According to the National Alliance on Mental Illness (NAMI), 1 in 5 Americans suffer from a mental health problem. And according to the World Health Organization (WHO), 1 in 4 people will suffer from a mental or neurological disorder at some point in their lives. That is an astonishing 25% of the global population, and yet mental health remains one of the most woefully under-diagnosed, under-recognized and under-researched conditions in the world. Globally, less than $3 per person per year is spent on mental health, and in poor countries, that figure is as low as 25 cents.

It is no wonder, therefore, that in April of this year, WHO announced a year-long study into depression — which it cites as the leading cause of disability worldwide, resulting in a global economic loss of $1 trillion a year — to galvanize governments to take action.

On a local level, Arkansas sadly ranks higher than the American national average for mental health problems in both youth and adult statistics, according to a study by the Substance Abuse and Mental Health Services Administration. Of these sufferers, over 50% of adults are not receiving any form of treatment, and just over a third are unable to participate in the labor force. But why are so many people, both at home and around the world, not getting the help they need?

Mental health is a complicated and sensitive issue, and there are a number of factors contributing to the enormous disparity between the number of sufferers and the number receiving help. But the main challenges can be narrowed down to a somewhat vicious cycle of stigma, the “invisible” nature of mental health, the hugely varied nature of mental health conditions, and a gross lack of underfunding.

Stigma surrounding mental health issues is, unfortunately, still highly prevalent and a major cause of sufferers or their families not seeking the help they need. Oftentimes, victims will feel too ashamed to talk about their issues, feeling that they instead need to “suck it up and deal with it” or feel that to admit that they can’t cope is a sign of weakness. Whereas victims of a physical disease, such as cancer, receive an outpouring of sympathy, mental health sufferers are at a higher risk of being ostracized or labeled “unbalanced” or “anti-social,” and in children, they are more likely to be labeled as “badly behaved” or stubborn.

Krysta White, a recreational therapist for Methodist Family Health (MFH), Arkansas’ comprehensive behavioral and psychiatric healthcare system for children and families, was herself referred to MFH’s residential program as a child following being taken into custody. “I do believe that children with mental health issues are more likely to be labeled as badly behaved rather than given the proper medical treatment. I believe this to be the case because most parents don’t want to believe that their child has a mental health issue. They would rather think it is just bad behavior that they can grow out of at some point. Sometimes kids with mental health problems display the same behaviors that children without mental health problems display, so it is easy to mistake the underlying mental health problem with bad behavior.”

Source: The National Alliance of Mental Illness

Peggy Kelly, Chief Clinical Officer at Youth Home, an organization helping Arkansas’ most emotionally troubled adolescents and families, is all too familiar with the problem. “The stigma associated with mental illness keeps so many who are suffering from asking for the help they need. Mental illness is treatable! Many don’t seek help because they feel shame or embarrassment. There are so many challenges in getting people to understand that they cannot just ‘man-up’ and get over it with shear willpower,” she says. “This challenge is true in both individuals and with families and friends who are not educated and give misguided information to them about how to feel better. There is such a need for good education and open, honest conversations.”

Another barrier to diagnosis and treatment is the vast spectrum of conditions that fall under the mental health umbrella and the plethora of symptoms they can present. These can include everything from anxiety, post-traumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD) to schizophrenia and anorexia, to name only a few. Oftentimes, sufferers may not even be aware that they have a problem and will pass off their symptoms of anxiety as “stress” or their depression as “a case of the blues.” Fewer people still realize that conditions such as PTSD are not strictly limited to soldiers but can also occur after any stressful event, such as a death, loss of one’s home in sudden traumatic circumstances or childhood abuse.

All of this is compounded by a chronic lack of funding and research. On average, governments allocate just 3% of health budgets to mental health, and in recent years, those budgets have been the first to be slashed. As Andy Altom, CEO of Methodist Family Health, explains, procuring funding for this field of medicine is particularly difficult. “Funding sources prefer clearly defined/observable disorders with procedural fixes. Mental health disorders are some of the most complex disorders to get funding sources to understand since they can’t be easily seen or measured and the type of treatment includes a range of options from intensive safe stabilization and pharmacological methods to time in therapy. Getting to a price point on treatment by disorder is often a moving target.”

