Mental health: Strength in mind, body and soul

I am not an expert on mental health issues; however, I have learned a great deal about the importance of proper mental health care and the general culture of denial about mental illness, the disability you can’t always see. Part of what I’m about to say may sound shocking to some and possibly even offend others—I hope it will serve only as a catalyst for talking points on the issues surrounding our community’s needs with respect to mental health services.

Despite all that I know about mental health services and with the exception of some reluctant attempts to sit through a couple of shrink sessions with my ex-wife, I have avoided psychiatric counseling like the plague…not because I don’t think it works, but because I find it to be a direct invasion of my privacy. To date, I have absolutely refused to lay myself out on the proverbial couch for anyone to get in touch with my personal demons whatever those may be. I’ll hear you knocking, but you can’t come in. And so through all the good I have seen by way of modern methods for psychotherapy, I still find the whole notion of traditional psychiatric counseling repulsive, intrusive and downright unnatural. After a hard day’s work, what I want is a cold beer, a smoky cigar and a few good friends…that’s what I call therapy, but here’s the rub: This timeless method for personal therapy does little more than temporarily distract me from the general stressors of my life and in some ways actually perpetuates them with the collateral damage of hangovers, chronic obesity and other general health concerns. I said give me a cold beer, but the reality is I rarely have just one. So, herein lies the primary barrier to appropriate mental health care. Some of us simply don’t accept when something may be wrong within our psyche, we won’t buy into psychotherapy and we choose unhealthy alternatives often in the form of self-medication to cope with our day-to-day angst.

As I started thinking about ways to achieve better mental health for myself, I began to look a little more closely at existing systems for mental health care in the CNMI. Sadly, in my opinion, the outlook is bleak. For one thing, there is no psychiatrist on island, thus we lack a very crucial piece of the medical model for psychiatric treatment. To my understanding, psychiatrists, unlike psychologists, are licensed to prescribe psychotropic medication on which numerous people rely. Currently, our Department of Public Health relies on a couple of its general practitioners to manage the caseloads for mental health treatment in addition to the regular workload of patients with other types of ailments, certainly not the ideal by any standard. I know of at least one instance whereby it took over a week for one psychiatric patient just to make contact with the doctor in charge of handling psychiatric needs. Beyond that, it is not uncommon for people to try and access services through our lone psychiatric ward only to be turned away at the door for reasons of which none seem to make much sense in the face of a psychiatric meltdown. The results of these gaps in mental health services have led to some extremely sad outcomes, including one instance wherein a young man stabbed another person multiple times shortly after being turned away from the psychiatric ward where he was trying to check himself in because he was “hearing voices”. That young man has been in jail since for murder, a tragedy that arguably could have been avoided with an appropriate response system for people in psychiatric crisis. Another incident involved a young lady who lit herself on fire sometime shortly after being denied access to the psychiatric ward. And then there is the story of another young lady being picked up by the police for causing a public disturbance only moments again after being directed away from the ward where she was trying to get help. The point being that the mental health system as we know it leaves much to be desired and this lack of an effective system of care poses yet another major barrier in the general quest for good mental health. It seems the reality of life in the CNMI is that most of our critical service areas are in dire need of an upgrade.

In recent years there has been a growing voice from among recipients of mental health services that is beginning to challenge the traditional views of mental health care with a paradigm shift in thinking away from the medical model of treatment to a broader, more earthly approach at wellness. Proponents of the “wellness plan” essentially argue that in order to get better, people with mental illness need to foster a sense of peace in and around themselves through an environment of supportive and mutually respectful peers. They might argue further that a typical treatment facility with a prison-like atmosphere and authoritarian wards goes against the grain of a true path to recovery. Additionally some debate that psychotropic drugs do little more than sedate feelings of torment whereas a daily dose of healthy activities (i.e., exercise and/or relaxation) can actually have a healing effect. In short, a wellness plan looks to develop a person’s strength in mind, body and soul independent of artificial drugs and the illogical settings of traditional treatment facilities. For lack of a better way to describe it, a wellness plan looks to draw strength from the positive vibrations of life, the natural mystic as it were—the presumption is that we all have an inherent capacity to be high on life.

Ultimately, every individual with a mental illness is just that, an individual, so contrary to what the different schools-of-thought may suggest, there really is no one-size-fits-all treatment plan for all people with mental illness.

The problem, and yet another significant barrier to good mental health, is our very human tendency to close ourselves off from possibilities outside of what we’ve been taught. The medical doctor may dismiss the notion of a holistic cure in lieu of a carefully scripted regimen of drugs and the natural healer may view artificial pills as the source of all evil. The fact is some people function very well with their mental illness without prescribed drugs and others simply do not. We are an ever-evolving, multi-faceted phenomenon, so what works today may not work tomorrow and what works for Dick might not work for Jane. Sometimes the best we can hope for is to live out our days in the comforting embrace of people who love, respect and support us. I personally don’t know of a better wellness plan.

For more on services for individuals with mental illness and people with other disabilities, please feel free to call NMPASI at (670) 235-7273/4 [voice], 235-7278 [tty], 235-7275 [fax] or check us out on-line at www.nmpasi.com.