It is Mental Health Awareness month, and I began to contemplate what mental health means to me.

Mental health and wellness is the state at which one feels, thinks, and behaves. Mental health can be viewed on a continuum, starting with an individual who is mentally well and free of any impairment in his or her daily life, while someone else might have mild concerns and distress, and another might have a severe mental illness.

Everyone has “stuff” that they keep contained in a tightly sealed plastic bag. There are some who occasionally can’t help but let the “stuff” leak, and there are those with the bag wide open.

However, in our society, we still tend to stigmatize those who let their “stuff” leak out instead of helping them, understanding them, or simply not judging them. Just as we all know someone with cancer, we all know someone with a mental health disorder.

In the past week, I’ve seen some incredibly sensationalistic articles published about the upcoming DSM-5 and a letter recently released by the National Institute of Mental Health (NIMH). In the letter by Dr. Thomas Insel, director of the NIMH, wrote in part, “That is why NIMH will be re-orienting its research away from DSM categories.”

Some writers read a lot more into that statement than was actually there. Science 2.0 — a website that claims it houses “The world’s best scientists, the Internet’s smartest readers” — had this headline, “NIMH Delivers A Kill Shot To DSM-5.” Psychology Today made the claim, “The NIMH Withdraws Support for DSM-5.” (The DSM-5 is the new edition of the reference manual used to treatment mental disorders in the U.S.)

So is any of this true? In a word, no. This is “science” journalism at its worse.

Suicide.

It remains a topic few health professionals want to discuss openly with their patients. It remains a topic avoided even by many mental health professionals. Policy makers see it as a black hole without an obvious solution.

And now grim new statistics confirm a disturbing trend — more people are taking their own lives than ever before in the U.S.

The U.S. Centers for Disease Control and Prevention released statistics yesterday showing that 33,687 people died in motor vehicle accidents, while nearly 5,000 more — 38,364 — died by suicide. Middle-aged Americans are making up the biggest leap in the suicide rate.

It’s data that should make us sit up and think.

I was going to comment on health care expenditures with an article entitled, “How the High Cost of Health is My Fault.” In it, I would briefly outline my experience with mental illness and detail the cost of caring for it, which, at present, includes medication and doctor visits, totals at least $10,500 per year. Much of this cost is borne by an insurance company.

Then I was going to relate the story about how, in the summer of 2002, I chose to stop taking my medicine the way my doctor directed me to take it, and then I stopped taking my medicine at all.

This was a bad choice. As a result, my illness became an emergency.

Nine hours in the ICU, four days in a private room, and two more weeks of hospital care brought a bill that topped $95,000.

The cost of nine years of care was eaten up by just a few weeks of my irresponsibility. That was cost that the health care industry, including my insurance company, would not have had to bear if I had only taken my medicine as directed.

If you were hoping to get some medications prescribed for attention deficit hyperactivity disorder (ADHD) while in college or at university, you might be in for a rude surprise.

Colleges and university are cutting back on their involvement with ADHD, primarily due to abuse of the psychiatric medications — stimulants like Ritalin — prescribed to treat the disorder. Students — whether they are malingering the symptoms or actually have it — are prescribed a drug to treat ADHD (sometimes from different providers in different states), then sell a few (or all the) pills on the side. Profit!

Now universities are becoming wise to the epidemic nature of the problem, as some studies have suggested up to a third of college students are illicitly taking ADHD stimulants.

This might help curb the abuse problem, but will it also make it harder for people with actual ADHD to receive treatment?

Pro-anorexia (or “pro-ana”) groups have been around online for over a decade, and we first discussed them here five years ago. More recently, with the rise of social networks such as Facebook, Twitter, and Pinterest, these groups have found a new life. Often associated with the label “thinspiration,” these groups elevate the idea of being thin to a virtual religion.

People who are all about thinspiration engage in disordered eating in order to be as thin as possible — a common symptom of anorexia. But they don’t see it as a disorder or a problem, making this an insidious problem.

Nonetheless, such eating and self-image problems can result in health problems, even putting the individual’s life at risk.

Some people have sought to get common words or terms that people engaged in thinspiration use banned from social networking websites. One such woman is Torri Singer, a broadcast journalism major who has recently begun a petition to get such terms banned from Twitter.

