seriously mentally ill. When interfacing with these individuals arm yourself with actual knowledge, not misguided assumptions about psychiatric disorders. You can make a huge impact every day.
Pamela Kulbarsh
Pamela Kulbarsh, RN, BSW has been a psychiatric nurse for over 25 years. She has worked with law enforcement in crisis intervention for the past ten years. She has worked in patrol with officers and deputies as a member of San Diego's Psychiatric Emergency Response Team (PERT) and at the Pima County Detention Center in Tucson. Pam has been a frequent guest speaker related to psychiatric emergencies and has published articles in both law enforcement and nursing magazines.
