Schwab 1 Leona Schwab Megan Keaton English 111 9 July 2013 The Mental Health Issue Mental illness

is a debilitating reality for many people around the world. There are new categorizations being made presently concerning mental illness and new discoveries as to biological origins and therefore new ways of treating them. This continuing new discovery and growing prevalence of mental illness in populations around the globe establishes a new ground surrounding mental health on a very slippery slope. In this paper, I will discuss how the attitudes of the public surrounding mental health itself and the varying views of it by the medical profession attribute to the incompetency of treatment and how this affects people suffering from mental disorders only to further perpetuate a state of illness rather than help them to get well. One big problem concerning the treatment of mental illness is that the general definition for what even constitutes a mental illness is not clear. In 2009, the National Institute of Mental Health began the Research Domain Criteria (RDoC) to develop a classification system for mental disorders based on biology of the brain and displayed behavior. The writers of the RDoC shifted emphasis in the psychiatric field from focusing on displayed symptoms of a disorder to the relationship between primary behavioral functions of the brain and the neural systems that are responsible for carrying out these behaviors. This shift has sparked much controversy, especially in the new 2013 revisions of The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (DSM), which was published using the RDoC as a guide to help clinical diagnosis of mental disorders in both the US and internationally (Cuthbert and

Schwab 2 Insel 1-4). Not only do professionals disagree on what constitutes specific mental disorders, but they cannot come to agreement on how to define mental disorders in general. This disagreement is one the factors that leads to many misdiagnoses, another major problem surrounding mental illness today. There is a common misconception of typical, natural behavior as a mental illness. Jerome C. Wakefield explains how easy it is to misdiagnose a normal reaction to stress as a mental disorder. Many mental disorders consist of normal defensive responses to stress . . . [and] the symptoms may be the same as in a normal reaction, but the duration or severity or context reveals that something has gone wrong with the response (339). He explains how the information established in the DSM as to the level of impairment or harm of a symptom in a mental illness does little to distinguish an effect of a present disorder verses a regular behavioral response (341). For example, grief stricken individuals suffering with a loss can have very serious reactions to their situation, but this is still a normal response and not indicative of an illness. Another cause of the problem concerning mental illness in the world is the hardships people face in getting help for them. An article in the American Journal of Public Health addresses how the stigma surrounding mental health and discrimination amongst those who suffer from it decrease a persons likelihood to seek treatment and continue in care. The journal asserts that the same lack of knowledge about the features and treatability of mental illnesses that exists on the professional level, as explained in the previous paragraphs, also exists in the general communities, and that this, coupled with an ignorance about how to access assessment and treatment, prejudice against people who have mental illness, and expectations of discrimination against people who have a diagnosis of mental illness all prohibit an individual from getting care (Henderson, Evans-Lacko and Thornicroft). Not only is there confusion among

Schwab 3 professionals about the definition of mental illness, but there is much confusion amongst the general population and bias concerning the individuals who suffer from it making it difficult to seek and receive treatment. Treatment itself is also a cause of the problem surrounding mental health with a dependency on medications as a solution. With the institution of prescription medication in treating the symptoms of mental disorders, beginning with Thorazine for schizophrenia and various antidepressants designed at manipulating serotonin receptors for depression in the 1950s, there was an immediate recognition of success but with the dangers of possible serious side effects. These side effects, especially concerning Thorazine, had a very damaging effect on the patients compliance to continue taking the medications and often times on continuing treatment altogether. The physical side effects of some prescription medication are not only uncomfortable and sometimes harmful for the patient, but can lead to feelings of embarrassment and further social isolation (Tanner 110). All of these things take what should be a path of recovery and rehabilitation, the ability to manage these symptoms so as to be able to maintain a productive life, and make it more a descent into further illness. A person faced with mental illness and tasked with the decision of what to do about it has many hurdles to pass in order to get better. First, they must determine if their problems constitute an actual disorder or if they are experiencing a natural response to a situation. They have to distinguish between the many differing professional opinions concerning mental illness taking into account that there is much debate among them concerning key issues. They have to overcome the stigma placed on people suffering from mental illnesses by the public opinion and its subsequent discrimination towards them. Finally, they have to decide on the effectiveness of

Schwab 4 using prescription medications as treatment and if they really help them or just cause them to deal with a different set of problems. Mental illness is a difficult problem to tackle. The writers of the RDoC seem to have it right. Through more research, there can be a better understanding of mental illnesses and how better to treat them. However, it seems that with their step forward, there are two steps back. There needs to be a better system in place to educate the public. I suggest that more research is done by the individual to better educate him/herself as to their situation that they are struggling with so they can find a professional that can help them more accurately answer their questions.

Schwab 5 Works Cited Cuthbert, Bruce N., and Thomas R. Insel. "Toward The Future Of Psychiatric Diagnosis: The Seven Pillars Of Rdoc." BMC Medicine 11.1 (2013): 1-8. Academic Search Complete. Web. 25 June 2013 Henderson, Claire, Sara Evans-Lacko and Graham Thornicroft. Mental Illness Stigma, Help Seeking, and Public Health Programs. American Journal of Public Health 103.5 (2013). CINAHL with Full Text. Web. 25 Jun 2013. Tanner, Jane. "Mental Illness Medication Debate." CQ Researcher 6 Feb. 2004: 101-24. CQ Researcher. Web. 25 June 2013 Wakefield, Jerome C. "Misdiagnosing Normality: Psychiatry's Failure To Address The Problem Of False Positive Diagnoses Of Mental Disorder In A Changing Professional Environment." Journal of Mental Health 19.4 (2010): 337-351. Academic Search Complete. Web. 25 June 2013