Imagine if we educated people about heart attacks by telling them the symptoms of a heart attack—but nothing about the leading causes. What if people didn’t know they could be genetically predisposed, or that eating fatty foods could lead to bad cholesterol, which in turn could lead to a heart attack. It seems a silly, considering the information is out there—however, what could this kind of education lead to? Perhaps most people would be unaware of heart attacks—they don’t affect everyone, after all. Perhaps there would be a stigma surrounding heart attacks—oh, only fat people have those, it won’t happen to me. Perhaps someone will live in fear of having a heart attack because they don’t know what to do to prevent one.
While this seems hypothetical, this is exactly how people are educated about mental illness in the Navy. We have a robust suicide awareness training program, but suicide is a heart attack. And while we teach some of the causes that can lead to suicide—traumatic experiences, personal loss—we don’t talk about the leading cause: mental illness.
For example, most people don’t know that attention deficit hyperactivity disorder (ADHD) is overdiagnosed in men and underdiagnosed in women. This is because testosterone causes the imbalance to go away when men hit puberty, but estrogen brings it out when women hit the same stage. This often causes women with undiagnosed ADHD to develop anxiety and depression as they attribute their struggles to “be normal” with their own person, rather than a chemical imbalance in their brain. This can lead to lack of self-esteem and self-worth, which can further lead to complications in their jobs and personal lives.
This example is a personal one, as I have ADHD, anxiety, and depression. I’ve probably had them at least since puberty, if not before, and I was not diagnosed until I was 21 years old. I spent 21 years believing that I was a lazy screw-up because I was unaware of my own mental illness. This was due to a lack of knowledge of symptoms and the general stigma surrounding mental illness and the idea that being diagnosed with a mental illness designates you as “crazy”. Both things stem from a larger problem—fear of the unknown.
If the Navy were to institute training on mental health, it could erase the stigma and ignorance surrounding the problem. Much in the same way that spreading awareness of AIDS has tempered the spread of the disease and lessened the fear, mental health training could get sailors manage their mental illness. It would be like someone with a genetic predisposition for heart attacks carefully managing their cholesterol level, whether through self-monitoring or medication.
Another thing that stops sailors from seeking treatment for mental health issues is the belief that they will lose a security clearance or get kicked out of the Navy—neither of which is true, something I can once again personally confirm. (I hold a security clearance and am still in the Navy, even after having been diagnosed by a mental health professional.) If an individual is not considered a danger to themselves or to others, there is no danger in getting treatment for a mental health condition. In fact, this training could not only save sailors from difficulties in their personal and professional lives, it could also improve Navy readiness.
I often wonder how much time and talent is lost to treating sailors after they have a psychotic break or suicide attempt. How much time could we save if we got them the help they needed sooner? It’s like someone with cancer— if you catch it in stage one or two, it’s usually very treatable or at least manageable, because it was found before it became a major problem. But if you don’t catch it until stage three or four, treatment becomes much more difficult, and often takes a great deal more time and maintenance to be effective.
A lesser spoken of reason sailors do not seek mental heal treatment is that they have lived with their mental illness for so long that they don’t know who they are without it. The fear of becoming another person—one you aren’t sure if you like—stops many people from seeking treatment that they need. If these people knew that they would have a support system waiting for them, and shipmates that understood their fear and were willing to encourage them, it could help ease even this fear.
The University of Washington and the National Alliance on Mental Illness agree that 90 percent of those that die by suicide experience mental illness. In addition, those suffering from mental health disorders are at higher risk of committing suicide (though the likelihood varies depending on the type of disorder). Studies done by the U. S. National Library of Medicine and BMC Psychiatry have shown mental health training increases participants’ awareness of mental illness and decreases the stigma surrounding mental illness. Unfortunately, there do not seem to have been any studies meausring the effectiveness of mental illness training on reducing suicide as there have been no long-term studies on the effects of mental health training.
While many education campaigns lack empirical evidence, we can still see the effect of AIDS awareness in the better treatment options available to those with the disease, screening programs that catch the disease earlier, and even reduction in stigma. In the 1980s, AIDS was believed to be the “gay disease” and only contractible by lesbian, gay, bisexual, or transgender individuals. Today, we know that AIDS was originally found in simians, and that it is contractible regardless of sexual orientation. We also know how to prevent the spread of AIDS and HIV with proper protection—all due to educational campaigns.
Mental illness education can support sailors and make sure they get the help they need. Many sailors come from a background that lacks understanding about mental illness, and society at large holds a stigma against mental illness—calling those with it lazy, attention seeking, or crazy. The truth is that mental illness is no different from physical illness. With the right treatment and support it can be managed, if not cured. Ignorance will only lead to more fear and less treatment. Education is the only way to prevent more heart attacks.
REFERENCES:
“Risk of Suicide.” National Alliance on Mental Illness.Org. NAMI: National Alliance on Mental Illness, n.d. Web – 22 March 2017.
“Facts About Mental Illness and Suicide.” Mental Health Reporting. University of Washington School of Social Work, 2017. Web – 22 March 2017.
Naismith S L, Hickie I B, Scott E M, and Davenport T A. “Effects of mental health training and clinical audit on general practitioners’ management of common mental disorders.” PubMed.gov. U. S. National Library of Medicine National Institutes of Health 16 July 2001. Web – 22 March 2017.
Kitchener, B A and Jorm, A F. “Mental health first aid training for the public: evaluation of effects on knowledge, attitudes and helping behavior.” BioMed Central. BMC Psychiatry, 1 October 2002. Web – 22 March 2017.
