Why are people uncomfortable talking about mental health?

[wish_me_luck]

I am not sure if this has been discussed/asked before (perhaps I should have perused the topic via the search bar before I asked); but, why are people so uncomfortable talking about mental health and/or mental illness?

This goes for not only lay people, but healthcare professionals (including nurses), as well. It's not a topic that involves any graphic nature (such as sex) and it seems to be a growing issue, yet people are very uncomfortable talking about it. Actually, I think people are opening up about sex more nowadays than mental health.

I never really understood why mental health and mental illness were a taboo subjects.

[sneeds]

NAMI is a great resource and group to join! Check them out.

[wish_me_luck, BSN, RN]

sgrondahl, I do not think they can turn people down; however, I think people are going to be paying out the behind for coverage to a point where it's not worth it.

sneeds, I am involved with NAMI. They are a great resource. It's a shame that there's not many more resources like them...now, if only we can get people talking and involved...that would be great.

[leslie :-D]

I have had several well-meaning folks suggest applying for SSDI after my recent job loss, which was directly a result of a mixed bipolar episode coupled with severe anxiety, but I refuse to do so and my psychiatrist is equally adamant about not certifying me as "disabled". He says that in his experience, 100% of the patients he's signed papers for have gotten WORSE. Who needs that??

There's a big difference between having a disability, as I do, and being disabled. And while I may need to modify my schedule and change to a job with fewer distractions, as long as I can work, I will work.

i *think* those well-meaning friends (who suggested ssdi) weren't/aren't aware of your capabilties at the time you spoke about it.

that maybe (and only YOU could answer that) you wouldn't be able to return to nursing.

speaking for myself, that is the only reason i suggested ssdi...in hopes of its thought bringing you a piece of comfort, knowing that you didn't have to try and return to the very environment that has created incredible stress for you.

iow, i suggested it only as a consideration...and not as an absolute and only option. :)

leslie

[VivaLasViejas, ASN, RN]

i *think* those well-meaning friends (who suggested ssdi) weren't/aren't aware of your capabilties at the time you spoke about it.

that maybe (and only YOU could answer that) you wouldn't be able to return to nursing.

speaking for myself, that is the only reason i suggested ssdi...in hopes of its thought bringing you a piece of comfort, knowing that you didn't have to try and return to the very environment that has created incredible stress for you.

iow, i suggested it only as a consideration...and not as an absolute and only option. :)

leslie

Ah, Leslie, I'd forgotten you were one of the ones who mentioned it. That's one of the most frustrating things about this illness and the meds I have to take to control it---all of this has turned my short-term memory to mush. The realization that I'll never again be able to do the kind of work that requires close attention to the tiniest details or the ability to concentrate for long periods of time, or involves constantly shifting priorities, bothers me a great deal but it is what it is and I have to accept some limitations.

Yes, I was pretty upset at the time and really didn't know if I wanted to stay in nursing....indeed, I wasn't sure even if I could stay in nursing. My self-confidence was in shreds by then, and it wasn't until my wonderful p-doc told me that HE thought I could still work as a nurse, that I decided to stick with it if at all possible. He is realistic in that I should never take another position such as the one I just left, nor should I work nights or variable shifts; but otherwise, if he thinks I'm capable, I think so too. I just have to be careful about choosing an area that's not so overwhelming and that I can leave AT work when I'm done for the day.

[leslie :-D]

That's one of the most frustrating things about this illness and the meds I have to take to control it---all of this has turned my short-term memory to mush.

the above (my meds) is one of the major reasons i haven't returned to nsg...

don't trust myself because a lot of my memory is shot and my mind is often discombobulated.

be careful, sweetie.

leslie

[Marshall1]

How does the BON find out about people's mental health? Unless something happens why and who is reporting it? To me it doens't make sense as someone who is diabetic would just as easily pose a risk while working (have a diabetic issue) and I also know someone who works/drives etc. with an implanted pain pump. Does not make sense to me why some health issues are made into SUCH a huge deal while others, equally concerning, are not.

I have gone to doctors and therapist over time and never once has any of them mentioned or said they were going to notify the BON.

The fear of this reporting is another reason I'm sure, some nurses and other healthcare professionals don't seek help.

[wish_me_luck, BSN, RN]

Marshall, in some states, if a healthcare provider (physician, nurse, etc.) goes in-patient, then the treating psychiatrist has to report them, by law. It's their license or yours, basically. Other states may not have mandated reporting; however, some psychiatrists feel like it's protection in reporting the person, anyway. If they have that philosophy and report the person; they are protected.

