Behavioral Health Frequently Asked Questions

Mental Health is how you feel about yourself, others, your life and how you are able to meet and handle the demands of life. Mental health is not the absence of problems. Rather, it describes the ability of the person to be flexible and resilient and able to address the problems with appropriate coping skills.

Mental illnesses are biologically based brain disorders that can profoundly disrupt a person’s thinking, feeling, moods, ability to relate to others, and capacity for coping with the demands of life. Mental illnesses include disorders such as schizophrenia, major depressive disorder, and bi-polar disorder.

Anyone may be susceptible to a mental illness. Psychiatric problems affect people of all ages, all income groups, all ethnic groups, all religious groups, urban and rural, male and female. No one is immune to a mental illness.

Mental Disorders affect one-quarter of all Americans. On any given day one out of every 4 people you pass may be experiencing a mental illness. By this count more than 2 million of Ohio’s 11 Million citizens experience some form of mental disorder including 200,000 children.

Evidence indicates that mental illnesses are biological based diseases of the brain. Genetics can play a part, but people can develop a mental illness with no family history of mental illness. Others may be emotional or psychological reactions to environmental or social situations. Some of these disorders may be temporary, caused by extreme stress or life change.

Ten Warning Signs
1. Marked personality change,
2. Inability to cope with problems and daily activities,
3. Strange or grandiose ideas,
4. Excessive fears, worries and anxieties,
5. Prolonged depression, apathy, sadness or irritability,
6. Feelings of extreme highs and lows,
7. Dramatic changes in eating or sleeping habits,
8. Excessive anger, hostility or violent behavior,
9. Abuse of alcohol or drugs,
10. And thinking or talking about suicide

Yes, Treatment Works…People Recover! Advancements in medications are continually improving the recovery rate of individuals with a mental illness. Additionally in the past two decades the recovery movement has blossomed, while treatment and support services for mental illness have improved significantly. More and more people are receiving treatments that allow them to recover and lead healthy, successful, and independent lives.

The National Technical Assistance Center's Mental Health Recovery: What Helps and What Hinders? report defines recovery as, "an ongoing dynamic interactional process that occurs between a person’s strengths, vulnerabilities, resources and the environment. It involves a personal journey of actively self-managing a psychiatric disorder while reclaiming, gaining, and maintaining a positive sense of self, roles and life beyond the mental health system, in spite of the challenge of a psychiatric disability. Recovery involves learning to approach each day's challenges, to overcome disabilities, to live independently and to contribute to society. Recovery is supported by a foundation based on hope, belief, personal power, respect, connections and self-determination".

Condition - Recovery Rate
Bipolar Disorder - 80%
Major Depression - 70%
Panic Disorder - 70%
Obsessive-Compulsive Disorder - 70%
Schizophrenia - 60%

Contrary to popular belief, addiction is NOT a moral or character defect. In fact, it is a complex brain disease. It is a chronic disease characterized by craving, seeking, and use that can persist even in the face of extremely negative consequences. Alcohol/Drug-seeking may become compulsive in large part as a result of the effects of prolonged use on brain functioning and, thus, on behavior. For many people, relapses are possible even after long periods of abstinence.

No, anyone may become addicted to alcohol and/or other drugs. Addictions affect people of all ages, all income groups, all ethnic groups, all religious groups, urban and rural, male and female. No one is immune to an addiction.

It is estimated that over 1.1 million or 1 in 10 Ohioans are addicted to alcohol and/or other drugs.

It has been estimated that every year addiction costs Ohio as much as $10 Billion in terms of lost work productivity, injuries on the job, hospitalization and primary health care, traffic accidents, court hearings, incarceration, cash assistance to adults too impaired to work or hold a job and removal of children from addicted caregivers.