Hyundai, the world’s fourth largest automobile manufacturer in the world, apparently believes showing a man trying to kill himself in one of their vehicles is good marketing. The ad, called “Pipe Job” and created by the ad agency Innocean Europe, depicts a man taping a hose from a Hyundai ix35‘s exhaust pipe into the cabin, trying to commit suicide.

It then shows the man sitting in the cabin, waiting to die.

A few frames later, the garage lights come back on, and the man opens the garage door. The tag line is, “The New ix35 with 100% water emissions.”

Yes, very tasteful. Maybe if you were brain and dead and haven’t been alive for the past three decades. Nothing like making fun of people with mental illness, clinical depression, or a disability, is there Hyundai (and Innocean)??

Warning, we’ve included a copy of the video below. Do not continue on if you don’t wish to watch it.

Nearly three years ago, we reported on the kerfuffle over psychologists who were upset to find that the “mandatory assessment” fee they thought was, well, mandatory turned out to be entirely optional. The fee was being paid to the American Psychological Association (APA), the professional guild association for psychologists, to fund a legally separate organization, the APAPO, tasked with lobbying (mostly at the state level — not the federal level).

A class-action lawsuit against the APA was thrown out earlier last year on technical grounds (but with prejudice, suggesting a new lawsuit has a harder road to climb).

Despite that, a new lawsuit was recently filed in federal court in California “accusing the group of misleading its members into paying a fee used to fund its lobbying arm as part of their annual dues.”

I fall into the category of the “uninsurable.”

It doesn’t matter that I wake up most mornings to swim 160 laps, am borderline obsessed with eating salads and whole grains, and that I haven’t drank a drop of alcohol in 24 years; that I do yoga twice a week, keep a mood journal, engage in cognitive behavioral therapy, and have a rich spiritual life; that I take omega-3 fish oil capsules, vitamin D, calcium, and other supplements with my extra-pulp juice in the morning; or that I work really hard at communicating anger, frustration, and disappointment so that the repression of feelings doesn’t end up as a tumor somewhere inside my body.

I can’t get an individual or family plan short of signing up for a $10,000 deductible.

Because I have a history of depression.

“Insanity is doing the same thing over and over again but expecting different results.”
~ Rita Mae Brown

Ya have to admire psychologists who endlessly lobby state legislatures for the right to extend prescription privileges to their profession (with a little additional training). They won’t take repeated defeat as a sign that perhaps their efforts are… insane?

Illinois is the latest state to hand psychologists seeking prescription privileges a defeat, with NAMI Illinois siding on the side of not supporting the bills in front of the Illinois legislature. After intense lobbying by both sides of this issue, they concluded, “NAMI Illinois opposes SB 2187 and HB 3074 in its current form to expand prescriptions privileges to psychologists.”

When will psychologists learn?

Jenn Ackerman has taken some fantastic black-and-white photography in a Kentucky prison. The photos depict the raw life of prisoners who are also dealing with mental illness. Because as the government has repeatedly cut back on funding mental health treatment, guess where the really sick people go?

They end up in prison, usually for repeated petty crimes or drug abuse. And society, in its infinite wisdom, has decided that spending 4x to 5x the cost of keeping the person in prison is “better” than simply getting them into a drug abuse treatment program.

“When I went on the tour (of the prison), I didn’t see it in color; when I came back, I was trying to remember what it looked like, and I couldn’t remember any of the colors at all,” Jenn Ackerman told Slate. “I knew there was something so gritty and raw.”

California has some patient-friendly regulations on its books, meant to help patients get the care they need in a reasonable amount of time. One of those regulations is that patients shouldn’t have to wait more than 10 business days for a regular appointment with their health or mental health care provider.

Yet, Kaiser Permanente’s health maintenance organization in the state — rather than abide by the regulation — regularly made patients wanting mental health care wait longer than the 10 business days. In fact, in one case from 2010, the California Department of Managed Health Care (DMHC) fined Kaiser $75,000 for unreasonably delaying a child’s autism diagnosis for almost 11 months! The new report found that anywhere from 17 to 40 percent of patients waited longer than 14 days for an appointment.

Last week, the DMHC was again at Kaiser’s doorstep, finding that Kaiser kept two sets of appointment records to try and circumvent this regulation — a paper appointment calendar and an electronic health record calendar. The DMHC cited Kaiser for “serious” deficiencies in how it manages and provides mental health care services to its patients.

Kaiser Permanente is one of those enormous health care providers that seems to have lost the plot — providing reasonable and timely health care for its customers.