Sounds like a question with an obvious answer, right? Did you respond with, “They’re in mental health hospitals?” Yes some are, but there is a countless number of people with some sort of mental illness working every day, walking the streets, living in homeless shelters, incarcerated in prisons, and living in our homes. So your next question is, “Well why aren’t they getting treatment services?” That’s the focus of our two-part blog!

Some illnesses go undiagnosed because they resemble a crime. Twenty-year-old Jimmy had an undiagnosed brain tumor that resulted in him acting like a 12-year-old. He committed pranks that he thought were funny. The one that landed him in jail was hanging out with a group of boys who tricked him into participating in an armed robbery. The tumor was discovered in a physical exam, but was so advanced that doctors could not operate. He needed mental health services, but due to the nature of his behavior, he was imprisoned. The National Alliance on Mental Illness (NAMI) reports that 2 million people with mental illness are booked into jails each year. 

Lack of knowledge prevents lay people from identifying signs that something behavioral is off track. Fear of not knowing what to do can result in doing nothing and hoping that the behavior will self-correct or simply disappear.

In an article by Pete Earley that appeared in The Washingtonian April 13, 2006, Earley illustrated some of the above mentioned points. Earley, a storyteller and New York Times bestselling author, tells the story of his son Mike who started showing signs of mental illness in his twenties. When Earley started researching help for Mike, he commented, “When I tried to get help for him, I found out that our mental-health system now is mostly in jails and prisons.”

In a commentary by Earley, Why the Stigma and Shame of Mental Illness Must End, he addresses why we blame the mentally ill for their condition. His theory is that by believing that a person chooses to be psychotic relieves us (society) from having to do anything. Earley authored a book that shed more light on his experience as a father seeking mental health services for his son…Crazy: A Father’s Search through America’s Mental Health Madness.

Another reason mentally ill people don’t receive treatment is denial that they have an illness. Xavier Amador M.D. penned I AM NOT SICK, I Don’t Need Help. It tells about Amador’s attempts to help his brother Henry, who developed schizophrenia, to accept treatment. Like millions of others diagnosed with schizophrenia or bipolar disorder, Henry did not believe that he was ill.

The Veteran Administration (VA) is experiencing heavy caseloads as a result of warriors returning with Post Traumatic Stress (PTS) and Traumatic Brain Injuries (TBIs). VA Secretary Robert Wilkie has said that what keeps him up at night is the issue of mental illness. In his view, we are in the “Sputnik Stage” of developing mental health treatment.

Cost is another deterrent to mental health services. There is an ongoing effort to create parity in insurance coverage for the mentally ill. Many insurance carriers cover more physical illness costs than they do for mental health services. In addition to being costly and at times not covered by insurance, psychotropic medication can carry undesirable side effects.

To sum up part one, a number of mentally ill people are not receiving treatment because:

  • the behavior is treated as a crime
  • there is denial from the those in need of mental health services
  • research is at the beginning stages of discovering effective methods
  • the cost is prohibitive
  • the side effects are undesirable

In part two, will we explore what is being done to address the needs of the “untreated mentally ill.”

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