The Waiting Is The Hardest Part

 Why Is Mental Health Segregated From General Healthcare Issues?

 

 

 

Why do we separate dental health from medical health? Especially since the mouth is the gateway to the entire gastrointestinal system. Dental issues lead to systemic issues, such as; blood clots, heart valve infections, sepsis, and even death. Not to mention poor nutritional intake if one lacks the ability to chew effectively or comfortably. Why are our bodies segregated by section for insurance purposes? To the medical world, our bodies are viewed much like the pieces of a butchered cow. Your parts are segmented, wrapped in separate insurance policies (health, dental, vision, cancer, etc) labeled with a price (your premiums, co-pays, deductibles) then placed out on a free capital market for sale. This is all done just as casually as you would find your local butcher has for sale some beef liver, chuck roasts, tongue, and that good juicy broth.

 

Every exhibited behavior from a person with a mental diagnosis is a symptom of an underlying biological process. Even those with personality disorders, develop those disorders because their brain chemistry differs from baseline. For this article, keep in mind the term “Pathophysiology,” defined as a disordered physiological process associated with disease or injury. Granted behavioral choices play into mental health too. Consider what it takes to lift your finger to touch something. The action of touching something requires two elements, a conscious choice to touch something, and the correct neural and vascular pathways to make that action happen. As much as a person with a spinal cord injury may want to reach out and touch something (the behavior) they are unable to, due to the current pathophysiology of their nervous system.  

 

The most commonly thought of symptoms of mental illness are hallucinations and paranoia. Delirium is defined as a confused state, often accompanied by agitation, and may or may not involve hallucinations. But did you know delirium, hallucinations, paranoia, and violent behavior can be caused by medical conditions such as a urinary tract infection, inflammation of the brain from a cold sore on your mouth, dehydration, respiratory distress, or even as a side effect from medications? When the public hears the term “hallucinations” they typically associate it with just mental illness such as bipolar or schizophrenia, which might I remind you are also pathophysiological imbalances of chemicals and neural connectivity in the brain. Hallucinations can also be caused by depression, bereavement, or brain tumors. Hallucinations can be auditory, tactile, or visual.

 

Then why do we consider “the mind” and body as two separate entities that reside in one body? In modern medicine, we tend to treat mental health as completely separate from medical health. Maybe this is due to the ease at which we can test medical health with labs, x-rays, scans, and visual assessments. The mental state and cognition of a person is much more of a subjective assessment; however, their mental state remains the result of a pathophysiologic process that is medical.  Today, the majority of health insurance plans don’t cover mental health benefits. Now your plan summary may say it does, when in fact it outsources all the mental health-related visits and costs to sub-insurers and treats them as completely different than medical. Something like your local butcher selling some of his beef to the big grocery store up the road and they place a marked-up price on the portions they sell. In some cases, you might find you have a medical plan deductible and a separate deductible for any mental health benefits and treatments, including outpatient therapy visits and hospitalization.

 

Now let’s suppose you are a productive member of society, you raise your kids, own your home, and work hard at your job. Then progressively, say over the course of a year, you fight constantly you’re your wife over little things that never bothered you before. You get easily angered and snap at your kids. Your wife talks you into going to the doctor, where your symptoms are chalked up to “stress.” Who knew stress is the diagnosis de jour for the side effects of living the American Dream?  

 

You begin to express paranoid thoughts about the neighbors trying to poison your water. All this leads to you building high fences around your house, quitting your job, and secluding at home. Your wife has had enough of your bazaar behavior, you get violent towards her and she calls the cops. You’re escorted via law enforcement to the Emergency Department where your behavior is too out of control to allow for any tests or assessments, therefore you are given calming medication injected in your arm against your will.

 

Once calm enough the hospital sends you to their inpatient psychiatric unit. During your week-long stay there, medications are not improving your symptoms much. The nurse finally gets you to urinate in a cup so she can send your urine to the lab for testing. While you are at the hospital you also refuse to drink anything but bottled water. Your urine test comes back positive for a raging urinary tract infection (UTI). Your UTI was likely caused by severe dehydration, since you refused to drink water, or any adequate fluid intake, for a week before your hospital admission. The doctor prescribes an antibiotic to treat your UTI and within a few days you are calm enough to tolerate a few more tests.

 

Months later, after being on heavy doses of antipsychotic medications, you get some full body and brain imaging done. Your wife has paid well over $10,000 out of pocket for your “mental health treatments,” including the deductible for both your mental health policy and your medical policy. What the full body scans reveal is you have a tumor on your kidney and one on your brain that impinges on your pituitary gland and the left hemisphere of your brain. These are a couple of neurological areas in the brain that can cause severe behavior changes and paranoia. Your renal (kidney) tumor likely started a couple of years ago and the cancer spread to your brain. Because your diagnosis was so delayed, the brain tumor is now inoperable and you are placed on just symptom management treatments, and within a year, find yourself on end-of-life comfort measures. Not only was your cancer diagnosis delayed, but the brain tumor was given super-growth powers by all the anti-psychotics you were injected with. You can have the kidney tumor removed, along with your left kidney.

 

Now hurray for modern medicine that we can diagnose and very often treat brain tumors, renal tumors, breast tumors, and all sorts of abnormal growths in the body. However, boo for modern medicine because we considered your symptoms as only “mental” in nature and did not consider to the check the pathophysiology behind it soon enough. Your mental health was wrapped and packaged nicely, then kept in the cooler in the back room, because frankly, cow tongues just don’t look that appealing to the majority of the population. Or shall we say, medical and general populations don’t like to see mental health issues on display, hence asylums and mental hospitals. The more “premium” parts of your body were overlooked while the insurance and medical world gawked at your grotesque and harry tongue (mental health) then the customers (insurance and medical facilities) decided not to buy any parts from your hypothetical beef body until it was too late and they had spoiled.