Mental Health and Public Relations

One of the primary problems in presenting mental health issues to the public is that there are two very different problems combined under the same heading. On the one hand, "mental health" is about the seriously impaired people with various forms of schizophrenia who need support and medication simply to survive. On the other hand are the people with depressions and anxiety disorders; as many as 35% of the population (or more) will experience one or more episodes of these disorders. Lumping them together in the same category is like treating cancer and pneumonia as equivalent.

People with depression and anxiety don't want to be lumped into the same category as the people they read about in the paper who have hallucinations and delusions or who are so impaired they can't survive without help. The more dramatic images and news stories are about such people. Movies about mental health, no matter how well intentioned, focus on the dramatic and the disturbed: "The Snake Pit", "One Flew Over The Cuckoo's Nest", "Fatal Attraction" and the like come to mind.

People with depression and anxiety are just us; our disorders are not generally permanent nor disabling and we don't want to be thought of as "nut cases". We look and (for the most part) function just like everyone else. There are a lot of us. We all know people who have depressions and anxiety disorders, and they look like us because they are us. We/They don't want to be thought about as "insane" or "mentally ill". And that makes it hard for them to decide to get treatment. Many people with depression or anxiety never get the treatment they need because of the stigma. They may spend years enduring their discomfort simply hoping to "get better" by themselves, and many of them eventually do, but at the cost of greatly extended discomfort and limited function.

While we say we don't want to stigmatize the "mentally ill", nobody thinking about getting treatment for depression wants their employer to find out they have a "mental health history". Depressions and anxiety disorders, no matter how common, are not considered as simply illnesses; no matter what we say, we don't treat people with a history of mental illness like others. If people find out that you were treated for depression or anxiety, you may be refused a job. You lose any chance at political office. In the military you are eventually dumped, especially if you are an officer. Insurance companies in the past have refused to insure you or provide funds for your treatment.

My point here is that we treat these two very different classes of mental illness as if they were the same. Treatment for each group is very different. Schizophrenias and bipolar disorders are chronic illnesses which cannot, at the present, be cured. At best they can be ameliorated. Anxiety and depression are curable, for the most part, and have no long-term consequences. It seems to me that we need to see these groups of disorders as very different and separate.

Perhaps it would be best to separate these categories into "Mental Illness" and "Emotional Difficulty". They really are quite different.