Healthcare's Final Frontier

Our Mental Wellness

The COVID-19 pandemic has sent us a clear message. Our mental wellness is the next frontier in healthcare to be addressed. Couple that with the understanding that our physical health and our mental health are inextricably intertwined, and we have a recipe for future healthcare success. Treat the mind, and the body will improve. Treat the body without treating the mind, and treatment will take longer or be far less successful. It’s time to come out from behind the looking glass and peer into ourselves and others with eager curiosity about our mental wellness.

What do the Coronavirus and mental ill health have in common? Well, for starters, nearly everyone is susceptible. With mental illness, one of every two people will experience a mental health issue in their lifetimes. And one out of five will experience a mental illness this year. Look around you. Someone in your family is at risk of mental ill health. Or someone with whom you work. Or a friend. Or someone in your neighborhood. Or in your social circle be it large or small. Or, sorry to say, you.

We’re all in this together, and if we want to leave mental ill health behind us, we’ll have to begin speaking openly about mental wellness and its importance to our overall health. We should demand that our healthcare providers talk to us about our mental health when we see a doctor for a physical health visit. It took a great deal of communicating about the ill effects of COVID-19 and educating people to wear masks and get vaccinated to make progress against this virus. People have felt the tug of isolation-related depression, anxiety, and PTSD as a result of the pandemic in greater numbers than ever before. As unfortunate as this may be, it opens the door to a new understanding that mental wellness must be taken seriously by all of us. Now, even as many countries are on the verge of leaving their masks behind, we still have a long way to go to leave the stigma of mental illness behind us. But there’s hope!

The economic benefits of mental well-being are finally beginning to be addressed in the workplace. In the United States, mental health and substance use costs businesses $80 billion to $100 billion annually. The Lancet Global Health suggests that for every $1 spent on scaled-up treatment for depression and anxiety, there is a $4 return in better health and productivity. That’s a 400% return on investment. It won’t be long before businesses large and small begin investing heavily in mental wellness programs across the board. Many have already begun, and 2021 is purported in Human Resource circles to be the year mental wellness in the workplace finally receives the attention it deserves.

Also like the pandemic and its cures, mental wellness won’t become a reality until we begin talking about it openly and in earnest. Mental ill health remains highly stigmatized in our culture. When we become comfortable discussing our mental well-being in our family units, in the workplace, and with our friends, openly and without judgement, only then will we begin the process of achieving true wellness — physical and mental — and discover a widespread social and personal healing process that’s desperately needed in this post-pandemic world.

The time is ripe now that so many people from all walks of life have been impacted personally by the social isolation wrought by the pandemic. Leaders of industry and governments were forced to stay home with their families, learning that living apart from their zealous world of ambitious high achievers brought sadness, depression, and loneliness. Many suffered directly from the Coronavirus and had to be hospitalized. Others faced stark days when they questioned their own worth. Still others wondered whether they would ever be the same, or whether their lives would ever return to normal. For many, they feared the unknown for the first time. Even the strongest felt the pull downward of a near-complete social, economic, and psychological inversion. Yes, the time is at hand to address mental wellness.

Mental wellness sits at the intersection of cultural beliefs, neurobiology, and behavioral health, with illnesses like anxiety disorder, depression, PTSD, bipolar disorder, eating disorders, and substance misuse among the most private and hidden of disorders. They are hidden because the general perception is one of impairment in such a way as to make the owner of the impairment a social pariah. With this kind of stigma in place across generations, it’s no wonder talking about mental wellness is a challenge. Nobody wants to raise their hand in the face of overwhelming societal pressure to keep them under wraps and under cover for fear it may expose a broad swath of society (50% or more!) as having the very illness they are afraid to acknowledge in themselves.

Fear. That’s also common ground shared by the Coronavirus and mental ill health. Until we overcome our fear of the unknown assailant, we’ll never overcome it. With COVID-19, a massive, global education campaign took place to encourage people to first wear masks and then get vaccinated. Getting the word out to people broadly in as public a way as possible was crucial. Wear a mask and you’ll be safe. Wear a mask and your family and friends will be safe. Get vaccinated and you’ll help protect yourself and others around you. It was a public information campaign that openly talked about a disease and normalized it in everyday conversation. It was exciting to see who would develop a vaccine first. It was about as close to a space race as I’ve ever felt. Finding a vaccine and getting it approved was akin to the first time we landed on the moon. People felt good, really good. And when they got vaccinated, they celebrated by placing their own personal photos on social media that circled the globe. Local, national, and international media coverage was non-stop. Whether people believed the virus existed, or that masks or the vaccine were effective, at least they had no fear talking about the pandemic. And for those who did believe the viral threat was real, they also talked about it openly and without shame or embarrassment.

