Mental Health Awareness Month

**VivaLasViejas**, ASN, RN

Raise your hands: How many allnurses.com readers know that in addition to mothers and deceased war veterans, the month of May is dedicated to mental health awareness?

Give yourself a gold star for the day if you were able to lift a palm in the affirmative. Most Americans---including healthcare professionals!---don't have a clue. And if you, like me, are someone who cares about mental health, it should alarm you that statistics show as many as one in four Americans is affected, either directly or indirectly, by a diagnosable mental illness.

That's a lot of misery. Some of the more well-known disorders, such as anxiety and depression, are relatively common and may affect as much as 10-12% of the population, depending on who you ask (my info is from the National Institute for Mental Health). But there are also millions of Americans who suffer from what some experts call the "serious" mental illnesses, which include schizophrenia, manic depression, and borderline personality disorder, and the cost of these conditions in terms of lost productivity---and lost lives---is staggering.

And yet these brain disorders are some of the best-kept secrets in America....that is, until a massacre at an elementary school, or some other atrocity, is splashed all over the news media. Then the mentally ill become the scapegoat for the nation's moral failings and the object of political fearmongering, not to mention a convenient target for judgment by a society which knows little (and cares even less) about those who live outside what it considers "normal" boundaries.

What so few ever care enough to see are the real, human stories behind the stereotypes. For every mentally ill man or woman observed wandering the streets and yelling at trashcans, there are many, many more psychiatric patients who are everyday people---sometimes even people we know and love, though we may not realize that they suffer.

There's the mail carrier who delivers our bills and never fails to smile; we don't see the severe depression that sometimes drives him to hide under the bedcovers for days at a time.

There's the hairdresser who cuts and styles our hair perfectly every time, and never charges a dime more than she knows the client can afford. Who knew that she occasionally sees people and hears voices that aren't really there?

There's the Realtor who lives down the street in a gorgeous home she bought thanks to her annual six-figure commission earnings; you'd never guess that she has social anxiety disorder and must literally force herself to go out and sell houses every day.

And yes, there's the RN who manages the health needs of our aging parents and oversees those of eighty other elders while struggling with the highs and lows of bipolar II.

When viewed in this light, does it still seem OK to label anyone as "crazy", "psycho", or, in the words of a (supposedly) educated public figure, "lunatic"? These are functional, productive members of society. The reasons for their success are as individual as they are, but what almost all of them have in common is good medical care, strong support systems, and an unquenchable desire for wellness.

Sadly, however, the first is woefully lacking in this country; the second requires faith in one's fellow humans (often problematic when difficult behaviors cause friction in a patient's relationships); and the third is all but impossible in the absence of the first two. Hence, the stereotyping and poor treatment of the most vulnerable among our mentally ill population.

But, prejudice and discrimination are not limited to those of modest means. Being "mental" in the eyes of one's work culture can damage, or even kill, a career. I cannot speak for others, but my own diagnosis in February 2012 was devastating to my prospects for promotion and created a very awkward relationship with my superiors, who once respected me and encouraged me to keep reaching for the stars. I am the same nurse they hired in October 2010; the only difference is that now we all know why my performance has been brilliant at times, but often erratic.

It is time for a change. The time for suffering in silence---and for fearing the social and occupational consequences of disclosing a mental disorder---needs to be over. Now. And this change needs to begin with us.

Over the next month, fellow AN member and mental health advocate, wish_me_luck, and I plan to post informational articles about the conditions from which we ourselves suffer, and we invite those of you with personal experience in living with mental illness (or caring for someone who does) to do the same. Between all of us, we can open up a dialogue that will be shared not only with other AN members, but an audience of clinicians from other disciplines and parts of the world.....and who knows what might come of it if we raise our many voices in support of more research, better access to care, and the elimination of stigma?

Let's find out.......together.