A Public Health Perspective

Sue Bergeson Health Guide
  • Recently, I attended a very large conference held by a very large and important public health agency. Since DBSA is painfully aware of how big an issue mental health is within the country, I was interested in joining the public health conversation. Depression is the leading cause of disability in the U.S., according to the World Health Organization and one out of every five people in the U.S. will deal with a major health issue during their life.

    For three days, this important group of individuals talked - almost exclusively - about three things: smoking, obesity, and wearing your seat belt. Mental health was discussed exactly three times: first, when I forced the issue after yet another speech by yet another important person; the second time, in the context of late life (men over 65 take their own lives more often than any other age/gender group. Check this site for a quick overview; and the third time, in the context of children. (Suicide in adolescence is a major public health problem. According to the Centers for Disease Control and Prevention, CDC, 9 percent of students in public and private high schools in 2003 had attempted suicide in the past year, and 3 percent of students reported needing medical treatment after their suicide attempts. Given the approximately 15.6 million high school students in the United States, this translates to over 1.3 million suicide attempts, thousands of which would have been handled in hospital emergency departments).
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    It saddened me. It frustrated me. And then, it made me mad.

    Those of us living with a mental health issue are the single largest group of cigarette consumers in the country. An interesting article about the antidepressive effects of nicotine can be found here.

    So, how can any U.S. agency spend billions on smoking cessation without once addressing mental health?

    Obesity is a major issue for those of us living with a mental health issue. According to this article, “Research suggests that depressed persons are more likely to develop the metabolic syndrome that often accompanies excess weight, especially when this weight is concentrated around the waist. People may console themselves with ‘comfort food,’ which is usually high in fat, sugar, and calories because they are anxious, lonely, angry, or suffering from low self-esteem. There is a characteristic type of depression with symptoms that include lethargy and overeating. Like most mind-body interactions, obesity can lead to ill health, which is linked to depression and anxiety.” Even Good Housekeeping knows the correlation between medication and weight gain; see their article.

    So, how can any U.S. agency spend billions on obesity without once addressing mental health?

    Finally, any of us living with these illnesses can tell you that driving without a seatbelt is often one of two things: an example of the risky behavior we deal with when we are in a manic state or an example of the passive, suicidal activity we engage in when depressed.

    So, how can any U.S. agency spend billions on the issue of seat belts without once addressing mental health?

  • Sadly, infuriatingly, I think I know the answer to all three questions: stigma.
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    As I sifted through all the responses I got when I pushed this issue, when I consider all the logical positioning various people provided me, it still all goes back to stigma. After all, these aren’t REAL illnesses we live with, illnesses we die with, illnesses that take every ounce of will we have to survive. They are just in our heads, right? Wrong. So very, very wrong.

    I will continue to fight, of course. I urge you to watch for conversations, legislation, and policies around these issues and raise your voice. Ask the questions: Why aren’t we allowed at the table? Why isn’t money going to deal with mental health on these subjects? It’s the only way things will change.

    As always, I am interested in your thoughts and strategies around these issues.

    Be well.
Published On: February 22, 2007