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Twanette’s Blog

Integrated Health Care

A study completed in the early part of the millennium found that individuals diagnosed with severe and persistent mental illness die 25 years earlier than their counterparts. This increased mortality rate was found to be largely due to treatable medical conditions, many of which had modifiable risk factors such as smoking, obesity, substance abuse, and inadequate access to medical care.

I have worked within the mental health field for all of my adult life. Over the years I have witnessed many people I worked with die at much too early an age. Things like diabetes, hypertension, obesity, cardiovascular/pulmonary diseases, and metabolic syndrome frequently plague individuals with mental illness. It could be argued that lifestyle is to blame for this disparity. However, it is of importance to note that second generation antipsychotic medications are highly associated with weight gain, diabetes, dyslipidemia, insulin resistance and the metabolic syndrome. Additionally, many individuals diagnosed with a mood disorder are prescribed these antipsychotic medications due to their usefulness in symptom treatment. I, myself, have been prescribed some of these for my depression management over the years which resulted in weight gain and diagnosed insulin resistant diabetes.

Please understand that I am NOT by any means saying that someone should not take these prescribed medications when directed. I know that without my medication that I experience such deep despair and suicidal ideation that I do not want to go without them. What I do want to bring to your attention is the need for highly integrated health care to allow for improved health outcomes and life expectancy.  Furthermore, the support of personal empowerment and individual responsibility permitting individuals to make healthy choices for recovery means engaging people with mental illness in their health care in new ways.

What is integrated health care?  Integrated health care is the systematic coordination of general and behavioral health care. Integrating mental health, substance abuse, and primary care services produces the best outcomes and demonstrates the most effective approach to caring for people with multiple healthcare needs. Me for example; I have been diagnosed with arthritis, bursitis, fibromyalgia, diabetes and depression, to name a few. With the amalgamated complexity of these conditions it would not behoove me to compartmentalize by healthcare. My providers really need to be on the same page as these medical conditions, and the medications taken for them, can affect one another. This coordination of care for the patient is what integrated health care is all about.

The country is starting to finally see that to decrease health care cost and increase health care outcomes that a new approach to treating health is needed. We need to stop being reactionary and be proactive. Therefore we need to focus on more preventative health care through integrated health.

Always keep the faith and celebrate life’s sweet moments!!!



Studies show that 1 in 5 people in the United States have a mental illness. That comes to about 42.5 million American adults or 18.2 percent of the total adult population. Data compiled by the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that approximately 9.3 million adults, or about 4 percent of those Americans ages 18 and up, experience serious and persistent mental illness which impedes day-to-day activities such as going to work. However, not all psychiatric statisticians agree with SAMHSA’s findings believing that these numbers underestimate the prevalence of mental illness. A professor of healthcare at Harvard, Ronald Kessler, who is an expert in large scale mental illness surveys told Newsweek in 2014 that although SAMHSA’s number is “good” that he estimates the prevalence of mental illness may actually include from 25% to 30% of adult Americans.

Considering that approximately 25% of the United States population will at some point have a diagnosable mental illness why, in the 21st century, do we still place so much stigma on mental illness?

To determine this we must first understand what stigma is. Stigma can be divided into social stigma and self-stigma. Whereas social stigma is directed toward those diagnosed with a mental illness due to the “psychiatric” label attributed to them, self-stigma is the internalization by the individual of their perceptions of discrimination. (Worth noting, significant self-stigma can lead to increased feelings of shame which oftentimes leads to poorer treatment outcomes.) Overall, stigma is characterized by attitudes of prejudice and discrimination. Even today there are still societal beliefs that view symptoms of mental illness as threatening which then causes attitudes that foster stigma and discrimination towards people with mental illness.

Why am I starting 2015 with a diatribe about the prevalence of stigma in mental health? Because not only would I personally like it eradicated for all those with a mental illness it hits me on a personal level. See, I myself have been diagnosed with a mental illness; severe depression. And although I have extensive education, multiple degrees and 17 years experience working in the mental health field it came no easier for me to hear that diagnosis. Why was this difficult to digest when I know it is a medical condition just like epilepsy or diabetes? Stigma!!!

But I am coming out to you today…let’s be straight, I have severe depression with uncontrollable thoughts of suicide…which is a mental illness. To be honest I have been told by professionals, and believe, this started in adolescence. I take medications daily and have spent years in and out of counseling. However, I would like to be clear that neither the symptoms (I have good days and bad days) or the diagnosis has hindered me as a wife, parent, or professional colleague. In fact, I believe it has made me more patient, compassionate, and understanding of others (and sometimes myself).

So let us make a stand in this New Year and vow to educate ourselves and others on the truth surrounding mental illness because ignorance is what perpetuates stigmatization. Recovery is possible. Life can be more than just tolerated and managed. We are one another’s hope, never stop believing in your dream, and stomp on the temptations of social and self-stigma.

If you need support, remember that NAMI has a team of people to help with education and support so call or come to a group!

Always keep the faith and celebrate life’s sweet moments!!!

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