Some days, reporters ought to just forego their paychecks; the fruit is hanging so low it practically falls into their laps.
Yesterday, Benedict Carey of the New York Times had one of those days, and he took full advantage this morning with a story that portrays a fascinating split in the mental health treatment field, replete with colorful quotes from protagonists involved.
Carey reports on a $20 million government study that declares that 55 percent of Americans will suffer from a mental disorder during their lifetime and, furthermore, that more than a quarter of the nearly 9,300 people interviewed had experienced a mental disorder in the last year alone.
Okay, okay, we admit, our first thought was, “Yeah, and all of them ride the 7th Avenue subway.” But our second thought was to wonder if maybe, just maybe, there wasn’t some built-in incentive on the part of researchers, psychiatrists and drug companies involved in this study to err on the high side — as in, the bigger the problem, the bigger the response?
Apparently, Carey wondered, too, because he introduces us to Dr. Paul McHugh, a professor of psychiatry at Johns Hopkins University. “Fifty percent of Americans mentally impaired — are you kidding me?” McHugh snorts to Carey. The professor is not amused with the ever-expanding definition of what constitutes a mental illness. “Pretty soon,” he says, “we’ll have a syndrome for short, fat Irish guys with a Boston accent, and I’ll be mentally ill.” McHugh says “the problem is that the diagnostic manual we are using in psychiatry is like a field guide, and it just keeps expanding and expanding.”
The lead researcher on the study, Dr. Ronald C. Kessler of Harvard Medical School, defends the purported rate of mental illness. “If I told you that 99 percent of Americans have had a physical illness, you wouldn’t blink an eye,” he tells Carey, somewhat defensively. But even Kessler admits that perhaps too many of the everyday emotional struggles that we all encounter on the path from the cradle to the grave have now been classified as wacko!, and therefore treatable. “The fact is that there is a very wide range [of disorders] included here, with the equivalent of many psychiatric hangnails,” he concedes.
For the record, the $20 million tab for the study was partly picked up by health research foundations — and by, natch, pharmaceutical companies ready to offer a pill for every mental twitch. Carey notes that the report seems certain to rekindle a heated debate about who and how many of us should be screened for mental instability, and where the line should be drawn between, say, a mental disorder on the one hand and just another bad day at the office on the other. “The answers,” he writes, “will have an enormous effect on who receives treatment and which disorders are covered by insurance.”
Now it’s true that we here at CJR Daily generally have an aversion to this sort of “he said/she said” journalism — and it’s equally true that some of the faithful toiling in the fields consider that to be our mental disorder. But this is a case where, literally, no one knows where the truth lies — and it’s enlightening enough just to watch a good reporter explore the split among researchers and calculate the stakes for all involved.
–Susan Q. Stranahan
Susan Q. Stranahan wrote for CJR.