A case for mental health physicals
Preventative, destigmatized mental health could transform the health of the world.
Scheduling an annual exam with a physician to discuss overall health and wellness has become the norm for many if not most of us. We consult with our doctor, have our blood work checked, allow a professional to listen to our heart and lungs, immunize ourselves, and walk out relieved to be finished and hopefully, to be healthy.
We as a society know that the cost of neglecting regular wellness care is more emergency room visits, more late stage diagnoses of treatable disease, more illness and fatality. And of course more money.
So why has preventative mental health care remained an enigma?
April 7 is World Health Day, and this year, the focus is on depression. A recent WHO study counted more than 300 million people worldwide who face depression, making it the “leading cause of ill health and disability worldwide.” This is an 18 percent increase from 2005 and 2015. These numbers force us to pay a bit more attention to mental health.
As a clinical social worker and therapist, I know about the importance of mental health, having born witness to the struggle as well as to the deep capacity for healing and resilience in my clients. I also know that most of us don’t search for a therapist until we are in crisis, until our lives feel unmanageable. And this is understandable, given the many obstacles when it comes to getting the right support and treatment.
Finding the right therapist can be challenging and exhausting. I get it, I really do. When a person you’ve only just met asks you to share your deepest pain, the full story of your complex life, this can feel overwhelming. Especially when you are already feeling overwhelmed; that’s why you’re here in the first place, right? And sadly, there are mental health professionals out there who lack the skill and empathy to hold your suffering with compassion and walk with you to transform it into strength and resilience.
Not to mention the cost of therapy and the limits of insurance reimbursement, a problem seen by both consumers and mental health providers. Many therapists do not participate with insurance companies, who pay them a third to a half less than the going reimbursement rate for private pay. This leaves consumers in the lurch; those with means are making a significant investment, and those without either go without or accrue additional debt and financial stress.
There are many others with more knowledge than me on the obstacles to obtaining mental health care. This study examined these obstacles, finding that the biggest ones self-reported were perceived lack of need, the “ability to fix it myself,” as well as social attitudes related to stigma and negative past experiences with treatment.
The most commonly diagnosed mental health disorders, depression and anxiety, have varying levels of severity and affect functioning in different ways. And most all of us can think of a time where we felt especially sad and isolated and unmotivated, or when we felt especially worried and overwhelmed and fearful. Normal grief and anxiety come up for all of us, and they can be useful emotions that inform us of when to slow down and be safe. So why do we stigmatize getting support when these emotions become overwhelming, or even when they don’t and we just want healthier ways to cope with them?
What could be the value of having preventative, regular, normalized mental health care accessible and available to all individuals?
I can imagine going in for a yearly mental health wellness exam. Instead of an EKG or blood tests, a mental health provider may give you a questionnaire to assess your stress levels and show you the comparison over time. Instead of asking your family history of disease, a mental health provider may talk to you about your family’s history of mental health and relational dynamics and give you insight and new approaches to deal with issues in your relationships. Instead of immunizations to prevent disease, a mental health provider may teach you new grounding techniques, relaxation methods, mindfulness practices, or other ways for you to release stress and enhance emotional well-being.
Of course, the effectiveness of therapy depends most strongly on the quality of the relationship between therapist and client, and a quality relationship cannot be built in an hour long session once a year. Still, taking time to touch base periodically with a mental health professional and to learn some practical wellness skills also means that when you are in need of a “sick visit,” when you find yourself in need of additional support, you already have a familiar face to call.
Mental health affects more than just an individual’s mind and emotional well-being. Anxiety, depression, trauma, and other mental illness affects relationships, families, communities. It’s easy to point to mass shootings and see the breakdown of mental health services. But work-place efficiency, parent-child relationships, school performance, marital satisfaction, community engagement, really any place where people are interacting, mental health factors in. Individual well-being increases relational, family, and communal well-being.
Just as we, unless we are trained professional medical providers, would never assume that we should be responsible for assessing and treating our physical illnesses, so should we take ourselves off the hook for being solely responsible for assessing and managing our mental health. Most of the time, many of us feel healthy and able to cope with life’s stress. But who among us couldn’t use some new relaxation techniques or insight and perspective on our most important relationships and roles? And it’s very possible that by proactively maintaining our mental health and wellness, we could find ways to manage stress-induced physical symptoms like headaches, muscle soreness, digestive issues, chest pain, weakened immune system function, and more, meaning less trips to the doctor’s office.
Of course, there are many structural issues that would need to change before our society is one where preventative mental health for all is accepted, accessible and celebrated. But that doesn’t mean that those of us who care about ourselves and those around us can’t give ourselves permission to take the steps to proactively promote our mental wellness. If you’ve had an awful therapist, try another one. If you can’t afford therapy, find a local clinic, or ask about a sliding scale. (Or check out Open Path, a non-profit collective of therapists who offer sessions from $30-$50 if you’re willing to go through their process and join.) Or reframe the expense as something valuable, not just an expendable luxury; maybe it’s worth spending less money eating out or updating your wardrobe.
Let’s find ways to care not just for our bodies but for our minds as well. Let’s reframe mental health as not just illness but wellness, eliminating stigma and shame around treatment. Let’s not wait until we are in crisis. Let’s make the investment to keep ourselves, our loved ones and our communities well. Our partners, friends, children, families, and the whole human family can and will heal and thrive when we do.