My 75-year old mother has had mental problems all her life. When I was a teenager and young adult, my mom was the only person I knew who had mental problems.  Nowadays, everywhere you turn, people talk about themselves or a family member who is dealing with some sort of mental health problem. Have we really come that far in identifying and helping people or are we too quick to label someone? Is this a positive thing?

It is safe to assume that there has been no real increase in the actual rate of most types of mental illness over the past few decades (or the centuries, for that matter).  Any apparent increase can be attributed to several factors:

As you suggest, there has been a significant increase in our ability to identify such illness, coupled with cultural changes in understanding the causes of such problems. What once may have been called “demon possession,” for example, might today be understood as a genetically inherited mental illness (such as schizophrenia or bipolar disorder).

As our understanding of such problems has changed, treatment methods have also improved. Improved understanding of mental illness, and of pharmacology, has resulted in many new and powerful tools that can reduce symptoms. For example, the devastating symptoms of schizophrenia can often be dramatically reduced with modern antipsychotic medications. Hand-in-hand with these changes in understanding of mental illnesses has been an increased acceptance by society of responsibility for the care and welfare of individuals who cannot care for themselves. While initially this may have been primarily in hospitals and asylums, improved treatments have increasingly made community-based treatment possible (and, therefore, greater visibility of the mentally ill in the community). Furthermore, increased understanding of emotional and behavioral problems as illness has reduced cultural stigma, making it easier for individuals and families to disclose such difficulties.

When you were a child, families that had relatives who could not function in society, quietly cared for them in their homes (or, too often, lost track of them into the streets and asylums). Today, with greater community understanding and acceptance (and potential support from other individuals and families facing similar problems), families can be more open. Having said this, some types of “mental disability” are on the increase. An example is dementia, including Alzheimer’s, marked by gradual loss of memory and cognitive functioning. Although there are several types of dementia, most are associated with aging and, as our population ages (in part, of course, due to improved medical treatment) more individuals are being afflicted. So are we “too quick to label someone” mentally ill?  Perhaps, sometimes; any new tool is subject to misuse or abuse. But misuse or abuse of useful new tools would not mean that understanding, acceptance or improved treatments for mental illness were not good, would it?

Ronald Scott, Ph.D.
Psychologist, private practice
St. Louis County, MO

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