Source: The National Alliance of Mental Illness

Doug Stadter, President and CEO of Centers for Youth and Families — Arkansas’ oldest non-profit — and President of the Mental Health Council of Arkansas, concurs and cites a lack of innovation as the biggest frustration. “In the public mental health system, it is very difficult to initiate new, innovative service delivery approaches. These changes take much too long, and there is little or no use of pilot projects. It’s kind of a ‘one size fits all’ approach.

“Currently,” he continues. “If a mental health provider has a new idea or wants to initiate a service outside of the established system, they must find private grants to fund the initiative. Arkansas needs to have state funding available for innovation grants. I also believe Arkansas needs to do a better job in suicide prevention. This epidemic needs to be given a higher priority.”

Peggy Kelly can attest to the issue of funding, or lack thereof. “Although we receive some reimbursements from Medicaid and private insurance for some of our services, that in no way covers the cost of treatment, and we must supplement that by private donations and fundraising efforts. Historically, government funding for mental health issues lags far behind that for physical health concerns. We hope to see that gap close in coming years, but that will take a lot of education, awareness and hard work to help legislators understand the impact of mental health, not only on individuals and their families but also on our economy and our overall health and safety as a nation.”

But there are signs of progress, and currently Arkansas is implementing new programming for mental health and substance abuse, which has been developing for the last four years. The Arkansas Legislature also recently passed Act 775, which establishes a new provider-led organized care model and is designed to improve access to care, provision of the most appropriate level of care, and a reduction in costs by streamlining services and treatment.

Doug Stadter is one of the many pleased with the progress. “I think the provider-led model of organized care moves Arkansas miles ahead of where we and other states have been in delivering mental health services in an appropriate and cost-efficient manner.”

But rather than wait for government and mental health providers to step up, those surrounding a person who is suffering also need to take action. “Family and friends are extremely important to the recovery process for a person suffering from mental illness,” says Stadter. “I see this every day at Centers for Youth and Families. The more we can get the family and friends of our clients involved in a child’s treatment, the quicker they recover, and their chances of leading a healthy life are greatly increased.”

Source: The National Alliance of Mental Illness

Most people also do not realize that prevention steps can be taken against mental health problems — especially by parents. Krysta White advocates for communication: “LISTEN and TALK!” she says. “After a certain age, I feel like parents and children go off and do their own things. They don’t really pay attention to each other even when they are under the same roof. I would tell parents to really listen and talk to their children. Don’t talk at them but talk to them. Don’t just pass it off as kids wanting attention. Children will usually speak up about the problems they are having if they feel like they will be taken seriously. I would also tell them not to jump on the medication train too quickly.”

Andy Altom goes further and adds, “Prevention starts at birth. Your child needs to be cuddled, rocked and nurtured as much as possible. This helps establish the synapse among neurons that allows a child to self-sooth later in life. Seek help any time you see an unusual change in your child’s behavior, such as aggression, remaining silent, withdrawing from friends and family, unusual problems at school socially or academically. Teaching children appropriate emotional coping skills would go a long way toward reducing some of the problems in children we see at Methodist Family Health.”

For children and adults alike, White advises patience. “Try out therapy first and see if that will help. Not everything needs medication. In my experience, doctors are quick to try to fix a diagnosis with medicine rather than dig deeper into the problems that the patient is having. I think now more than ever, when someone is diagnosed with something, everyone looks for a quick fix so that everyone can carry on with their normal lives. I think that people think medicine will fix it before therapy can. Therapy takes time, and I don’t believe people are willing to give their time to issues if they think that medicine can fix it quicker.”

Stadter adds, “Family members should ask their loved one’s therapist for information about support groups and training available in their local community. Another resource is the Arkansas Chapter of the National Alliance for the Mentally Ill (NAMI). Most of all, families need to recognize that mental illness is no different from a physical illness and should seek help for their family member and support them.”

NAMI Arkansas
11th Annual Walk — Strike Out Stigma on May 27
9 a.m. registration | 10 a.m. walk | Dickey Stephens Park.
Registration + Info: 800.844.0381 | NamiWalks.org/Arkansas