While having lunch with a friend recently, I learnt that his wife has been clinically depressed for years. He described how destructive her state of mind is to their marriage, which had been perfect before her depression. While reflecting on her irrational behaviour towards him and their children, I must have said something like, “It’s such a shame”.
The comment angered him; he correctly responded by saying, “Imagine if I had said my wife has cancer or another serious physical disease. You would have reacted with much more empathy and shock at the terrible effect on my formerly intact family.” The fact that her condition was mental, rather than physical, unconsciously triggered me to partial blame her for her condition.
Therein lies the crux of the problem from a societal point of view: We still have not accepted mental illness as the equal of physical disease and do not give victims the medical attention they deserve, thereby further worsening the condition.
Such societal behaviour becomes exponentially problematic when dealing with post-traumatic stress disorder (PTSD) on a large scale. When refugees arrive in Europe in need of our help, we also need to care for their mental health, next to ensuring they receive the appropriate vaccinations and other medical care.
Most of them are fleeing from traumatic experiences, which, if neglected, can be extremely destructive to the individual and those around them. To be properly integrated into our society, a person needs to have good mental health.
We must treat mental affliction as a disease, instead of categorising it as a threat and treating it as misbehaviour to be isolated from society and punished. The less understanding our society has towards the problem, the more victims will be motivated to hide their mental illness and thereby worsen the situation for all.
Therefore, in late 2016, I initiated a written declaration in the European Parliament, ‘The mental health of asylum seekers’. I failed to receive enough signatures from my MEP colleagues, but the process was crucial in raising awareness for this important topic.
The greatest obstacle is the inadequate insurance coverage for mental health problems. Insurance companies should be the first to understand that, without their endorsement of the problem, many people cannot afford to be treated and their situation will consequently worsen.
This increases costs for the insurance company, through the many related side effects and, on occasion, the complete breakdown of the individual. In addition, care for mental health patients is often fragmented.
Medication is often prescribed without support from, for example, behavioural psychologists. At the same time, psychologists are unable to prescribe the adequate medication to complement treatment.
Each healthcare system needs to conduct a community health needs assessment and create an integrated system that takes into account the characteristics of each population. Has a national trauma occurred, such as war or a repressive dictatorship? Do certain groups or segments of the population live in an alternative reality to the other?
Just as it is naive to believe that Syrian refugees that have suffered the horrors of a civil war can be integrated seamlessly into local society without previously dealing with their PTSD in a serious manner, it is wrong to simply overlook the mental effects of the fascist dictatorships in Portugal and Spain on large segments of the population.
The same applies to the psychological effects of the oppressive rule of communist dictators in many eastern European countries. We need to ask ourselves what it means to live in a constant state of threat and/or fear and we need to deal professionally with the results once the threat or fear dissipates. As with all problems, mental disorders grow if not confronted and treated.
The time has come for the integration of mental and behavioural health within physical health. Tens of thousands of people with mental health problems are living in psychiatric and other institutions in Europe today. Hundreds of thousands live under full guardianship, isolated from society and deprived of the right to make the choices that make up our everyday lives.
People with mental health problems need to be placed at the heart of their treatment plan and need to be able to make their own decisions on their respective care.
Too many patients are still being isolated and let down by a coercive mental health system. We can, and should, do better in order to ensure that mental health services are centred around people, their recovery and that they fully respect their human rights.