It shouldn’t take a crisis to address mental illness – let’s find a better way [Sacramento Bee]

As you gather with children this Father’s Day weekend, consider how far you would go to ensure their well-being: If your child had cancer or diabetes, would you wait until the disease were critical before you called doctors to intervene?

Of course not. And yet this year, as in every year, thousands of young adults will cross the threshold into serious mental illness and go untreated because of a health care paradigm that California must change.

To understand the need, consider that threshold, which typically involves a marker known asa psychotic break. Those who’ve experienced it describe a form of waking nightmare. Forces outside your control invade your thoughts and carve up your sense of self, sometimes questioning your right to exist, or threatening or demanding destruction.

You might believe that people are following you, or can steal your thoughts. You might even believe that a portion of your brain has gone missing, the piece that held components critical to your identity, such as your love for friends and family.

Psychotic episodes are a defining factor in diagnosing schizophrenia and schizoaffective disorder, and often accompany the onset of mood disorders such as depression and bipolar disorder. These are illnesses that generally manifest themselves in adolescents and young adults – with 40 percent of serious mental illness developing by age 14 and 75 percent by age 25.

Every year in the United States, 100,000 young adults – sons and daughters – experience their first psychotic break. Some get help, but tens of thousands stagger forward in frightened isolation. Some go years without treatment even as their illness progresses, undermining their family life, friendships and ability to function.

For decades, this has been the paradigm for mental health care in this nation: intervention and treatment that come well after the illness has taken hold.

Consequently, much of the conversation continues to revolve around crisis care. We see thousands of homeless people – their lives broken by mental illness – living on the streets, and we wonder how to reach them. We see thousands of inmates living behind bars with mental illness, and we wonder how to fix them.

Try to think of another serious illness that we routinely treat only after it’s reached crisis status. When it’s cancer, our goal is to intervene at Stage 1, and bring the disease into remission. With heart disease and diabetes, it’s the same. Our whole approach is about intervention, education, lifestyle changes and medication – all with the goal of managing the disease.

Why, then, when it comes to mental illness, do we routinely intervene at Stage 4?

HERE to read the entire article written by Darrell Steinberg and Dr. Cameron S. Carter, Special to The Bee