THE BLOG
08/05/2013 11:12 pm ET | Updated Oct 05, 2013

Stop Recycling Clichés About the Mentally Ill

Lately, it seems that there has been a spate of articles and op-eds regarding the mentally ill, in which writers have referred almost routinely to "revolving-door patients" as well as a "cycle" of homelessness, incarceration and hospitalization that, the writers suggest, afflicts people with mental disorders. The writers sometimes qualify their phrasing a bit by indicating that not all or even most of the mentally ill fall into these categories.

And yet because news outlets almost never report on stories of survival and hope, the reader is left with the distinct impression that the mentally ill are hopeless, destined to a life in and out of jail.

Further, the reader comes away from these columns with the sense that the mentally ill are irresponsible, cannot work and drain the country's resources more than anyone else.

While I have not come across any studies that specifically break down mental illness by income level, I did discover salient demographic information on the web site of the National Institute of Mental Health, which documents the prevalence of mental illness by age, gender and race.

As per data from the Substance Abuse and Mental Health Services Administration, serious mental illness afflicts roughly 4% of adults in this country. Women are more likely than men to experience a mental disorder, a result that may not be surprising given the self-defeating, macho attitude of many men, who often do not wish to report such an illness.

Of more relevance to this discussion, whites are more likely than minorities to suffer from a serious mental illness. I am struck by a few points here. For one, it is possible that whites overall have a greater awareness of mental illness, feel a lower level of stigma and thus are more likely to report a mental disorder.

But it is also true that whites on average tend to have greater financial resources than minorities and as a result are more likely to be able to afford mental health care and avoid the so-called "cycle" of despair discussed earlier.

That is not to say that mental health care is cheap, but it is far from the most expensive medical cost exacted on society.

According to the Agency for Healthcare Research and Quality, the average costs of mental illness in this country declined from $1,825 per person in 1996 to $1,591 in 2006. Compare that to the average cost of cancer treatment, which was more than $5,000 per person in 2006, and the average cost of heart treatment, which was about $4,000 per person in 2006.

I cite these statistics because if one did not know any better one would think that the mentally ill not only siphon off more funds than those with other illnesses, but also that the mentally ill are recidivists who keep ending up in jail, in hospitals and on the streets.

Yes, I believe in Kendra's Law and the equivalent laws in other states. It is important to enforce outpatient treatment on those who have severe mental illness and a propensity toward violence. And, yes, I recognize that a reasonable percentage of the incarcerated have some form of mental illness, but, as I have written time and time again, those with severe mental illness commit only 3 % to 4 % of violent crime in this country.

There is no doubt that President Obama's Affordable Care Act, when fully implemented, will continue to lower the costs of mental health care in this country. And it should lessen the frequency of people with severe mental illness showing up in emergency rooms, which costs the country more dearly than outpatient treatment.

We should all cheer this law, which will cover people with pre-existing conditions, including mental illness.

But we should also keep in mind that the vast majority of people with mental illness will never spend time behind bars.

It would be nice if we could stop recycling such clichés about the mentally ill and report instead on some of the great success stories in this country in recent years. I would like to think that some of these success stories have come about due to the persistence of those of us who have helped to decrease stigma by writing for years about our recovery from severe psychosis and depression. Not everyone gets better, but the lion's share do not become "revolving-door patients" either. That distinction seems to have been lost in the recent articles on this subject.