By Diana Semmelhack, PsyD, ABPP Professor, Midwestern University
What is mental illness? This is a question that is not well understood in America. Mental illness is defined as a clinically significant behavioral or psychological syndrome or pattern of behavior that occurs in an individual which can be grossly debilitating. Chronic mental illness such as schizophrenia, bi-polar disorder, schizoaffective and major depression disorder can impact an individual’s ability to function at a normal level throughout his/her lifetime.
Today, the population of severely mentally ill adults residing in long-term care facilities in the United States is growing (National Center for Health Care Statistics, 2014). With one out of four individuals suffering from a severe mental illness (SMI) and 14.5 million Americans being disabled as a result of SMI, the costs are staggering—billions of dollars in disability payments are being spent annually. Between 40-80 percent of these institutionalized individuals have untreated severe trauma histories.
Contrary to popular belief, gaining access to their creative selves benefits severely mentally ill, institutionalized adults. There are many reasons why creativity and positive communication are important in making the right healing environment. Winnicott (1971) suggests that creativity is the root of being, an expression of the self. He states that “it is only in being creative that the individual discovers the self (p. 54).” Furthermore, many of the most innovative ideas that have shaped society have come from the minds of individuals considered to be mentally ill. Artists, writers and thinkers such as Vincent Van Gogh, Virginia Woolf, Abraham Lincoln and Winston Churchill have been deemed by society to be “mentally ill” (A. Adkins—NAMI, personal communication, February 15, 2017).
Many people today diagnosed with SMI are highly creative individuals with few treatment options other than medication management (NAMI, 2007), homelessness, jail or worse. Rosenhan (1973) suggests that in many cases institutionalization has a depersonalizing effect. Severely mentally ill, institutionalized individuals are frequently seen as being “sick,” “crazy” or “insane.” Their sense of themselves as “artists,” “writers,” “scientists,” “musicians,” etc. can be quickly lost. Treatment is needed to help these people regain their sense of themselves as creative individuals.
SMI individuals are stigmatized in our society. Stigma involves labeling, discriminating against and stereotyping individuals who bear this label. Negative stigma assumes that the person with a mental illness has a character flaw. He/she is seen as having negative qualities such as being weak, dishonest, violent, out of control, etc. The stigma of mental illness in our culture contributes to keeping over a third of those stricken with these diseases from seeking help. Stigma permeates all strata of society from mental health providers to those consumers who internalize the stigma. Internalized stigma occurs when individuals with mental illness believe the negative views of themselves held by others. Self-stigma limits the quality of life– makes the person less likely to be hired, to buy a house or to be seen as a fully functioning human being. Stigma is best captured in the excerpt from a poem by Debbie Sesula, a woman diagnosed with schizoaffective disorder, titled You and Me:
If you’re overly excited
If I’m overly excited
If you imagine the phone ringing
You’re stressed out
If I imagine the phone ringing
If you’re crying and sleeping all day
You’re sad and need time out
If I’m crying and sleeping all day
I’m depressed and need to get up..
If you’re afraid to leave your house at night
If I’m afraid to leave my house at night
If you speak your mind and express your opinions
If I speak my mind and express my opinions
If you talk to strangers
You’re being friendly
If I talk to strangers
I’m being inappropriate.
For all of the above you’re not told to take a
Pill or are hospitalized, but I am!
Underlying this column is the conclusion that: the social interactions of people diagnosed with severe mental illness plays a fundamental role in their mental health and treatment—ultimately facilitating their capacity to be creative human beings. Psychotropic medication, it is true, is important in the treatment of severe mental illness. However, pills are not enough to recover from the devastation of a psychotic break and the trauma that frequently precedes it. As a parallel, a person cannot recover from the death of her entire family in the Holocaust simply by taking an anti-depressant. The social interaction surrounding a person can facilitate recovery, or play a major role in maintaining her mental illness.
There are organizations available to help mentally ill people and their families that promote the social interaction dynamics just mentioned. The largest grass roots organization helping people with SMI in the USA is the National Alliance on Mental Illness (NAMI). NAMI (an organization currently flourishing in Chicagoland) provides free support to people with mental illness and their families. Through individual advisement and free group participation in such programs as Peer to Peer and Family to Family, NAMI is on the front lines of helping individuals to get their mental healthcare needs met.
Another example of a frontline organization in Chicagoland is Lydia HealthCare, who in its 30-year history has helped virtually thousands of people with mental illness re-integrate into society. The focus at Lydia is on person centered care in an integrative health setting. Today, Lydia Healthcare’s population consists of a highly diverse group of severely mentally ill adults. With a potential of 412 consumers, it provides 24-hour care administered by qualified, licensed professionals. Lydia recognizes both the uniqueness of behavioral care and the potential each consumer possesses. At Lydia we understand you have questions and need answers. With a training program of 12 doctoral graduate students in clinical psychology from Midwestern University and a top-quality staff, Lydia is cutting edge in meeting the needs of this underserved population.
We hope that mental health professionals and other interested parties will act like NAMI and Lydia Healthcare and reflect on the tremendous importance of growth promoting communication in the lives of the “severely mentally ill” individuals who tend to be alienated from our society. We need to bust stigma and recognize that individuals with mental illness like any other disease deserve treatment and not stigma. A person-centered focus that makes transformation and mental health happen is hopeful and helpful. Ignorance is certainly the root of misunderstanding and something we need to address first hand when it comes to mental illness. Creativity, empathy and unconditional positive regard are the seeds of mental health.