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Sunday, April 16, 2017

Minority or Marginalized?

I've read an extraordinary number of scholarly articles and books about mental health, both clinical and public policy oriented. There exists a tremendous quantity of published written material about children, substance abuse, trauma, recovery, how to relax and meditate, and cultural diversity. These are important issues, and certainly are useful to many professionals and patients. In spite of the abundance of these publications, there exist the following facts that I cannot ignore.

  • Severe mental illness often strikes in early adulthood. Suicide is more common among older adults. 
  • Substance abuse covers up signs of severe mental illness.
  • Trauma does not cause schizophrenia. Trauma does not cause bipolar disorder. Trauma does not cause bipolar disorder with psychotic features. Trauma does not cause schizoaffective disorder. Trauma does not cause depression with psychotic features. 
  • Some people never recover from mental illness. Find fifteen articles about mental health at random. Count how many times the word "recovery" is used. Then count how many times the word "deterioration" or "relapse" or anything opposing "recovery" is used. How and why did this one word become so popular? 
  • Relaxation techniques, including meditation, can be useful. I can't think of anyone not interested in learning about or being reminded of such techniques. These are not appropriate treatments for acute psychosis. 
  • Being sensitive to one's culture when psychotherapeutically intervening is important. Schizophrenia exists across all cultures. 

The percentage of higher functioning people with mental illnesses is much higher than the percentage of those with untreated psychosis. Statistics might account for the large quantity of such written publications educating clinicians and the public about these topics. Is there another reason for this?