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Why Should We Put Mental Health First?

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When the subject arises of giving preventative mental healthcare an increased priority – it is typically a short discussion. Why is this? First, and foremost, we have a healthcare system that is built around the treatment of symptoms, rather than preventative care. This is true at all levels, the insurance industry included. There have been efforts made, and some progress, toward fostering preventative care on the medical side of the equation, but these have been largely ineffective because individuals are not held accountable for maintaining preventative health goals. On the mental health side of preventative care, there has been no progress of any significance. There is a limited screening of a person’s mental “state” during most annual check-ups but the activities quickly turn toward medical treatment and, again, largely treatment of symptoms. 

If you look closer at why mental health is not given more of a priority, one of the major reasons is that there is a lack of understanding, society-wide, regarding the volume of medical issues that result from poor mentalhealth. The purpose of this article is to broaden the understanding of the relationship between mental health and medical treatment. There is no better illustration of this than the area of addiction.

Hospitals, clinics, specialized treatment centers, and individual medical practices in the United States (US) are filled with patients who have addiction-related medical issues that find their origin in poor mental health. In a recent discussion with a Nurse Practitioner, they shared that at a national nursing conference they learned that as much as 35% of everything treated in hospitals is related to addiction. It is widely acknowledged that addiction can have a genetic component. However, the primary cause of addiction is poor psychological health, issues that might be addressed in the early stages with preventative mental health care. 

The 35% addiction-related hospital treatment statistic will cause most people to stop in their tracks and think – “How can that statistic be correct?” To understand this you must take a broader view of what represents addiction and understand the true scope of medical care that is required as a result of addiction. This more comprehensive perspective on addiction helps to foster an understanding of why we need to place an increased priority on preventative mental health care.

Why is it important to consider mental health?

Addiction

When someone hears the word addiction, what normally comes to mind are addictions related to substances including alcohol, tobacco, and drugs. Drug addictions include heroin, cocaine, prescription drugs, marijuana, and a long list of others. To have a complete perspective on the total breadth of addiction, you must add behavioral addictions and impulse control disorders to the list of substance addictions previously noted. The behavioral addictions include food, sex, shopping, pornography, playing video games, and some of the less frequently discussed behavioral addictions like work, co-dependency, exercise, spiritual (religious devotion), self-harm (cutting), and others. The impulse control disorders include gambling addictions, stealing, impulsive aggressiveness, pyromania (setting fires), and many others. All of the addictions highlighted above have an underlying cause that is somewhere on the poor mental health spectrum. A deficit of healthy coping skills (used for living life on “life’s terms”) are often replaced with the use of substances, addictive behaviors, or impulse disorders that become a diversion and an alternative reality for the individual. 

Medical Treatment of Addiction

The second step to broaden your perspective on how addiction can impact 35% of what transpires in medical care is to look at examples of medical treatment that result from two of the major addiction areas – substance abuse and food addiction. Starting with substance abuse, here is a profile of the direct and indirect medical treatment stemming from it.

Substance Abuse Medical Treatment Examples

  •  The treatments most commonly associated with addiction are hospitalization for overdoses and aftercare. This might include hospital detox, inpatient facility treatment, and various forms of outpatient care that fall under psychiatry and psychology but are funded under the “medical insurance” umbrella. 
  • The list of direct medical treatments associated with substance abuse is extensive and includes cardiomyopathy (heart muscle issues), an irregular heartbeat, strokes, and high blood pressure. Other areas impacted by substance abuse include cirrhosis of the liver, alcoholic hepatitis, fibrosis, and pancreatitis. Last, there are a host of cancers associated with substance abuse including throat, mouth, larynx, breast, liver, colorectal, and esophageal.
  • The last category of medical treatment associated with substance abuse are the issues that arise from addictive behavior. To get an appreciation for these, you only need to be reminded of the types of cases that show up at the door of emergency rooms at hospitals. These include all forms of trauma due to car accidents, gunshot wounds, stabbings, beatings, falling down stairs, and other forms of injury resulting from an individual acting under the influence of substances (or acting under the influence of not being able to obtain their substance of choice).

The second example of medical treatment resulting from addiction is the area of food addiction and the resulting obesity. In 2009, obesity as a primary and secondary diagnosis appeared in 9.3% of the discharge records of hospital stays. Here are examples of the significant medical treatments that resulted from food addictions and related obesity.

Food Addiction (Resulting in Obesity)

Medical Treatment Examples

  • Primary Diagnosis Treatment – The most common procedures for patients who have obesity as a primary diagnosis are bariatric surgery, upper gastrointestinal endoscopy with biopsy, diaphragmatic hernia repair, gastrectomy – partial and total, and excision of adhesions. 
  • Secondary Diagnosis Treatment – The medical treatment for people with obesity as a secondary diagnosis includes osteoarthritis, congestive heart failure, coronary atherosclerosis, skin and subcutaneous tissue infections, cardiac dysrhythmias, pneumonia, chronic obstructive pulmonary disease, bronchiectasis, and acute myocardial infarction.

These substance abuse and food addiction treatment examples, taken as a whole, represent just a portion of the total treatment that occurs in the medical system due to addiction. If you take all of the addictions combined (substance, behavioral, and impulse disorders cited earlier in the article) and consider the medical treatment that results from each, it is easy to comprehend how 35% of all medical treatment could result from addiction. Considering that all addiction issues are impacted by poor mental health and that the volume of medical treatment stemming from those addictions is significant, it is imperative that mental health care is given more of a priority in the overall health care picture. 

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Glenn Rader is an author, public speaker, and resource in the addiction recovery community. He has two popular books in the addiction field. STOP – Things You MUST Know Before Trying to Help Someone with Addiction (A book for family members and friends of someone struggling with addiction) and Modern 12 Step Recovery (A modern introduction to Alcoholics Anonymous (AA) that includes modern translations of the Steps and the psychology behind the AA program).

Here are links to Mr. Rader’s two books on Amazon: STOP  and Modern 12 Step Recovery.

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