Making link between mental illness and drug abuse is key to treatment
Our community is painfully aware of the effects of substance abuse: domestic violence, crime, homelessness, and shattered families are just a few of the tragic outcomes.
We are also increasingly aware of mental health issues which, if left untreated, can lead to many of the same dire consequences.
But what we may not fully understand is the direct link between the two.
As poverty, crime and other social ills become more prevalent, we must examine the undeniable link between mental illness and substance abuse. While we can't say that one "causes" the other, we can say with certainty that persons who have either a mental illness or a substance abuse disorder are at high risk of developing both.
In her address to the Community Anti-Drug Coalitions of America, Center for Mental Health Services director A. Kathryn Power said, "Mental and substance use disorders overlap to a dramatic degree. We will be more effective in preventing and treating drug use when we are more effective in preventing and treating mental illnesses ... and when we recognize their connectivity with one another and that recovery is achievable."
At Kahi Mohala Behavioral Health, Hawaii's only free-standing, licensed center for psychiatry specializing exclusively in behavioral health, more than 80 percent of our patients diagnosed with mental illness are also facing problems with substance abuse. On a national level, the statistics are just as staggering:
» Americans with a substance abuse disorder are almost three times as likely to have a mental illness as those without a substance abuse problem;
» American adults with serious mental illness (such as chronic depression or bipolar disease) are more than twice as likely to "self-medicate" with illegal drugs than those without mental illness;
» Half of persons with a serious mental illness will develop a substance abuse disorder.
A recent study showed that more than 23 percent of adults with serious mental illness were dependent on or abused alcohol or illicit drugs (vs. 8.2 percent among those without serious mental illness). For many depressed, anxious, shy, fearful, hyperactive or bi-polar people, the motivation for substance use/abuse is to just feel what they self-define as "normal." Mental health symptoms may be temporarily relieved by "medicating" with alcohol and drugs. However, as the drug effects wear off, the post-intoxication rebound tends to worsen the original negative feelings, frequently resulting in addiction.
Mental illness and substance abuse disorders are very real illnesses that, fortunately, can often be prevented and cured. Both addiction and mental illness are caused by a complex interaction of psychological, biological and environmental factors. Thus, particularly with an integrated, holistic approach, prevention and treatment of one becomes prevention and treatment of the other.
In 2000, the U.S. Department of Substance Abuse was merged with the Department of Mental Health to form the Department of Mental Health and Substance Abuse -- reflecting the many common approaches to management of both these illnesses.
At Kahi Mohala, we have integrated substance abuse treatment programs, because we know first-hand that our patients with mental illness are more likely to have been diagnosed with substance abuse problems than the general population.
Kahi Mohala is also in the process of working collaboratively with Hythiam and Hawaii Medical Services Association in piloting a new and promising treatment protocol, Prometa, which has had reports of remarkable success rates in treating addictions, particularly alcohol, cocaine and meth-amphetamine (ice).
Nearly all of the patients treated at Kahi Mohala are Hawaii residents, and through treatment, outreach and education programs, Kahi Mohala serves patients across the state. We are proud to have the highest concentration of medical professionals certified in a full range of emotional, physical and behavioral health care, enabling Kahi Mohala to offer the most progressive treatment services and support therapy programs in Hawaii.
We are making progress. We hope that as many of the myths and stereotypes surrounding mental illness are stripped away, the link between mental illness and substance abuse will continue to be recognized and considered in our collective approach to the growing mental health challenge.