Maine Voices: Connection Between Physical and Mental Health Visible in Obesity, Stress
By Dennis King, President and CEO, Maine Mental Health Partners, and Jeannine Lepitre, CEO, Counseling Services, Inc.
Appearing in the Portland Press Herald June 21, 2011
Obesity is a popular topic today, as America grows heavier - especially our children (note first lady Michelle Obama's "Let's Move" campaign).
We also hear a lot about stress and its aftermath, primed by the hundreds of our young men and women returning from war with post-traumatic stress disorder, psychologically damaged by their experiences.
We note those two examples of physical and mental health because they are frequently in the news and talked about. Less discussed, but equally important, is the relationship between good physical health and good mental health, because the two are deeply and profoundly connected.
That good physical health and good mental health are connected may sound incredibly obvious, hardly worth talking about. But the truth is that until quite recently in our history, they have been viewed more or less separately, with unfortunate results.
With the benefit of modern scientific research, we now know that the two are inextricably intertwined. But interestingly, and to many alarmingly, Western - particularly American - culture, science, philosophy, medicine, law, and public policy have for centuries treated physical health (of the body) and mental health (of the mind) as if they were two separate and unrelated things. Not two sides of the same coin, but two foreign currencies.
In the 17th century, the philosopher Rene Descartes conceptualized the "mind" as something completely distinct from the "body."
We have been living with this duality for some 300 years. The concept of the mind being one thing and the body another is more common to Western cultures than to Eastern ones, which often emphasize the interconnectedness of all things.
Our Western philosophy has long influenced the thinking of many people who have a profound effect on our lives, including traditionally minded health care professionals and policy makers. Here are a couple of concrete examples:
1. Health insurance. Until very recently, it was financially better - from an insurance standpoint - for a person to get heart disease, a physical disease, than to be diagnosed with schizophrenia, a mental disease. Better to have cancer than depression. Better to have diabetes than an eating disorder.
Why? Because insurance companies provided better coverage for the treatment of a physical illness than for the treatment of a mental illness.
Fortunately, this is beginning to change, albeit slowly. A federal law (The Mental Health Parity and Addiction Equity Act of 2008) requires insurers to cover mental and physical illness equally, at least in employer-sponsored plans with 50 or more employees.
This law was decades in the making. It took years of credible scientific research proving the biological causes of mental illness to overcome our ingrained cultural bias that the body was biological and the mind was, well, something else.
2. Physical exercise. A vast amount of recent scientific evidence now proves that a definite relationship exists between physical exercise and improved mental health - especially in the reduction of anxiety and depression.
To quote a recent U.S. surgeon general's report on the state of mental health in America: "One of the foremost contributions of contemporary mental health research is the extent to which it has mended the destructive split between 'mental' and 'physical' health."
That research includes the 2004 National Co-Morbidity Survey Replication, in which 25 percent of people seeking primary (physical) care were also found to have a significant mental health condition that could benefit from treatment.
In light of this, MaineHealth and its subsidiary Maine Mental Health Partners (one of the only integrated mental health networks in the country) have been working to integrate the diagnosis and treatment of mental health conditions within primary care practices for more than six years.
Just recently, Maine Mental Health Partners began the integration process with Southern Maine Medical Center's PrimeCare Physician Services in York County. The goal is to develop an increasingly seamless, truly integrated continuum of care, breaking down the bureaucratic, communication, and cultural barriers that for decades have kept mental health and physical health separate from one another - with better, more complete health care as the ultimate result.
The concept of total good health, integrating both the mind and the body, is now happening in Maine, and should be a high national priority.
There are too many challenges that confront us as a state and as a nation to be anything less than completely healthy, both mentally and physically.
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