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Mental Hygiene: Preventative Care for Mental Illness

Mental hygiene: lives made better with preventative care.

"How many of you have seen a dentist in the last year?"

During Mardi Gras in New Orleans, I posed this question to about 200 psychologists at the Southeastern Psychological Association to demonstrate the need to shift our focus from mental illness to mental health. Almost everyone in the audience raised their hands. "How many of you have seen a psychologist or a counselor in the last year to assist you with a personal issue?" A smattering, maybe ten raised their hands, most of these with a hesitant, bent elbow. No one, not even professionals in the field, wants to be labeled as mentally ill.

Julie K. Hersh
A Mardi Gras float Canal Street viewed from the balcony of the Sheraton
Source: Julie K. Hersh

Has anyone died of tooth decay? No. Has anyone died of mental illness? About 36,000 per year die by suicide. I would argue that most of these 36K suffered from some form of mental illness, be it depression, bipolar disorder or another flavor. With the costs so high, why is it socially acceptable to practice dental hygiene but not mental hygiene?

Could it just be vanity? If one fails to brush her teeth, one's teeth rot. Severe tooth decay at best means expensive dental care and in the worst case a toothless smile. Everybody knows this. We have cute dancing cartoon teeth encouraging us to brush from an early age. Good teeth are seen as a good thing.

Mental illness, on the other hand, is invisible. Humans have a long history of disregarding what they can't see. Take Dr. Ignaz Semmelweis, a physician in the mid-1800s, who discovered a dramatic reduction in mortality of his patients simply by forcing the doctors to disinfect their hands. He noticed the doctors' ward had mortality rates three times that of the midwives' ward, and suspected that the doctors carried infection from one patient to another.

Unfortunately, Semmelweis fell victim to bad timing. Microbiologist Louis Pasteur proved his germ theory around the time of Semmelweis's death in 1865, too late to prove Semmelweis right. Doctors took offense to sanitation; they wore their bloody surgery coats as a badge of honor. Semmelweis died in disgrace, in an asylum.

Even when Dr. Joseph Lister became an apostle for antiseptic surgery years later, he could not save the life of President Garfield in 1881. Arrogant surgeons insisted on probing Garfield's wound with bare, unwashed hands, leaving Garfield to die not from a bullet wound, but because of invisible germs. Candace Millard's Destiny of the Republic provides an extraordinary account of this catastrophic medical blunder.

Thinking about these stories makes me wonder if human beings won't take mental hygiene seriously until we can see brain scans or DNA mapping to convince ourselves that mental illness is physical. If we taught strong mental hygiene, my guess is we'd see the same dramatic reductions in suicide rates as Semmelweis did with in hospital deaths over 150 years ago.

 Julie K. Hersh
A decadent breakfast, part of my mental hygiene
Source: Julie K. Hersh

What is mental hygiene? Each person's answer will be unique, but there are some things necessary for every plan. All of us need daily attention to the basics: sleep, nutrition, and exercise. Most of us also need a measure of strong social support, as well as cultivation of purpose, perspective and humor in one's life. Finally an annual check by a good mental health care provider, be this a counselor, psychologist or psychiatrist, allows two major benefits: 1) symptoms could be caught earlier, when they are less severe and easier to alleviate, and 2) if a major life crisis occurs (divorce, a death or major life transition) a person would already know where to go for help.

Some of us must attend to our mental hygiene more carefully than others, just as some get more cavities than others, even when they brush. I've been to the dentist twice in the last year even though I have strong teeth (only one cavity). I know the chance of dental decay is unlikely, but I still seek professional help for maintenance. Mental health isn't a permanent state; life changes and we are forced to adapt. We all need mental hygiene. What do you do to brush your brain?

PS I must credit Dr. Susan Sugerman with the dentist/mental health analogy. I heard her use this comparison at the Grant Halliburton Luncheon, so I promptly stole the idea.

For more information about Julie K. Hersh or her speaking engagements, check out the Struck by Living website.

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