There's a continuum of mental health and we are all somewhere on this continuum.
Let's say you grew up in a healthy family and life has been smooth – healthy genetics, haven't inherited any illnesses – and a curveball comes at you at a young age. You can be slapped back a bit, but because of where you are on that continuum, you handle the ball and make the play. Mental health has its ups and downs just like physical health. It's no different. It's all connected.
At a recent Wyoming County Board of Supervisors meeting, May was proclaimed as Mental Health Awareness Month. The proclamation states in part:
Each business, school, government agency, healthcare provider, organization, and citizen shares the burden of mental illness and has a responsibility to promote mental wellness and support prevention efforts...
“When someone believes they are a whole person, secure in knowing their strengths and limitations, they have good mental health,” said Wyoming County Mental Health Department Director of Community Service Nancy Balbick. “When they feel like a worthwhile human being and feel grounded, are secure and safe, have good self esteem and self image, and their personal interactions are for the greatest good for themselves and others...That’s what I believe to be good mental health.
“The greatest good doesn't mean with just people, but the whole of the world and looking toward the future with the vision of the future for the greatest good.”
On the opposite end of the spectrum, someone who had a traumatic childhood may be someone who doesn't trust human relationships. The person may harbor feelings of hurt and abandonment, which in turn could cause chaos in their environment. That would be in conflict with their living circumstances.
Someone who is healthy mentally would have good boundaries. Being okay with both their strengths and limits and move about in their world in a proactive, instead of reactive, manner.
“You know your own moral codes and who you are,” Balbick said. “When life throws you a curveball, because you are grounded you can handle that curveball in a healthy way.”
“Mental health is a state of well-being, with a positive attitude filled with hope and the future,” said Wyoming County Community Health System (WCCHS) Director of Mental Health Mary Richards.
According to mental health professionals, when people see people who are odd it makes them uncomfortable.Yet, mental health issues are manifested behaviorally. Years ago, if someone said they heard voices they would be put in asylums, people didn’t know how to handle that behavior.
“They talk about a man named Roy who grew up in Rolling Hills (Asylum, East Bethany),” Balbick said. “As the story goes, Roy had giantism, because it was partially shameful at that time and there were no resources to understand his condition, he was sent to the asylum. It was the same for an aunt of mine who had cerebral palsy. There were no resources to help people with disabilities and nobody really knew how to handle those who were disabled. Even in this day and age, we are uncomfortable with people who are different or who have a handicap. It’s a developed condition – being uncomfortable.”
Mental health issues impact a family. They can break families apart, but can also shape them.
“Some of our lucky patients have very supportive families who understand their illness and are very supportive,” Richards said. “Others are unable to deal with the behaviors that sometimes are destructive of the loved ones. It’s not that they don’t care for them; they just can’t deal with what is going on with them at the time. The goal is always to reunite and resolve issues.”
Historically, those who have mental illnesses have also been victims of society. However, as the understanding of mental health issues grew, some practices became no longer acceptable, for example lobotomies and trepanation.
Trepanation is thought to be one of the earliest treatments for the mentally ill. It involved using a tool to create a hole in the skull. People were given this treatment because it was thought that insanity or mental illness was caused by demons, thus creating the hole would allow the demons to escape.
By the mid-1900s, medications began to be developed and helped to address some mental illnesses.
“With the inception of medication the public became aware that mental health issues can be treated and there is hope for recovery,” Richards said.
However, even with the advent of medication, there are still many barriers to getting treatment. While some are perceived, others are more obvious. Personal beliefs and the sense of failure will often keep someone from getting help. Some people may isolate themselves due to how they think society sees them. Transportation is often a barrier and insurance companies don’t make it easy for individuals suffering from mental illness or substance abuse to get help. Even with services provided by Spectrum, ARA, the MIT (Mobile Integration Team), and the hospital for those in crisis, there is a shortage in psychiatrists throughout the state.
“About 50 percent of those diagnosed with a mental illness also struggle with substance abuse,” Richards said. “It’s important to note that not everyone who suffers from mental illness also suffers from substance abuse, however, addictions will often undermine the treatment of mental illness.”
As progress is made in integrated care, the understanding of how the two diseases interact with each other is becoming clearer. It is hard to tease out what comes first, the mental illness or the substance abuse. Oftentimes, the substance abuse is a result of an individual self-medicating their mental illness. They may think the alcohol or drugs are slowing down their racing thoughts or voices, if they are hearing voices. On the other hand, substance abuse could be the precipitator of mental illness. The current movement of integrated care aims to procure a better understanding of how to treat co-occurring disorders.
“Addiction will certainly impact someone’s mental health and well being. Addictions have significant impact on individual’s lives, relationships, family, ability to hold jobs and their independence,” Richards said. “Many individuals end up in the legal system (because they are) trying to support their addiction.”
In the recent Community Health Assessment, Wyoming County Department of Health Public Health Administrator Laura Paolucci notes the two priority areas in the county: promote mental health and prevent substance abuse, and prevent chronic disease.
“The first thing we did was to try and understand what systems of care there are in the Office of Mental Health (OMH) and then align mental health and substance abuse,” Paolucci said. “In many cases, substandard health and mental health go hand in hand and the person afflicted often has poor physical health as well. It’s a complicated system of care.”
The OMH and OASAS (Office of Alcohol and Substance Abuse Services) stand separately. In order to get information and resources available to county residents, the health departments of Wyoming, Genesee and Orleans counties made a data repository on the Western New York 2-1-1 Web site. Calling 2-1-1 is a free, confidential, 24/7 phone referral and information helpline and the Web site connects people to health and human services in the area including inpatient and outpatient mental health services.
“Treatment is tough. Physical addition is powerful. Support to move through post-addiction is imperative to keep the energy moving forward,” Paolucci said.
“There are many barriers to identifying and treating mental illness. I believe knowledge is power. Understanding mental illness and how to get help is essential. Understanding and believing that recovery is possible for everyone,” Richards said. “People with mental illness are some of the bravest people I know. They struggle every day with different aspects of their illness. Increased societal awareness and understanding of the impact of the illness will break down the barriers to treat those in need.”
Part of the initiative Paolucci and the Steering Committee are working on is finding out what programs are not in the three counties and working toward making them available for residents. The committee ensures sustainable funding for substance abuse and mental health services.
“Nobody begins their day saying to themselves ‘I'm going to overdose today.’ With more treatment and such available and accessible, why not give them a chance?” Paolucci said.
“Everyone is at risk to develop a mental illness,” Balbick said. “However, men and women recognize and manifest depression differently. It’s not identified as easily with men as it is with women because of that difference.”
Like the other aspects of ourselves we have to take care of mental health and understand that it is an important component in life. According to mental health professionals, if someone has a mental health disorder and it is left untreated it can get out of control and has the potential to escalate.
“What is 'normal'? That’s a good question,” Richards said. “For me, normal is very subjective and different for everyone. It is also judged by everyone as to what they perceive to be ‘normal.’ ”
As Charles Addams once said, “Normal is an illusion. What is normal for the spider, is chaos for the fly.”
For more information on services available visit http://www.wyomingco.net/mental/main.html.