“There’s nothing really wrong with him, it’s just anxiety.” How many times have you heard someone say this—or said it yourself? Mental health problems are among the most marginalized health conditions in the United States. They’re viewed as less “real” than physical illnesses; there’s no tumor to be palpated, no abnormality to be spotted on an X-ray. Emotional and psychological problems are often thought to be under a person’s control in a way that, say, multiple sclerosis or cancer is not. And because mental health problems can be construed as signs of weakness, sufferers may hide their symptoms. People who suffer from a mental illness need to feel comfortable seeking care and to trust that they’ll be treated with skill, compassion, and respect. This is vital: studies consistently find that mental illnesses, particularly depression, take a terrible toll on health. Such illnesses have been associated with an increased risk of stroke, coronary artery disease, and dementia, as well as increased mortality in people with cancer, diabetes, or chronic kidney disease and following a myocardial infarction or coronary artery bypass surgery.

That’s from “Examining our Biases About Mental Illness,” the Editorial in the February issue of AJN by clinical managing editor Karen Roush, MS, RN, FNP-C. What biases and assumptions about the mentally ill, the depressed, the anxious have you seen in your practice? Do you ever find yourself slipping into such biases yourself as a kind of default setting?

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