But, how the Board finds out is either something happens while working or the nurse goes in-patient for treatment and gets reported. If you do not disclose on application (or renewal, if asked), then you are risking being found out and punished for lying. Usually, the punishment is suspension of the license and you still might have to do a monitoring program.

[Sadala, ADN, RN]

Honestly, I'm not sure. It's never been a taboo for me personally. I tend to see all health concerns in terms of functionality. So I see mental health as just a part of overall health. I think the "healthiest" people strive for the optimal functionality that they can achieve, given their innate makeup and abilities, in all aspects of their lives (kind of a la Maslow, if you will). I think it's kind of weird, actually, to ignore any particular aspect of functioning. How can you seek self-fulfillment if you can't even examine yourself holistically?

Oh wait, you were talking about in reference to patients... Ok. Yeah. Same thing.

[Indy, LPN, LVN]

People are afraid to deal with mental issues because they aren't an easy fix, and out of fear, but also from denial. "That is not me, that is not my family, that is dangerous, etc." Then they get upset when it affects them or someone they love and people still have the same responses they once did. People don't change easily.

I come from a large family full of mental issues. We have alcoholics, one known suicide, many attempted suicides, at least two schizophrenics, at least two autistics, a whole bunch of drug addicts and some that just haven't been classified but surely need to be. My current adaptive measure is to take care of my daughter, who is autistic, and to ignore the rest of them, because one is about all I have the patience for, realistically. And that includes my nutcase of a mother.

I would like to be understanding. Right now, I am supportive of disabilities that include the autism spectrum and mental retardation, and it's lovely to help folks "be all they can be" and see them start to develop a sense of purpose in life. I am regularly in contact with folks who have all the other issues, as they don't have good support systems and self medicate, and wind up in my ICU with problems that ultimately, hark back to mental illness and their inability to deal with it. All I can do is adapt in how I respond to them, attempt to suspend judgement and try for the barest of behavioral contracts with them: I'll be nice if you be nice, and this is what the rules say, etc.

I will say that I see parallel, but not the same, types of reactions with regard to other chronic, currently incurable conditions and having been smacked in the last year with RA, I can see why nurses don't routinely share their struggles with other nurses. My patients are more understanding of my issues than my coworkers. I don't talk to all of them, but when I start to preach biofeedback, I reference that I have a reason to be concerned about how I personally take pain meds, and this is how I manage and stay away from a narcotic dependency, at least for this year. Most patients love to see a nurse working who is human, who overcomes adversity to help others. It's inspiring.

Only once have I heard of a nurse discussing their own mental struggles with a patient, and it's because that coworker shared with me the gist of their conversation after the patient was, later, successful in her quest to leave this life. I don't think that nurse has really processed how to feel about it, and may come back to it time and time again, but that's just my guess. That is where the parallel breaks down; those with MI feel that maybe no one, patient or coworker and likely not even family, will understand the issues. I certainly don't; the closest I've come is a reaction to prednisone and I knew at the time that the effect would be temporary, although it was really interesting. I'm at risk for any of the things that my family has in their history, maybe not schizophrenia or autism since I'm middle-aged and would have been diagnosed or dysfunctional before now, but certainly addiction, depression, those are still things that could come around and visit.

I don't know why I can't understand, except maybe that it requires personal experience to do so. All I can do is try to accept. Those that deal with these things personally, know that I am thankful for your honesty, and I wish the gap could be bridged more successfully.

[kbrn2002, ADN, RN]

The stigma is nothing new. The old psych hospital in my town has a graveyard with no names. People lived and died in that place and were buried with only their medical record number on their stone.

Once people figured that there is a genetic link to mental illness, people with certain traits were hidden. Members of a family didn't want to get a reputation for mental problems; they would become disadvantaged in the marriage market. A mentally ill family member would be enough to taint the rest of the family with the stigma.

That is probably why those graves have no name.

How sad! If the medical records even still exist wouldn't it be a nice thing to give those poor souls back there names?

[NCmcMan]

1 word,,, Stigma

[DLS_PMHNP, MSN, RN, NP]

100% agree about the PRN/part time work. I feel VERY fortunate that my husband has a decent job, and I can afford to work part time. I used to work full time (plus overtime), and my PTSD would kick in big time. I work in hospice, that in and of itself can be emotionally draining, just like most nursing jobs.