By Margaret Mouracade, MD
May is associated with Maia, the goddess of spring and growth. It is in this spirit that I as a nephrologist wish to write about the topic of Mental Health as May is deemed as National Mental Health Awareness Month. As a physician closing in on her 26th year of practice, I can attest to the need for all healthcare providers to appreciate and to grow in their ability to recognize the importance of mental health wellness and to incorporate in their practice a means to address. Mental Health includes our emotional, psychological and social well-being. It affects how we think, feel and act. It also helps determine how well we handle stress, relate to others and how we make choices. For us in the healthcare field, our ability to engage our patients in partnerships as well as to motivate them to embrace change and to adopt new lifestyle habits relies heavily on the state of their mental health.
Data from 2020 reported by NAMI (National Alliance on Mental Health) showed that in the United States, 1 in 5 adults (21% or 52.9 million people) experience mental illness. Furthermore, 1 in 20 adults (5.6% or 14.2 million) experience serious mental illness. NIHM (National Institute of Mental Health) defines serious mental illness as a mental, behavioral or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. This is a disease that we find rooted in our youth, noting that data reviewed from 2016 showed that between the ages of 6-17 that 1 in 6 (16.5% or 7.7 million) experienced a mental health disorder. Data reviewed showed that 50% of lifetime mental illness begins by age 14 and 75% by age 24. Suicide is the 2nd leading cause of death among those aged 10-14. As a physician who also has board certification in addiction medicine, I found it quite noteworthy that 6.7 % (17 million people) were identified as experiencing a co-occurring substance disorder and mental illness. In adults anxiety far leads as the most prevalent mental illness with 19% experiencing (48 million) the next prevalent is depression at 8.4% (21 million) and rounding out the top 3 would be PTSD at 3.6% (9 million).
Raising awareness that mental health illness should be treated like any other chronic disease entity is paramount. Similar to other chronic diseases, mental health illness has genetic propensity as it can be found in families as well as its manifestation in terms of severity often can be related to environmental factors as well as coexistence of other illness/conditions. Like other chronic diseases there can be periods of stability /dormancy and then flares can occur if triggered. Its treatment, like most other chronic diseases, is best appreciated when an integrative approach is taken with a combination of optimization of self -care, therapeutic endeavors and/or pharmacologic interventions. NAMI reports that the average delay between onset of mental illness and treatment is 11 years. In 2020, 46.2 % of US adults with mental illness received treatment while 64.5% of those with serious mental illness were treated. Data reviewed from 2016 showed that 50.6% of youths aged 6-17 with mental illness received treatment.
The impact of mental illness can be appreciated in that depression raises the risk of developing cardiovascular and metabolic diseases by more than 40% than the general population. Depression has been recognized as a leading cause of disability worldwide. Substance use disorder has been identified in 32% of those with mental illness. High school students with significant symptoms of depression are more than twice as likely to drop out compared to their peers. Some date collected from the Department of Corrections show that 37% of adults incarcerated have a diagnosed mental illness and that 70% of youth in the juvenile justice system have mental illness. Mood disorders are the most common cause of hospitalization for those under 45 years of age in the US excluding pregnancy and birth.
It is my hope that I have helped raise awareness of the need to address Mental Health and to appreciate the need to seek treatment and care like any other health issue. Treatment must be provided in a holistic, integrative and respectful manner. A state of wellness can be attained when an individual is provided a nurturing and restorative environment in which the skills and knowledge can be learned and gained to navigate through life and its challenges.
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