Why is mental illness considered pts. fault?

[mrs.captain.kangaroo]

I'm a student thinking of going into psych.nursing. I really am struck by how many of my fellow students think that mental illness is the pts. fault, that they just need to 'buck up', that they (the students) have no sympathy with folks w/mental illness, addictions...

Why is there this attitude towards mental illness as opposed to physical illness or even mental problems that may manifest as physical illness i.e. IBS - these people get sympathy because there is a physical expression instead of those who are more honestly 'mentally ill'. There are plenty of people who have physical illnesses that could be controlled with effort (borderline diabetes, high blood pressure) with exercise and diet yet those folks receive our sympathy (and medication) , why not mental illness?

[NightOwl0624]

I have a question about nurses' attitudes toward mental illness.

Don't you have to study it in nursing school? We haven't gotten there yet, but I was under the impression it was required to pass a class with clinicals to qualify for the state boards. What kind of a job are these instructors doing when so many nurses turn out so ignorant? If this is the way that professional nurses treat mental illness, no wonder so many people don't go for help.

[Katnip, RN]

Some people's prejudices defy education. If a person goes into nursing school believing something, they'll often hang onto that belief no matter how much education they get stating the opposite. I personally have met numerous nurses who still think hospice nurses are killing their patients on a regular basis.

[cwishes]

As a psyc RN in a CA state hospital I deal with individuals who are afflicted with mental illness on a daily basis. There is a negative stigma to M.I in much of Western society. These stigmas are missing in a good number of societies throughout third world countries. In those third world societies, M.I. is seen as a illness or injury no differently than any other illness or injury and are treated as such. Those afflicted with M.I in said societies have a much higher recovery rate than those who are "treated" in Western societies, especially in the US. (This information gathered from the WHO and the President's Council on M.I.). It seems that our society, not the afflicted, need to make the change.

[FireStarterRN, BSN, RN]

Actually, I think people also blame people for physical illnesses. COPDers who smoke, diabetics who overeat, alcoholics with liver failure, are examples that come to mind.

[DaFreak71]

As the previous posters said, mental illness still (despite it being 2007!) is highly stigmatized. In addition, I think that many people simply do not know how to handle thinking outside of the box. Some conditions, such as diabetes, B/P, COPD, have protocols that are outlined, which makes the nurse feel competent to deliver the standard care. It basically becomes routine.

For those with mental disorders, it can't be quantified by a blood test and treatment is often difficult because you have to really take the time to get to know the patient, their histories, family dynamics, etc. This is a time consuming effort, albeit a worthy one.

In the ADN program I am in, we have a five week psych rotation. Five weeks is not long enough to understand or be exposed to the myriad of patients who suffer from varying mental disorders. It is also made more difficult to deal with the patient who suffers from a mental disorder because often times they do not present according to how the textbook defines their symptoms (this goes back to thinking outside the box). Many people are simply not interested or capable (even nurses) of understanding these complexities.

To confound matters even more, there is a massive disparity between medical coverage and psychiatric coverage. For example, if you had to be hospitalized due a car accident or a heart attack, you generally are not discharged until you are stabilized. Most all insurance companies will put a time limit on how long a patient with a mental disorder can stay in an inpatient setting or even how many visits to a mental health practitioner. So even at the level of insurance companies, these practitioners are reimbursed at a much lower rate and are confined to the length of their therapy.

It is an extremely sad situation. So many people SUFFER in silence with mental illness because, they too, feel stigmatized. The patient themselves may feel that their condition is transitory or that they just need to "buck up". They can feel very embarrassed about approaching a health care professional about a suspected disorder. They may feel that their symptoms will be taken with a grain of salt, or worse yet, they may be ignored all together.

Our system is broken. Many people with mental illnesses have other conditions that can be exacerbated by stress, depression, isolation, and psychosis. The underlying mental illness is often ignored while the "real" medical issues are addressed. What does this accomplish? As nurses, we must take a holistic view of the patient and this absolutely must include their mental status, as this plays a large role in their "real" medical problems.

If this is an area of nursing that you feel a strong connection to, I suggest that you consider specializing in psychiatric nursing. You seem very compassionate and have a true understanding of the "realness" of mental illness. Please, if you can, enter this field because it's a field that can be very rewarding.

I say all these things as a nursing student who suffers from bipolar I disorder, PTSD, and severe anxiety. My medications have stabilized my symptoms thankfully. I have a much greater appreciation for those who suffer from the same issues. THESE PATIENT'S LIVES CAN BE TRANSFORMED BY A CARING NURSE AND THE CORRECT MEDICATION REGIMINE. They deserve to be taken seriously and to get the treatment they need so that they can go on to lead the most productive life that they are capable of. If you can think of a higher calling, please fill me in. :icon_hug:

[mrs.captain.kangaroo]

Actually, I think people also blame people for physical illnesses. COPDers who smoke, diabetics who overeat, alcoholics with liver failure, are examples that come to mind.

jlsRN: You are right but I've not heard people say they didn't want to work with/have no sympathy for diabetics that overeat, COPD smokers....a lot of people do not want to work with alcoholics either. They see the overeating and smoking as contributing but not the cause of the illness whereas they seem to think that if someone has mental illness it is all their doing and under their control.

You make a good point in that it is harder for some people to quit drinking/eating/smoking than others and it isn't necessarily willpower....I think everyone is different and some more prone to addictions...and there is always luck involved in getting sick...we have a relative who drinks heavily (for years) and has not developed any health problems.

[LydiaNN]

Last year there was a thread about Christmas carols that make fun of people with mental illness. I was shocked at some of the people who participated in it, and at some of the justifications offered when others suggested that maybe these jokes were inappropriate. Venting about the struggles of caring with difficult patients is one thing, making fun of them is another, IMHO.