You’ve got to scratch your head when one of the government’s chief advocates for health care in the Veterans Administration just reinforces the old stigmas associated with mental health concerns. Testifying before a federal judge in San Francisco, Michael Kussman said:
“The number of patients who have adjustment reactions to the experience that they have in Afghanistan or Iraq is very important, but we don’t believe that’s mental illness,” Kussman said. “It would be unfair and inappropriate to stigmatize people with a mental health diagnosis when they are having what most people believe are normal reactions to abnormal situations.”
Well, golly gee Dr. Kussman, are you saying that traumatic reaction to wartime situations isn’t a mental illness? Because posttraumatic stress disorder (PTSD) surely has existed in one form or another since all wars have ever been fought. Is PTSD simply an “adjustment reaction” (whatever that is)? Or are you saying that an adjustment disorder isn’t a real, diagnosable mental disorder? Because, if you are, you’d be wrong on that account as well.
Or, perhaps worse of all, are you suggesting that because mental disorders remain stigmatized within our society today — especially within the military — we therefore shouldn’t seek to properly diagnose and treat soldiers with real and often serious mental health problems? As the undersecretary of health for the VA, you don’t exactly help reduce the stigma with beliefs like this. One of your jobs is to help reduce the stigma of all health and mental health concerns through education and information. Instead you’re only reinforcing the stigma by suggesting people with mental health disorders are somehow damaged or treated unfairly. And if that’s the case, Mr. Undersecretary, I suggest you work to change the system you head that allows veterans to be treated unfairly because of such a diagnosis.
Having a depressive, traumatic or anxious reaction to combat is actually not a normal reaction (even if some of us believe it should be). And sadly, war and combat fighting is not an “abnormal situation” for a soldier — it is exactly what is expected of them (and what they signed up for).
In a perfect world, we wouldn’t need soldiers. But in a perfect world, we would definitely take care of those who fought for us. That especially means not minimizing the effects of wartime, nor reinforcing the stigma of mental illness — a condition that returns with so many of our military men and women who have seen combat.
Read the full article: Official defends VA’s mental health effort
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4 Responses to “Undersecretary of Health Reinforces Stigma of Mental Illness” (Pingbacks/trackbacks not shown below)
Alison Hymes at 10:31 pm on
April 25th, 2008
I believe this is part of an unorganized but common effort to segregate certain diagnoses as “serious mental illness”, much like some folks used to be called “chronic” from everyone else with mental illnesses, an “othering” of those who elicit the most fear and hatred among the non-diagnosed.
Eddy A at 3:02 pm on
April 26th, 2008
This is one way to view the Undersecretary’s comments, but another is equally important: Normalization of suffering may actually reduce stigma and lead the skeptical to treatment. It is helpful for people to hear that what they’re experiencing is in fact typical of such unusual and inhumane circumstances - that they’re not “crazy” for experiencing something distressing. This type of approach, coupled with an open door to mental health treatment, can get people over the hurdle of stigma, and out of the private closet of anguish, because they can see that other people also experience similar things. I agree that Kussman may be minimizing the experiences of some with PTSD by generalizing about “adjustment reactions”, but to assume that everyone will have the same severity or chronicity is incorrect and to assume that soldiers are more likely to get treatment when it’s called TRAUMA as opposed to adjustment is dubious.
John M. Grohol, Psy.D. at 3:11 pm on
April 26th, 2008
I understand what you’re saying, but I don’t think this sort of tactic works as intended. To wit–
It sends a message that puts people squarely into one of two classes — either you’re “normal” and are having a “normal” reaction to something, or you’re abnormal and having an abnormal reaction to something (e.g., you’re “crazy” and have a “mental disorder”).
The problem is, with mental disorders, you can get depression or bipolar disorder from no trigger. You can be leading a perfectly happy and normal life, and boom — you’re automatically in the “abnormal” camp. In my mind, it just reinforces this division that you’re either one or the other.
The reality is that mental health is a continuum. Disorders are discrete and don’t tend to recognize the continuum of our mental health, and certainly the public doesn’t look at these things with a finely-tuned appreciation for the complexity of mental disorders. I think the Undersecretary’s comments reinforce a simplistic view of mental health and mental disorders, and, perhaps unintentionally, the invalid dichotomy — either you’re mentally ill or you’re not.
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I believe this is part of an unorganized but common effort to segregate certain diagnoses as “serious mental illness”, much like some folks used to be called “chronic” from everyone else with mental illnesses, an “othering” of those who elicit the most fear and hatred among the non-diagnosed.
This is one way to view the Undersecretary’s comments, but another is equally important: Normalization of suffering may actually reduce stigma and lead the skeptical to treatment. It is helpful for people to hear that what they’re experiencing is in fact typical of such unusual and inhumane circumstances - that they’re not “crazy” for experiencing something distressing. This type of approach, coupled with an open door to mental health treatment, can get people over the hurdle of stigma, and out of the private closet of anguish, because they can see that other people also experience similar things. I agree that Kussman may be minimizing the experiences of some with PTSD by generalizing about “adjustment reactions”, but to assume that everyone will have the same severity or chronicity is incorrect and to assume that soldiers are more likely to get treatment when it’s called TRAUMA as opposed to adjustment is dubious.
I understand what you’re saying, but I don’t think this sort of tactic works as intended. To wit–
It sends a message that puts people squarely into one of two classes — either you’re “normal” and are having a “normal” reaction to something, or you’re abnormal and having an abnormal reaction to something (e.g., you’re “crazy” and have a “mental disorder”).
The problem is, with mental disorders, you can get depression or bipolar disorder from no trigger. You can be leading a perfectly happy and normal life, and boom — you’re automatically in the “abnormal” camp. In my mind, it just reinforces this division that you’re either one or the other.
The reality is that mental health is a continuum. Disorders are discrete and don’t tend to recognize the continuum of our mental health, and certainly the public doesn’t look at these things with a finely-tuned appreciation for the complexity of mental disorders. I think the Undersecretary’s comments reinforce a simplistic view of mental health and mental disorders, and, perhaps unintentionally, the invalid dichotomy — either you’re mentally ill or you’re not.
