Speaking of mental health

Mental illness affects around 11.2 million adults 18 or older in the United States. Of the affected population, people ages 18-25 have a higher prevalence of Any Mental Illness (AMI) and Serious Mental Illness (SMI) than any other age bracket.  A serious mental illness (SMI) results in substantial limitations or impairment in one or more life domains. While the impairment produces significant reduction in functioning, 2 out of 5 young adults with mental illness do not receive the appropriate level of care. The disparity in the number of affected people versus those who eventually receive treatment is attributable to many factors, among them lack of knowledge of the signs of mental illness, stigma around mental illness, dearth of treatment options, inaccessible treatment (including long waitlists and regional availability), and treatment affordability (see CDC report).

The absence of timely responses to early signs of mental illness carries significant societal and economic cost as the sufferer eventually becomes unable to maintain normal functioning and ceases to be a productive citizen, student, worker, or parent. In addition, 5-10 percent of them will require care from a psychiatric emergency department. The Suicide Prevention Resource Center attests to an increase from 31.3 to 40.2 per 1,000 in ED visits by patients whose chief complaints were psychiatric in nature, an indication that earlier symptoms had not been adequately attended to. Many families are forced to take drastic measures in order to meet the needs of a child with mental illness, including stopping employment and taking out loans to pay for private care.

Unfortunately, awareness of early signs of youth mental illness has not enjoyed the same popularity as physical development, for instance, while parents know of and do monitor proper nutrition, weight gain, growth and motor performance. Certain traits may be accepted as personality quirks instead of maladaptive patterns requiring intervention for fear of pathologizing a child’s personality or temperament. In fact, emerging ideologies support the endorsement of such characteristics as uniqueness. Admittedly, the line is not always clear at that stage due to the dynamic process of development and socialization throughout which young people do experiment with various ways of being.  As such, parents do their best to be measured and thorough in their assessment of behaviors that may lead to more pervasive dysfunction.

While no exact profile of mental illness has been compiled and exhibiting one or two of the following symptoms does not confirm a mental disorder, the sudden unexplained onset of a cluster of symptoms warrants a closer look by a mental health professional. They include

Emotional symptoms

• Excessive worrying or fear
• Feeling excessively sad or low
• Extreme mood changes, including uncontrollable “highs” or feelings of euphoria
• Prolonged or strong feelings of irritability or anger
• Lack of emotional response

Social symptoms

• Avoiding friends and social activities
• Difficulties understanding or relating to other people
• Frequent fights or conflicts with peers
• Disregard of or desire to hurt others

Behavioral symptoms

• Changes in sleeping habits or feeling tired and low energy
• Changes in eating habits, such as increased hunger or lack of appetite
• Difficulty perceiving reality (delusions or hallucinations, in which a person experiences and senses things that don’t exist in objective reality)
• Inability to perceive changes in one’s own feelings, behavior or personality (”lack of insight” or anosognosia)
• Abuse of substances like alcohol or drugs
• Multiple physical ailments without obvious causes (such as headaches, stomach aches, vague and ongoing “aches and pains”)
• Thinking about suicide
• Inability to carry out daily activities or handle daily problems and stress
• Confused thinking or problems concentrating and learning
• Self-harm behaviors

In order to facilitate accurate assessment of the observed condition, certain key information will be necessary and may include

• The onset (time, occasion, place) the symptoms first occurred
• Frequency, duration, occasion of the symptoms
• Intensity
• Impact across life domains
• Current environment, social, medical condition
• History of mental health symptoms

Adequate preparation for the first clinical visit is critical to ensure accurate diagnosis, prompt treatment delivery, and appropriate referrals to beneficial services and supports.  Additionally, due to the stigma associated with having a mental illness, people who have negative first experiences are less likely to pursue and complete treatment. People suffering from mental illness can lead rewarding and productive lives, and the sooner they receive treatment, the greater the likelihood of a full recovery.

Sources

1. Substance Abuse and Mental Health Services Administration (2018).
2. National Institute of Mental Health statistics
3. National Alliance on Mental Illness: Mental Health by the Numbers
4. Centers for Disease Control and Prevention (CDC): Web-based Injury Statistics Query and Reporting System (WISQARS)
5. National Institute of Mental Health: Child and Adolescent Mental Health

References

CDC: Making Sure Children Get the Mental Health Care They Need

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