Saturday, May 6, 2017

National survey finds many Americans can't identify mental-health problems, and even some who do are unfamiliar with treatment

By Melissa Patrick
Kentucky Health News

Fewer than half of Americans recognize symptoms of anxiety, and many don't know what to do about it, even when they recognize them. And most don't know that prescription drug abuse is a treatable problem.

These were just some of the findings in a federally funded study conducted by Michigan State University that looked at mental-health literacy around four major issues: anxiety, depression, alcohol abuse and prescription drug abuse. It's timely, since May is Mental Health Awareness Month.

Sheila Schuster
"I think that Kentucky has a poor level of health literacy, period, and I would say probably, as the case is nationally, also a poor understanding of mental-health issues," Sheila Schuster, of the Kentucky Mental Health Coalition, said in a telephone interview. She noted that often, Kentucky adults and children alike, tend to use the catch-all phrase "my nerves are bad" to describe any state of poor mental health.

Participants in the study were asked to read short stories about each of the four issues and then asked questions about the stories. Nearly 4,600 people participated in the national, web-based survey.

It found that 54 percent of the participants were not able to recognize the symptoms of anxiety, while 46 percent could. Those who recognized the symptoms were more likely to recommend professional help over self-help strategies, and were also less likely to feel stigma.

Stigma about anxiety remains strong, with 63 percent of the respondents having some level of stigma toward anxiety and 73 percent of them reporting that this stigma exists in their communities.

Anxiety symptoms include restlessness, fatigue, worry, difficulty in concentration, muscle aches, and changes in sleeping patterns.

The study also looked at depression. Nearly one in five Kentucky adults at some time in their life have been told by a health-care provider that they are depressed, according to polling by the federal Behavioral Risk Factor Surveillance System. Nationally, 16 million adults reported they had a "major depressive episode" in 2015.

Symptoms of depression include difficulty concentrating, fatigue, hopelessness, insomnia, overeating, undereating, muscle aches and sadness.

Study participants were better able to identify depression than anxiety, with 69 percent of them correctly identifying the condition, half again as much as the percentage who could identify anxiety. Again, those who recognize the symptoms of depression were much more likely to recommend professional help than those who didn't recognize the symptoms.

A recent Kentucky Health Issues Poll found that nearly half of Kentucky adults know someone who has a serious problem with depression and nearly 70 percent of those polled said they knew who to contact for services for treatment.

Asked about stigma from depression, 62 percent of the respondents expressed some level of stigma about the condition and 71 reported some stigma in their communities.

"Stigma toward people with depression is a huge barrier to treatment, as individuals do not discuss their depressive symptoms, and are therefore unable to get the help they need. Almost 60 percent of individuals who have depressive symptoms do not seek treatment," says the report.

Schuster, a retired clinical child psychologist, said fear of being labeled and fear of stigma often keeps individuals from seeking treatment for any kind of mental health care.

"We see that in the local communities, small-town communities where people are reluctant to be seen going into the community mental health center," she said. "If it was just a doctor's office building or a health center where services were co-located, where you could get physical and mental health services, people would probably be more likely to go in."

The study also looked at alcohol abuse and prescription-drug misuse.

More than three out of five respondents (63 percent) were able to identify alcohol abuse, which affects almost 16 million Americans; 37 percent were not able to identify it.

Two-thirds of those who correctly identified alcohol abuse recommended self-help strategies instead of recommending professional help, suggesting that many might not be aware that professional help exists for this condition.

About half (51 percent) of respondents who couldn't identify alcohol abuse recommended professional help, while 35 percent of this group recommended self-help strategies.

Symptoms of alcohol abuse include spending a great deal of time obtaining and using alcohol; failing to fulfill obligations at work, home or school due to alcohol use; and continuing to use alcohol despite its negative impact.

Prescription drug abuse is a huge problem in Kentucky. In the survey, 68 percent could correctly identify it, but nearly one-third couldn't.

Signs of prescription drug abuse include taking higher doses than prescribed, excessive mood swings, changes in sleeping patterns, poor decision-making and seeking prescriptions from more than one doctor.

And like alcohol abuse, those who recognized prescription drug misuse were much more likely to recommend self-help strategies than professional help, whereas those who did not identify the misuse were more likely to recommend professional help than self-help.

"Nearly eight in 10 people don’t recognize prescription drug abuse as a treatable problem," says the release.

"I'm not sure that people really understand what an addiction is, as opposed to thinking well, they just made a bad choice or they aren't right with God, or those kinds of things," Schuster said.

Individual and community stigma for alcohol abuse and prescription drug misuse was about the same, 77 percent for individuals and 80 percent and 82 percent respectively for communities.

"There is more talk about the addiction issues than there has been, so in some ways there is a lot less stigma about say, that person has an opiate addiction or is on heroin," Shuster said. "I'm not sure it's any better on the mental-health side. . . . If you see people who are agitated, very anxious or very depressed, I think people tend to shy away from them. They don't want to engage with them. They don't want to talk about it. So, I'm not so sure that that is any better than it has been."

Mark Skidmore, one of the researchers, said the survey aims to give health officials and policymakers a better understanding of where to target education and prevention efforts for these major societal issues. The study is funded by the U.S. Department of Agriculture and the Substance Abuse and Mental Health Services Administration.

Schuster said parents need to start talking to young children about how they react to things and help them learn how to better define their emotions. "We really need to educate our kids as much in health topics, both physical and mental health, as we do on pure education topics," she said.

"It would be really helpful if we developed a curriculum where we [encourage] people to ask questions about their mental health, their spiritual health if you will, their behavioral health as well as about their physical health. . . . [to have a] pretty simple check-list of things to at least acquaint people with some of their symptoms" so they would better know when to get help.

Most primary-care physicians and nurse practitioners, don't ask patients, "How are things with you? What's going on in your life? What kind of stress are you under? How are things now compared to six months ago? What is your outlook for the future?" Schuster said. "I don't think they are taking the time to look at that, and yet we know that I think it's 80 percent of the doctor visits are for symptoms that are much more psychological than organic in nature. We need to focus on the whole person."

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