Drug or alcohol addiction is a diagnosable disease characterized by several factors including a strong craving for drugs/alcohol, continued use despite harm or personal injury, the inability to limit drug use/drinking, physical illness when using stops, and the need to increase the amount used in order to feel the effects.Abuse is a pattern of drug use/drinking that result in harm to one’s health, interpersonal relationships or ability to work. Certain manifestations of abuse include failure to fulfill responsibilities at work, school or home; using/drinking in dangerous situations such as while driving; legal problems associated with drug/alcohol use, and continued use despite problems that are caused or worsened by drug use/drinking. Abuse can lead to addiction.

No, there is no safe level of alcohol use during pregnancy. Women who are pregnant or plan on becoming pregnant should refrain from drinking alcohol. Several conditions including Fetal Alcohol Syndrome have been linked to alcohol use during pregnancy. Women of child bearing age should also avoid binge drinking to reduce the risk of unintended pregnancy and potential exposure of a developing fetus to alcohol.

There is no easy answer to this. If and how quickly you might become addicted to a drug depends on many factors including the biology of your body. All drugs are potentially harmful and may have life-threatening consequences associated with their abuse. There are also vast differences among individuals in sensitivity to various drugs. While one person may use a drug one or many times and suffer no ill effects, another person may be particularly vulnerable and overdose with first use. There is no way of knowing in advance how someone may react.

Drugs/alcohol is a problem if it causes trouble in your relationships, in school, in social activities, or in how you think and feel. If you are concerned that either you or someone in your family might have a substance problem, consult your personal physician.

If a person is compulsively seeking and using alcohol/drugs despite negative consequences, such as loss of job, debt, physical problems brought on by drug abuse, or family problems, then he or she probably is addicted. Seek professional help to determine if this is the case and, if so, work to get that person into the appropriate treatment.

Approximately 25% of individuals needing treatment will actually seek it. The widespread societal stigma attached to addiction is cited as the major reason why people do not seek treatment.

Yes, research shows that the success rates for addiction treatment are equal to the success rates for other chronic illnesses such as diabetes, hypertension and asthma. Approximately 40 - 60% of individuals who complete chemical dependency treatment and attend self help groups (such as Alcoholics Anonymous) are likely to remain abstinent from alcohol or other drugs.

If someone tells you they are thinking about suicide, you should take their distress seriously, listen non-judgmentally, and help them get to a professional for evaluation and treatment. People consider suicide when they are hopeless and unable to see alternative solutions to problems. Suicidal behavior is most often related to a mental disorder (depression) or to alcohol or other substance abuse. Suicidal behavior is also more likely to occur when people experience stressful events (major losses, incarceration). If someone is in imminent danger of harming himself or herself, do not leave the person alone. You may need to take emergency steps to get help, such as calling 911. When someone is in a suicidal crisis, it is important to limit access to firearms or other lethal means of committing suicide.

More than four times as many men as women die by suicide; but women attempt suicide more often during their lives than do men, and women report higher rates of depression. Men and women use different suicide methods. Women in all countries are more likely to ingest poisons than men. In countries where the poisons are highly lethal and/or where treatment resources scarce, rescue is rare and hence female suicides outnumber males.

There is a common perception that suicide rates are highest among the young. However, it is the elderly, particularly older white males that have the highest rates. And among white males 65 and older, risk goes up with age. White men 85 and older have a suicide rate that is six times that of the overall national rate. Some older persons are less likely to survive attempts because they are less likely to recuperate. Over 70 percent of older suicide victims have been to their primary care physician within the month of their death, many did not tell their doctors they were depressed nor did the doctor detect it. This has led to research efforts to determine how to best improve physicians’ abilities to detect and treat depression in older adults.

Although the majority of people who have depression do not die by suicide, having major depression does increase suicide risk compared to people without depression. The risk of death by suicide may, in part, be related to the severity of the depression. New data on depression that has followed people over long periods of time suggests that about 2 percent of those people ever treated for depression in an outpatient setting will die by suicide. Among those ever treated for depression in an inpatient hospital setting, the rate of death by suicide is twice as high (4 percent). Those treated for depression as inpatients following suicide ideation or suicide attempts are about three times as likely to die by suicide (6 percent) as those who were only treated as outpatients. There are also dramatic gender differences in lifetime risk of suicide in depression. Whereas about 7 percent of men with a lifetime history of depression will die by suicide, only 1 percent of women with a lifetime history of depression will die by suicide.

