Public health enemy No.1

Press, 24 May 1977, Page 19

Public health enemy No.1

The Mental Health Foundation is to benefit from this years South Pacific Television Telethon on June 25 and 26. The chairman of the foundation, PROFESSOR BASIL JAMES, writes of . . .

Psychological and emotional disorder has a good claim to be public health enemy No. 1 in New Zealand. Official statistics, newspaper reports and personal experience show it to be among the most pressing health problems of our time. No-one is spared being a potential victim. It can — through suicide — prove fatal. But probably more poignant are the prolonged, sometimes life-long crippling effects it can produce, not just on the patient but on his whole family and others around him. Mental ill-health has replaced diseases like tuberculosis and diphtheria as important sources of disability, distress and invalidism. Based on figures supplied by the Minister of Health, * psychiatric hospital beds cost the nation some S2OOM a year. In a Dunedin survey it was found that with the exception of cerebral palsy and mental retardation, emotional and psychological disorder was the most common cause of chronic disability in persons under the age of 40. And, on a national basis in New Zealand mental disorder -is, through suicide, the second most common cause of death up to that age. How is it that, up to now, there has been no campaign?

With 11,000 Aiew Zea-

landers in mental hospitals why has there been no public outcry, no huge mobilisation of resources to prevent and combat such common forms of disorder which cost so much suffering and waste in human and economic terms? There are several reasons; and the first lies in fear and shame based on outdated superstitions and ignorance. It is a self-perpetuating and vicious circle — distress leading to shame and guilt, to silence, to a concealing of the real problem and hence to a concealing of its solution. At best, there can be an over-reliance on the magic of medication and often attempts are made by the distressed person to treat himself with drugs; most commonly, alcohol. Alcoholism is itself a symptom of stress and alone costs the nation SIOM a year in hospital treatment. But there is at last a glimmer of life resulting from improved public and professional education. For the first time, the true nature of alcoholrelated disorder is being recognised and is finding its way into the statistics instead of just being submerged in figures relating to diseases of the liver and stomach. Similarly, the longhidden problem of violence in the home is at last becoming something we are able to talk about

openly and therefore begin to take appropriate preventative and remedial action. I refer to wife-bash-ing, child abuse and so on. The answer here, clearly, is not just better casualty departments but rather a will to understand and alleviate severe emotional distress and disorders which are so often related to these problems. A second reason for the failure to respond appropriately to problems of emotional and mental health is that they are less tangible. You can see a broken leg, or understood in physical terms a diseased heart or stomach ulcer. But emotional distress is often not directly visible. You can’t easily measure it and' all the brusing and hurt tend to be private and hidden on the inside. Thirdly, the 1 mentally unwell often experience a feeling of alienation or helplessness, or are too distraught and unable to muster the will to fight back. Those not so helpless are often reluctant to speak out for fear of pub- ”: humiliation. In recent years doctors, especially psychiatrists, social workers, clergy, various professional groups, and others in touch with the community generally have come to recognise the need to advance an energetic and national-wide campaign. The Mental Health

Foundation of New Zealand was established to assist in the process of educating the community at large, and also groups of professionals and volunteers, on mental health matters. The psychological wellbeing of ’ the community can only be improved by joint action between the public and the professionals. Many chronic physical disabilities have been virtually eliminated in this way. Most people’s health fluctuates. Downward turns often take care of themselves, but sometimes they need early help to prevent these turns from becoming severe or chronic. In some people the causes are known and lie in childhood or in their environment. In others, the causes lie in the body; in still others the causes remain obscure. We know already much more than we are able to put into practice because of the fear and ignorance and silence I mentioned earlier, and because of the lack of available material resources. Much can be pi evented, much can be treated early. The community can do a lot for itself and the Mental Health Foundation hopes to provide the stimulus. It wants to deal with matters which touch the needs and lives of virtually every person in New Zealand.