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Never has it been more important to break the stigma surrounding mental illness.
The nation is experiencing a mental health crisis. In 2017, there were an estimated 46.6 million adults aged 18 or older in the United States with mental illness. This number represented 18.9% of all U.S. adults.
Despite the clearly significant prevalence of mental illness in the U.S., far too often it remains a taboo topic to discuss. Arguably, no one is more aware of that frustrating irony—and more equipped to do something about it—than the nurses and other health care professionals who see the consequences of untreated mental illness in their work every day. They are the ones to spot the issues early on, to encourage treatment, and most importantly to reinforce the idea that there is no shame in having a mental illness. They promote that it’s OK to talk about it and ask for help.
To support those nurses and health care professionals on the front lines who are working hard to destigmatize mental illness, Capella University has launched a #BreakTheStigma campaign. The following five strategies can help raise awareness of the importance of talking about mental illness, eliminate the sense of shame associated with it, and provide actionable advice for health care professionals and others to bring the topic of mental illness into the light without judgment.
Not all of those who are suffering from a mental illness seek treatment. They are embarrassed. Or they don’t think of themselves as mentally ill. They believe they can handle it. The problem is, too often, they can’t. Unfortunately, sometimes help only arrives when they visit a clinic or hospital for another illness, and only then if the nurse or other health care professional knows enough to explore the psychological side of their issues.
“We are seeing so many more patients with underlying mental health issues,” says Beth Houlahan, DNP, RN, CENP, senior vice president and chief nurse executive with UW Health. “So often we focus on the presenting physical issue but don’t pay attention to signs of an underlying mental illness. It’s critical that we look at the whole person. We need to ask those probing questions.”
Laurie Benson, executive director of Nurses on Boards Coalition, strongly agrees.
“Absolutely, asking those more intimate questions can lead to a critically needed path of treatment,” Benson says. “When I visit my health care provider and am asked those very personal questions, I tell them how thankful I am that they are asking those questions of every patient because it’s so important. It can be as simple as taking a long, respectful pause in the conversation to give the patient the time and space to go from fear and embarrassment to sharing and opening up.”
Because the unwarranted shame and embarrassment that so often accompanies mental illness can be deeply rooted, simply asking a series of questions and taking the answers at face value doesn’t always expose the issue. This can require something more: an intuitive sense when something isn’t right that a patient is holding something back.
“Nurses in particular have deep gut instincts, and it is so important that they use them,” Houlahan says. “Nurses need to trust their intuition and take the time to further the conversation or find another way to unearth the issues. There is always another path if you sense something is wrong.”
One of the most effective ways to get patients who are exhibiting signs of mental illness to open up is simply to let them know they are not alone. Everyone has been affected by mental illness in some way. Everyone. Either personally or through a family member, friend, neighbor, co-worker, etc. Health care professionals who share their own stories of how mental illness has impacted their lives can open up a dialogue that otherwise might never happen.
“As professionals we have a privilege and responsibility to be honest with ourselves about our own experiences dealing with mental health issues,” Benson says. “Our patients need to know that we get it. That we’ve been there. That we are not going to judge them. That we care deeply for them. Once they believe that, they are more likely to share.”
For many who suffer from a mental illness the feeling of isolation is not just emotional—it can also be physical. For those who live in rural or remote areas, or for those who have mobility issues, accessing a qualified mental health provider can be a challenge. The good news is that there are a multitude of technologies to break down that isolation—if they are invested in and used.
“There is so much we can do today to connect with people via technologies like real-time video chats, texting, or just phone calls,” Houlahan stresses. “We need to leverage all of the technology at our fingertips and continue to invest in tele-health. Our patients deserve that. They need to know that is an option for them.”
As the sobering statistics regarding the prevalence of mental illness indicate, we must not think of mental health education and care delivery as anything other than core to overall health care strategy. Unfortunately, at many hospitals, clinics, and higher education institutions, that is not yet the case. According to Jennifer Dixson Hoff, vice president of Portfolio Strategy for Strategic Education, Inc., it absolutely needs to be.
“Educating the next generation of nurses and mental health professionals needs to be deliberate, thoughtful, and comprehensive,” Dixson Hoff explains. “There is too much at stake to not take this head on and with as many resources as we can. Plus, there is such an incredible feeling of meaning and purpose for those who choose a career in the mental health field. You may not ever fully know the impact you have in choosing a career in mental health, but it is so very, very real. It’s huge.”
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