Although we continue to distinguish between various mood states the sad fact is most people diagnosed with a mood disorder problem experience more than one. For example, the most common issues for people with anxiety are depression and substance misuse. If we look at the breakdown of mental health issues we find anxiety disorders top the list, then depression with anxiety and then depression alone. In fact depression is now so prevalent that it affects roughly 5 per cent of the population in the USA at any one time. Look at the stats more broadly and we find that 17 per cent of people will experience a major episode of depressive illness at some point in their lives.
What are we to make of this level of misery? The standard approach to treating mental health hasn't changed much for a long time and involves treatment, of sorts, being offered once symptoms appear. You only have to look at the average forum to see how poorly the current system recognizes and deals with the array of distress that people experience. Perhaps, in a general sense, the current approach reflects a preference to emphasize physical wellbeing? Whether or not this is the case the mental health needs of patients remain a pretty hazy, costly and poorly understood state of affairs.
Yet, we have to look to experts in the field to identify problems and then show us what to do about them. As far as psychiatry is concerned we have a revised diagnostic manual to look forward to, but this is likely to be a reshuffling of the same hand we've been dealt for decades. Perhaps we need to dig a bit deeper and ask more searching questions about the nature of psychiatry, what it has to offer and how well it is providing the answers and leadership we need?
Self-help literature isn't the first place you might expect to find a coherent challenge to what is currently on offer. However, Professor Jane Plant & Janet Stephenson manage to deliver something of a broadside to the system we're all expected to cope with. They challenge psychiatry's ageing interpretive framework which still seems to stand outside of much of what is known of the biological bases of memory and emotion.
Psychiatry remains a Cinderella service and this has all sorts of ramifications for the type of person it tends to attract and the nature and sophistication of research undertaken. Have we not reached a point where technicians should be screening for mental illness in much the same way we screen for other health problems? Shouldn't specialists be available to routinely interpret functional brain scans? We have the technology yet it is barely used outside of a few research centers.
If we could turn things around where should we start? Maybe we could do worse than follow Plant & Stephenson's call for all specialists involved in the treatment of mental illness to pass advanced examinations in neurology, physiology and biochemistry of the brain and nervous system. This new neurophysician, would replace psychiatrists as the person most capable of fully comprehending and treating the complexity of mental illness. It may seem contentious but if we want to get serious about mental health we surely need to take a fresh look at the service that currently purports to serve our psychological wellbeing and demand more and better.