Mental illness awareness â€” or the lack of It August 1, 2004 Regular News Mental illness awareness — or the lack of It Angela D. Vickers Why do we know so little about mental illnesses? Perhaps it is, as a physician speaker at a recent national mental health conference reminded attendees, that 90 percent of what we know about the brain has been learned in just the last 10 to 15 years. A typical physician or mental health professional over 40 may be greatly outdated in his or her knowledge and understanding of psychiatry, mental illnesses, and the latest advances in assessment, treatment, and recovery. Many physicians and other professionals have not invested the substantial time necessary to keep pace with the rapidly advancing medical information. The Report of the Surgeon General’s Conference on Children’s Mental Health: A National Action Agenda, 2001, states that we are “facing a crisis in mental health for children and adolescents.” This report emphasizes the need for education.Medical specialists understand that early recognition and treatment will prevent what was, for years, considered to be the inevitable progression to chronic and severe mental illness. Although much is now known about how to treat the common mental illnesses, getting this vital information out to the public is the challenge. Education —through the combined efforts of the media, medical professionals, our faith leaders, our educators, and our legal community —is the solution.National jurisprudence is just beginning to focus on “mental illness awareness,” and legal education about mental illnesses will protect both lawyers and clients. In 2001, the Florida Supreme Court launched what was a quiet, polite, courtroom-based civil rights movement for the 54 million Americans who have mental illnesses. The court changed the Rules Regulating The Florida Bar, adding “mental illness awareness” to the mandatory category of continuing legal education courses for all Florida lawyers. Rule 6-10.3 (2001). Placement in the mandatory category of CLE courses prioritizes this topic equally with ethics, professionalism, and substance abuse. Despite the addition of mental illness awareness to the categories of mandatory courses that every lawyer must take, many areas of the state and many areas of practice have not offered any CLE courses in mental illness awareness. Additionally, some of the CLE courses approved for mental illness awareness credit did not teach attendees about mental illnesses, although they may have dealt with procedural issues concerning mental health laws, such as the Baker Act. As a result, advocates, persons with a mental illness (and their families), and lawyers aware of the injustice are approaching bar associations in nearly every state, requesting training for the protection of the rights of those with a mental illness.The wheels of justice turn ever so slowly. Although national studies commissioned by President George W. Bush and former President Bill Clinton have confirmed that mental illness problems have a major negative impact on our economy, our workplace, our safety, our marriages, our productivity, our general health, and our children, America is slow in overcoming the shame and fear of discussing mental disorders in public. Until the legal system understands the illnesses and the legal issues they create, millions of Americans will remain shamefully closeted, fearing discrimination.Delay in recognizing and properly treating mental illnesses can be deadly; untreated illnesses cause devastation in thousands of families every year. Over 30,000 Americans, including lawyers, take their own lives each year through suicide. Their deaths could have easily been prevented, if they, and those around them, had learned basic facts about brain illnesses. Medical experts report that 95 percent of all suicides are the result of untreated, or improperly treated, depression or bipolar disorder. These mood disorders are very treatable (with an 80 percent recovery rate with prompt and proper medical care), and are easy to recognize when the observer has had at least a basic introduction to the common symptoms. Yet thousands die each year.Perhaps this is due in part to the stigma attached to the popular stereotypes of mental illness that are promulgated through the media. It would be safe to say that most people view mental illnesses as a serious, but negative, condition. They would not wish to acknowledge that a friend, or they themselves, is afflicted by such a serious problem. The fact that mental illnesses are responsive to many forms of treatment and have a high rate of recovery is not discussed on the morning talk shows. Accurate information about mental illnesses never seems to reach the public.Major social reform has often come through the courts — from school integration to addressing sexual harassment and other forms of discrimination. With civil rights including the inalienable rights of life, liberty, and the pursuit of happiness, many rights of the mentally ill are being violated. Persecution is so likely that most in this huge class of citizens do not even tell their closest friends about their area of diversity, despite the fact theirs is a common, treatable medical diagnosis, affecting approximately 20 percent of the population. These millions share common, treatable brain illnesses, and are referred to, shamefully by many, as “the mentally ill.” A civil rights lawyer explained to me that “they are not a protected class.” If they were even able to find representation that understood basic facts about the disorders and recovery, we might not be in our present mental health crisis. Only with the help of an educated legal community will civil rights be protected and restored to the over 54 million Americans who have one or more of the common mental illnesses.As the legal community becomes more educated about problem areas in mental health, there will be increased accountability for the medical profession and all mental health professionals. This will encourage “best practices” and will raise the level of practice in all mental and substance abuse treatment fields. For too long, mental patients have been presumed “crazy” and not credible witnesses. Misunderstanding and misinformation about mental illnesses has discouraged malpractice litigation in psychiatry or psychology, due to the lack of training for judges, lawyers, and juries. We have tools to remedy this situation, and now we must use them. Angela D. Vickers of Jacksonville is a member of the Quality of Life and Career Committee and is the recipient of the 2004 Clifford Beers Award of the National Mental Health Association. This column is published under the sponsorship of the Quality of Life and Career Committee. The committee’s Web site is at www.fla-lap.org/qlsm.