Treat Stage 1 Mental Illness, Not Stage 4

It was disconcerting to read about the decades-old shortfall of treatment beds for the mentally ill, followed by the article about the new $68 million Cancer Center. Is that stigma quantified?

Ken Duckworth, MD, medical director of the National Alliance on Mental Illness, said at the July 2016 NAMI Convention that psychiatrists should “stage” mental illness like oncologists stage cancer and the focus of treatment should be on “stage 1” intervention, not “stage 4”. He was referring to the RAISE trials, a large-scale research project funded by the National Institute of Mental Health (www.nimh.hih.gov/raise). Analysis of research shows that “the right treatment at the right time” is correlated with an improved outcome; it can change the trajectory of a mental illness. And the right time is early after the onset of psychosis.

Like cancer, mental illness can occur at any age, but most who suffer from a severe mental illness showed signs by the teen or young adult years. Early intervention can limit the severity of illness, improve function at work or school, foster self-care and social support, and reduce suicides, incarceration, disability, and dependence on mental health services. A young person with a mental illness can have a life worth living.

Can we confront our squeamishness with mental illness, concede that the brain is part of the body, and strive for a more balanced approach to all illness through public policy, education, even changing our vocabulary?