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David Baxter

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Stigma Stands in the Way of Mental Health Treatment
11/08/2006
by Russell Murdock
Special Issue of American Journal of Public Health

Mental health is often stigmatized, resulting in programs not receiving the funding or attention that they deserve, according to a forum hosted by APHA and the Community Voices Initiative of the National Center for Primary Care at the Morehouse School of Medicine.

The September forum, held in Washington, D.C., marked the release of the October 2006 issue of APHA's American Journal of Public Health, which focuses on mental health and includes new studies that shed light on mental health and the scope of mental illness. According to the studies in the issue, mental health problems affect more than a quarter of all Americans each year.

David Satcher, PhD, MD, former U.S. surgeon general, who spoke at the forum, said mental health is just as important to protect as physical health. In fact, Satcher said, mental disorders are physical disorders; it's just that the brain is the affected organ.

Satcher defined mental health as the ability to adapt to changes in one's environment, the ability to have positive relations with other people and the ability to cope with adversity. There is a continuum between mental health and mental illness, Satcher said. As long as people subscribe to the notion that mental illness is someone else's problem, he said, it will not be resolved.

"None of us can take our mental health for granted," said Satcher, director of the Center for Excellence on Health Disparities, and the Poussant-Satcher-Cosby chair in mental health at the Morehouse School of Medicine in Atlanta. "We can't ostracize people because they're mentally ill."

Among the research in the journal is a study that calls into question the link between antidepressants and increased suicide. In 2004, the Food and Drug Administration ordered that all antidepressants carry a "black box" warning label cautioning that such drugs are linked to increased suicide risks among children and adolescents.

In the new AJPH study, however, Robert McKeown, PhD, associate dean for research and professor of epidemiology at the Arnold School of Public Health at the University of South Carolina, found there have been declines in the rate of suicide among people ages 15 to 24 and those ages 45 to 64 in the past 10 to 15 years. McKeown said the declines coincide with the increased use of anitdepressants know as SSRIs, or selective serotonin reuptake inhibitors.

McKeown told The Nation's Health that his study shows that the issue of SSRIs and suicide is a complicated issue. Many suicides among people taking antidepressants occur when they first start using the drug, before the drug takes effect, he said. McKeown said people who are prescribed antidepressants should not allow the warning to prevent them from using the medication, as long as they have someone supervising them and monitoring their progress.

In another AJPH study, researchers found that married mothers and fathers of infants have better mental health than do their unmarried counterparts. Among the three subgroups of unmarried parents, differences also occurred. Couples that were living separately and no longer romantically involved tended to have the highest rates of problems. Michele DeKlyen, PhD, of the Center for Research on Child Wellbeing at Princeton University and lead author of the study, said in the study that the rates of major depression for fathers were particularly remarkable.

According to the study, 21.6 percent of fathers who did not live with and were no longer romantically involved with the infant's mother suffer a major depressive episode, higher than any rate among mothers, "despite the well-established finding that women are more likely than men to suffer from depression and anxiety disorders."

Another study in the journal examined the link between discrimination and mental health. Researchers discovered an association between self-reported discrimination and mental illness among both black and Hispanic populations. Study author Gilbert Gee, PhD, said the results show the very real role race plays in mental health.

"Policies to protect civil rights are not just important from a political standpoint but also from a public health standpoint," said Gee, assistant professor of health behavior health education at the University of Michigan School of Public Health.

To watch a webcast of the forum, visit www.kaisernetwork.org/health_cast and look for the Sept. 28 event. For more information on the American Journal of Public Health, visit www.ajph.org. For more news from The Nation's Health, visit www.thenationshealth.org.
 

Halo

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Great article David :) One part that seemed to really make a lot of sense to me was this

mental disorders are physical disorders; it's just that the brain is the affected organ.

Wow....great way to look at it.
 

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