Can you imagine if we’d been afraid to talk about COVID-19? Or find a way to counteract the Coronavirus? We’d be dark, huddled masses, succumbing to an unseen foe. It would have been akin to the days of the Bubonic Plague (Black Death) back in the 14th Century in Asia and Europe. At that time, there was no rational explanation for it, though today, we know it was spread through the air and via rats and fleas. Back then, people simply died. They expected to die. Today, we know we can take preventive measures, and our scientific and medical research infrastructure’s curiosity-seeking professionals discover cures every day. They talk openly about their discoveries as if they are great accomplishments to be shared with everyone. Gone are superstitious beliefs of the plague being transmitted through the dying looks of an infected person. Or that clouds covering the moon meant imminent death. Or bloodletting, or bathing in rosewater as cures.

Today, we hold out hope for a triumph over cancer. A cure may well be right around the corner. The dark days of fearing to tell people you or a loved one had cancer? Along with the stigma associated with it? Thankfully, those day are long gone. Now there’s surgery, chemotherapy, radiation and myriad other treatments that extend and save lives. The same is true for HIV and AIDS. For polio. For smallpox. For a host of viral and bacterial infections that once caused severe illness or certain death.

Now, it’s time to address the next looming health problem in our society: our mental wellness. The stigma that exists is of our own creation. It is a stigma of the mind as ill versus the absence of stigma when the body is ill. Why must the mind be such an anomaly? It is part of us, we are part of it. We inhabit both. The mind and the body are interconnected so closely as to be almost one. Physical health is needed for mental health. Mental health is needed for physical health. The only way we’ll ever make progress on this front is to begin talking about mental ill health, reporting on it, getting it into the news and social media streams on a daily basis. Can you imagine if every major news outlet, and all across social media, statistics about daily suicide rates in each country, province, state, and city were reported upon daily? Just like Coronavirus infection and death counts. Or that we tracked and reported the number of diagnosed cases of depression? Or those of stress-related anxiety disorder? And that we celebrated as their numbers dwindled?

Similarly, can you imagine how we would begin to understand and triumph over mental ill health if statistics about people completing successful treatment for depression, anxiety, PTSD, eating disorders, or substance misuse were in the daily news cycle? We’d be talking openly about treatment mechanisms, where the best treatment outcomes were occurring, and who had the best therapies available for certain illnesses. It would become a race to find cures, be they therapeutic or pharmacological, naturopathic or neurologic, holistic or some new treatments yet-to-be discovered. It would be exciting for our nation and the world to be a leader in treating mental wellness on a large scale with a personal touch. Sort of like landing on the moon, or discovering the vaccine for COVID-19.

Yes, the next healthcare frontier, now that we’ve developed so many successful treatments for the physical ailments, is the mind. The mind remains the great unknown. It is deeper than the outer reaches of galaxies in how little we understand it, but so close to home because we each own it. But if we allow ourselves to fear the unknown, then we’ll never understand it. If we let the unknown continue to lurk in the shadows it will remain undiscovered and undiscoverable, untreated and untreatable. Today, the final healthcare frontier is our mental wellness. I challenge every reader of this article to talk about their mental health openly with their family members, doctors, friends, co-workers, neighbors, and everyone they meet, with frequency. It’s how we’ll make the next great advance in healthcare. Mental wellness, like it or not, is everyone’s issue. It’s healthcare’s final frontier. Now, let’s address it head on.

We’ll move from here, a place of fear:

to here, a place of greater contentment:

Until we do address our mental wellness in the public forum, openly and without reservation, people who need help will remain out of reach due to the shame of being stigmatized, and they’ll forgo seeking help before a crisis moment occurs. Talking about mental wellness has immediate positive benefits. That person you’re talking with, or asking how they feel emotionally, whoever it may be, young or old, rich or poor, male, female, or otherwise gendered, whatever their race or national origin, may finally feel comfortable reaching out to a therapist or substance misuse counselor. Your words, our words, of encouragement that normalize mental ill health will absolutely have a positive impact on others.

I hope for the day when talking about a therapist and the mental wellness treatment they’ve delivered will be as commonplace as recommending a cardiologist, oncologist, or orthopedist. It would be a whole new world if everyone who talks eagerly about how their latest knee replacement allowed them to get back to walking or playing with their children or grandchildren would speak similarly and excitedly about how their mental wellness therapy helped them get out of bed in the morning with a spring in their step, ready to approach the day. Let’s strive for such a day by actively discussing mental wellness with others.

Here’s a suggestion: be courageous. Let your guard down when you next speak with a friend, relative, or co-worker. Tell them how you feel, for better or worse. I mean how you really feel emotionally, in the moment. Are you happy, sad, stressed, lonely, afraid depressed, anxious, excited, worried, relaxed, nervous, fulfilled, ashamed, fragile, hopeful? Let them know. Tell them why. Then ask how they feel. Let’s see what you get.

Dave Celone lives in Sharon, VT. He is director of development & community relations for West Central Behavioral Health, one of ten community behavioral health centers in New Hampshire, with clinics in Claremont, Lebanon, and Newport. https://www.wcbh.org/