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What is mental health?

Gaylord Herald Times - 7/26/2017

Editor's note: As part of a yearlong series, the Petoskey News-Review, sister paper to the Herald Times, will consider a number of different issues relating to mental health and mental illness in Northern Michigan. This is the first installment in the monthly series on mental health in the community.

Mental health and mental illness face stigma and challenges of being unknown and rarely addressed in the community.

But changes to the approach of health care, along with efforts to raise awareness, can help address the needs and concerns of mental health in Northern Michigan.

Mental health used to be considered a separate concept from a person's everyday health, yet more primary care physicians and mental health specialists now are working in conjunction to address the health, both physical and mental, as an integrated approach to wellness.

"The brain is another organ the body. And just like other treatments for organs, like your heart or your pancreas, they're all seen as physical health. But we separate the brain from everything else in the body. So if something happens with the brain, we attach this judgment to it," said Stacey Chipman, chief clinical officer of North Country Community Mental Health in Petoskey.

The issue of mental health faces a strong stigma, but according to the National Alliance on Mental Illness, one in five adults in the United States experience a mental illness in a given year, while one in 25 in the country experience a serious mental illness in a given year that substantially interferes with or limits their everyday life.

"Basically, when we talk about mental health, it's about people being able to live their lives in a way that is relatively free from undue distress," Chipman said. "We all have hard times in our lives, and obstacles to overcome. And there comes a point for some people, either because of brain chemistry or an anomaly, or extreme emotional distress, that they aren't able to navigate regular life without a great deal of distress."

Health on a spectrum

Rather than considering mental health as a binary issue - either you have a mental illness or you don't - Natalie Kasiborski of the Health Department of Northwest Michigan suggests thinking of mental health as a spectrum, similar to how we address physical health.

For physical health, we address lesser issues with over-the-counter medicines or bandages and annual checkups, and see primary physicians for more moderate concerns. When a physical injury or ailment becomes more severe, we visit a specialist to address the problem.

Kasiborski said the same spectrum exists for addressing mental health, but it's just not commonly realized by the general public yet.

"Everyone falls somewhere on that spectrum," Kasiborski said. "I try to normalize mental health as a regular part of wellness. Right alongside how someone takes care of their physical health, they need to be conscience of or mindful of their mental health."

The spectrum can be broken down into two parts. There's the level of the stressor, whether it's mild, moderate or severe mental health issues. Mild can be the everyday stressors we face, moderate can start to see the everyday stressors being exasperated, and severe reaches more clinically diagnosed mental illnesses.

Everyone deals with stresses in their life, and that can cause issues for mental health. These tend to fall on the mild to moderate areas of spectrum. The severe end of the spectrum can be a more chronic or persistent condition.

The second spectrum that Kasiborski mentions is the spectrum of addressing mental health concerns for everyone. It ranges from promotion to prevention to intervention.

Promotion is helping people be mindful of their mental health and conducting activities that help relieve mild stressors and conditions.

"Promotion is being aware of the concept, that mental health plays a part in how you feel every day. You need to make decisions in your life to support your mental health. Then there's prevention, which can be different for everyone. It's what works for you. I might enjoy yoga, or going for a walk by the water. That's positive for me, but you might enjoy fishing or a crossword puzzle. It's really individualized," Kasiborski said.

These can help address more mild stressors, but prevention for more moderate or severe concerns can also involve talking to a licensed mental health provider.

Intervention largely involves the far end of the spectrum, where an individual seeks treatment from professionals to address a specific mental health issue. That can range from anxiety, depression, bipolar disorder or schizophrenia, the more severe and chronic conditions that affect mental health.

Body and mind connection

The health of your mental state can also be affected by your physical health, and vice versa, said Amy Christie, chief quality officer for North Country Community Mental Health.

"It's really important to know that physical health goes hand in hand with mental health. It impacts each other," Christie said.

For example, diabetes and having high blood sugar can affect a person and make them feel more reactive and argumentative or feel depressed.

Yet in the last year, according to National Alliance on Mental Illness and the Substance Abuse and Mental Health Services Administration, 60 percent of adults with a mental illness didn't receive mental health services.

"It's important to get the awareness out there that it can impact anybody at any time. And it makes it more challenging because it's not something you can touch or see. It's something that's internal. You can see someone is bleeding, or a broken bone, but you can't see depression. You can't easily verbalize it,' Christie said.

The link between physical and mental health is one reason why there's a stronger emphasis of integrating treatment of both in medical services. Christie said she works with teams which include nurses. In these, she and her coworkers work on mental issues while nurses work closely on the medical side of the condition.

"It takes a village. You need the support from all aspects of the community to focus on community mental health. The hospitals, the health department, law enforcement and the general community. You have to have everyone at the table to solve the problem," Christie said.

"The more that we talk about mental health and reduce the stigma of talking about it, I think the more aware everyone becomes," said Chipman.