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Mental health a significant aspect of care for the whole person

Nov. 10, 2023, 9:06 a.m.

Original article published in The Paper


Family health care is a field of medicine which focuses on health promotion, disease prevention and treatment of diseases for all ages and genders.

The underlying concept involves a holistic approach that focuses on treating the whole patient and not just the disease. Simply put, you are not your disease, you are a person with a disease.

Mental health is a significant aspect of care for the whole person. Primary care providers (PCPs), who are the backbone of family health care, understand that mental wellness is interconnected with physical health, relationships, and life circumstances.

By considering the whole person, PCPs can identify, diagnose, and treat mental health concerns and partner with the person and other community resources to achieve a balanced life.

Why is mental health important? Undiagnosed and untreated mental illness can result in poor health and social isolation.

There are many physical symptoms of anxiety and depression such as: pain, fatigue, poor sleep, weight changes, nausea/vomiting, diarrhea or constipation, chest pain, palpitations, rashes, headaches, and sexual dysfunction.

Long term outcomes of untreated mental health disease include: addiction, social isolation, higher rates of diabetes, heart disease, strokes, obesity, and suicide. 

Although every person is at risk for mental health disorders, the greatest risk are those who have a parent or sibling with a mental health disorder.

Going through major life events such as trauma, divorce, death of a loved one, or loss of income are significant risk factors. Finally, changes in health and diagnosis of chronic (lifelong) diseases can trigger anxiety and depression. 

There are many barriers that keep people from seeking mental health care. According to a Health and Human Services report, there is a lack of specialty care, such as psychiatry and psychology, in rural areas.

Telehealth may improve access to care in rural areas.  Unfortunately, telehealth visits and urban areas often see long wait times for new patients and follow-up.

Lack of insurance coverage and resources are also a hindrance, for example a 60-minute therapy session costs $100-200 each, according to the US Department of Health and Human Services. 

The stigma around diagnosis and treatment of a mental disorder can cost the person and family both socially and financially. Hysteria is an ancient term first used to diagnose mental health in women.

The idea was that the uterus was wandering in the body causing erratic behavior, seizures, sadness. Later, the uterus was found to not wander, rather considered a bad uterus that caused the symptoms.

During the Medieval times mental illness was viewed as satanic possession and sin. As you can see, our opinions have changed; however, there are remaining stigmas and myths associated with mental health.

 Movies and TV shows often depict people with mental illness as crazy and unpredictable or violent. Public opinion historically has been negative towards mental illness with stereotyping as weak, incompetent, unreliable and to blame for the disease.

 The end result is the individual may experience low self-esteem, anger, and self blame. These myths can result in isolation, homelessness, job limitations or loss, and resource withholding. 

Gender and age are another factor in seeking care. A study by Kaiser Permanente found adults under 35 and women are more likely to seek treatment for mental health. Reasons for this gap include societal norms expecting men to be strong and self-sufficient.

Men often seek external solutions such as increasing work, drinking alcohol, and other behaviors, rather than looking for medical care. Age studies show that generation x and older have not placed priority on mental health and view anxiety and depression as something to deal with quietly. 

Depression screening is a part of your annual wellness exam and anytime mental illness is suspected. Expert recommendations are to start screening at age 12 and throughout the lifespan. There are a variety of worksheets used to detect and diagnose depression. These are in the form of questionnaires. 

Family practice can help to fill in the gaps for various mental health illnesses, such as anxiety, depression, and bipolar disorder.

This is accomplished through screening, diagnosis, referral, and treatment that includes medications and non-medication options.

Health promotion with a balanced diet low in processed and high sugar foods, daily exercise, and adequate sleep are key comments to both mental and physical health.

By addressing mental health within the primary care setting, PCPs ensure that individuals and families receive the support they need to achieve optimal well-being. Together, we can promote a society where mental health is prioritized and nurtured.

Nicole Moore is an NP-C with Burke Primary Care in Morganton.

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