Examining Our Biases About Mental Illness

“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?

Psychiatrists as Therapists: A Vanishing Breed

By Maureen Shawn Kennedy, AJN editor-in-chief

In an article in the New York Times on Sunday, writer Gardiner Harris described how many psychiatrists have abandoned psychotherapy in favor of short consultations and pharmacotherapy; if patients want to discuss their problems, they are referred to a therapist. The main driver of this trend is money—with other, cheaper professionals available to provide therapy with comparable results, insurance companies won’t pay the higher fees most psychiatrists charge. So, instead of seeing 50 to 60 patients a week for the traditional 45-minute session on the psychiatrist’s couch, the psychiatrist can see 1,000 or more patients in a 15-minute, “what’s happening? do you need a medication adjustment? see you next week” check-up. As the wife and business manager of the psychiatrist profiled in the article says, “It’s all about volume.” One only hopes that most of the patients take his advice to see a therapist.

In fact, there is a growing body of evidence favoring psychotherapy over medications in mental health, notably in depression. In a recent meta-analysis in the Journal of Nervous and Mental Disease comparing psychotherapy with second-generation antidepressants (SGAs), researchers found that “ [b]ona fide psychotherapy appears as effective as SGAs in the short-term treatment of depression, and likely somewhat more effective than SGAs in the longer-term management of depressive symptoms.” 

And in the March issue of AJN, we report on a study published in the Archives of General Psychiatry, which found that “cognitive therapy combined with […]

Today is Veteran’s Day . . .

By Shawn Kennedy, Interim EIC of AJN

 . . . and unfortunately, because of conflicts in Afghanistan and Iraq, there will be many more veterans of war and its brutality. And there will also be many more families who struggle with the stress of having a family member deployed, often to dangerous places.

In this month’s issue of AJN, Erin Gabany and Teresa Shellenbarger, authors of the feature article “Caring for Families with Deployment Stress,” note that “deployment was found to have a markedly negative effect on health and well-being, with spouses reporting loneliness, anxiety, and depression in 78.2%, 51.6%, and 42.6% of all cases, respectively.” And just this week, a study published in the journal Pediatrics reports that, among children ages three to eight, “[m]ental and behavioral health visits increased by 11% in these children when a military parent deployed; behavioral disorders increased 19% and stress disorders increased 18%.”

While nurses in the military may be aware of the demands and stresses on active duty military families, civilian nurses may not be—and they are the ones who are likely to see the families of the many reserve and National Guard troops now deployed. We’re pleased to be publishing Gabany and Shellenbarger’s article, and hope it will increase  awareness of the issues many families face and help nurses provide support to these families.  

Nurses, too, are being deployed in large numbers; many, like army nurse Major Christopher Vanfossen, author of our new […]

2016-11-21T13:15:01-05:00November 11th, 2010|Nursing|0 Comments
Go to Top