Another way about thinking of suicide risk and depression is to examine the lives of people who have died by suicide and see what proportion of them were depressed. From that perspective, it is estimated that about 60 percent of people who commit suicide have had a mood disorder (e.g., major depression, bipolar disorder, dysthymia). Younger persons who kill themselves often have a substance abuse disorder in addition to being depressed.

A number of recent national surveys have helped shed light on the relationship between alcohol and other drug use and suicidal behavior. A review of minimum-age drinking laws and suicides among youths age 18 to 20 found that lower minimum-age drinking laws was associated with higher youth suicide rates. In a large study following adults who drink alcohol, suicide ideation was reported among persons with depression. In another survey, persons who reported that they had made a suicide attempt during their lifetime were more likely to have had a depressive disorder, and many also had an alcohol and/or substance abuse disorder. In a study of all nontraffic injury deaths associated with alcohol intoxication, over 20 percent were suicides.

In studies that examine risk factors among people who have completed suicide, substance use and abuse occurs more frequently among youth and adults, compared to older persons. For particular groups at risk, such as American Indians and Alaskan Natives, depression and alcohol use and abuse are the most common risk factors for completed suicide. Alcohol and substance abuse problems contribute to suicidal behavior in several ways. Persons who are dependent on substances often have a number of other risk factors for suicide. In addition to being depressed, they are also likely to have social and financial problems. Substance use and abuse can be common among persons prone to be impulsive, and among persons who engage in many types of high risk behaviors that result in self-harm. Fortunately, there are a number of effective prevention efforts that reduce risk for substance abuse in youth, and there are effective treatments for alcohol and substance use problems. Researchers are currently testing treatments specifically for persons with substance abuse problems who are also suicidal, or have attempted suicide in the past.

At the current time there is no definitive measure to predict suicide or suicidal behavior. Researchers have identified factors that place individuals at higher risk for suicide, but very few persons with these risk factors will actually commit suicide. Risk factors include mental illness, substance abuse, previous suicide attempts, family history of suicide, history of being sexually abused, and impulsive or aggressive tendencies. Suicide is a relatively rare event and it is therefore difficult to predict which persons with these risk factors will ultimately commit suicide.

Often suicidal people will give warning signs, consciously or unconsciously, indicating that they need help and often in the hope that they will be rescued. These usually occur in clusters, so often several warning signs will be apparent. The presence of one or more of these warning signs should not be taken as a guarantee that the person is suicidal. The only way to know for sure is to ask them. In other cases, a suicidal person may not want to be rescued, and may avoid giving warning signs. Typical warning signs which are often exhibited by people who are feeling suicidal include:

1) Withdrawing from friends and family
2) Depression, broadly speaking; not necessarily a diagnosable mental illness such as clinical depression, but indicated by signs such as:

* Loss of interest in usual activities
* Showing signs of sadness, hopelessness, irritability
* Changes in appetite, weight, behavior, level of activity or sleep patterns
* Loss of energy
* Making negative comments about self
* Recurring suicidal thoughts or fantasies
* Sudden change from extreme depression to being `at peace’ (may indicate that they have decided to attempt suicide)

3) Talking, Writing or Hinting about suicide
4) Previous attempts
5) Feelings of hopelessness and helplessness
6) Purposefully putting personal affairs in order:

* Giving away possessions
* Sudden intense interest in personal wills or life insurance
* 'Clearing the air' over personal incidents from the past

This list is not definitive: some people may show no signs yet still feel suicidal, others may show many signs yet be coping; the only way to know for sure is to ask. In conjunction with the risk factors listed above, this list is intended to help people identify others who may be in need of support.

If a person is highly perturbed, has formed a potentially lethal plan to kill themselves and has the means to carry it out immediately available, they would be considered likely to attempt suicide.

For additional help or information please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).