Mental health is a final frontier for human rights

Impact
ByDr. Stephen P Hinshaw

It’s essential to remember what an important year it’s been for combating mental illness stigma in the world of sports. Cleveland Cavaliers star Kevin Love wrote an essay on his struggles with anxiety and panic attacks. Washington Wizards’ Kelly Oubre Jr. and Toronto Raptors’ DeMar DeRozan have both publicly discussed their mental health battles. Former WNBA superstar Chamique Holdsclaw has openly revealed her family’s — and her own — encounters with serious mental illness, including bipolar disorder.

All of them are leading the fight against the stigma still associated with mental disorders. And they’re not the only athletes doing so — witness Michael Phelps with anxiety, depression and ADHD — and so many gymnasts who’ve bravely confronted sexual predator coaches and doctors and disclosed their resultant struggles with PTSD and related conditions.

The mental health crisis is real. One in 4 adults lives with a mental illness, leaving millions of individuals and families in need of evidence-based services. Rates of child-onset conditions like ADHD and autism are soaring. Depression can be a truly devastating illness. Suicide rates are rising, not falling — and suicide is now the number-one cause of death worldwide for teenage girls and young women.

Americans know far more about mental health than 60 years ago, but attitudes have hardly budged since the silent 1950s. In fact, nearly three times more U.S. citizens now believe that mental illness is associated with violence, related in part to stereotyped media images. With the pervasive shame and silence that still exist, and without access to care, the vicious cycle becomes self-perpetuating.

Throughout history, mental-health conditions were thought to emanate from evil spirits or weak personal will. Poor parenting was blamed during most of the 20th century; more recently, “bad” genes have been the culprit. In truth, like heart disease, cancer and diabetes, mental illnesses are shaped by genetic vulnerability as amplified by trauma or serious life stress. Although cures do not yet exist, evidence-based treatments can greatly facilitate recovery. Yet a 10-year gap exists between noticing core symptoms and pursuing treatment — related to ignorance, shame, poor access to care, lack of financial resources or combinations of these factors.

I learned about all this the hard way. Growing up in a warm, academic Midwestern family, I was baffled by my father’s periodic disappearances for up to a year at a time. Unspoken was that he was placed in barbaric mental hospitals for bouts of wild mood swings and irrationality, which had been misdiagnosed as schizophrenia since he was 16. At that time, he jumped from the roof of his family home with the belief that his “flight” would signal the free world to stop the oncoming Nazi threat. Despite his tortured stays in some of the country’s worst mental facilities, he survived and eventually thrived as a professor of philosophy.

Like most kids in situations of silence, I took on the blame, wondering what I’d done wrong. It wasn’t until my first spring break from college that Dad revealed his bouts of chaos amid his academic and teaching achievements. I became entranced with psychology and soon helped to diagnose him correctly with bipolar disorder. Yet, keeping silent myself for too long, I fought the terror that I might follow in his footsteps and end up hospitalized. Once I got support and therapy, I became dedicated to clinical psychology and to reducing the stigma enshrouding the entire topic.

Progress is at hand: Many people are now discussing mental health more openly, with self-help and advocacy groups a major part of the effort. Even world-class athletes, whose prowess often seems superhuman, are vulnerable — and many have joined the fight. Pursuing therapy is viewed a sign of strength, not weakness, even in the NBA.

What can be done? At the policy level, we must continue to fight for mental health parity and enforce anti-discrimination laws. A far more humanized set of media images also is needed. Investing in evidence-based treatments will not only yield major long-term savings, but it will also ease the tragic personal and family-related burden of mental disorders. With compassion and intervention, the huge financial burden of mental illness, totaling a trillion dollars worldwide, can be reduced, along with the personal and family suffering that so often co-occur.

People with mental disorders are not “them” — a deviant, flawed subspecies. They are us: our children, our parents, our relatives, our closest contacts, even ourselves. And they are elite athletes, including NBA and WNBA players.

Mental health is one of the last frontiers for human rights. We all lose by remaining silent and allowing stigma to fester.