Tuesday, December 10, 2013

Who are the Mentally Ill? Please take my Brief Survey!

We hear about "the mentally ill" all of the time.  They shouldn't have guns.  They die an average of eight years younger than those without mental illness.  We don't have enough hospital beds for them.  They're filling our prisons and some of them are homeless... oh, the list goes on.

Defining the term is important because we single this group out for all types of discriminatory practices related to employment, driving, gun ownership, and even the ability to enter the United States for a vacation (at least on a few occasions).  We also single this group out for special benefits such as being allowed to take their dogs on airplanes or to receive benefits from the government in the form of disability payments,  health insurance in the form of Medicare, and entry into specialized day programs and vocational rehabilitation programs.  But there is no agreed upon definition of who is mentally ill, and the Diagnostic and Statistical Manual ( DSM) lists hundreds of disorders, limiting its utility as the determinant of who is mentally ill and therefore eligible for discrimination, stigmatization, or special benefits.

I'm a psychiatrist, and I confess, I have no idea who these "mentally ill" are.  I think if you asked many people in treatment about being mentally ill, they might think you are talking about someone else.  People may not think the term applies to them because they don't have the insight to realize they are sick.  Or, they may not think of themselves as mentally ill because with treatment, they've gotten better.  Finally, many people who get treatment don't identify themselves as mentally ill because they are too busy identifying themselves as being Mary's husband, Tom's mother, a doctor or a lawyer or a barber, master gardener, avid Raven's fan, or any other aspect of identity that consumes time, generates income, and adds value to society.   It might not occur to a patient to identify themselves as "the mentally ill" even if they take medicine and go to therapy. 

So I'm going to ask you.  Who are the mentally ill?  Please take my quiz only once, and please ask your social media followers to take the survey-- it should only take a few minutes.   It's am important question, one that guides all types of legislation and policies and I'd love to know what you think.  And thank you!  Comments on the post are welcome.