Mental health stigma persists; lessons from the treatment of Naomi Osaka | COMMENTARY

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Japan's Naomi Osaka returns the ball to Romania's Patricia Maria Tig during their first round match of the French open tennis tournament at the Roland Garros stadium Sunday, May 30, 2021 in Paris. She later withdrew from the tournament citing her mental health. (AP Photo/Christophe Ena)
Japan's Naomi Osaka returns the ball to Romania's Patricia Maria Tig during their first round match of the French open tennis tournament at the Roland Garros stadium Sunday, May 30, 2021 in Paris. She later withdrew from the tournament citing her mental health. (AP Photo/Christophe Ena) (Christophe Ena/AP)

More so than any other illness, injury or disease, mental health disorders are subject to intense stigma, scrutiny and even discrimination. While individuals contend with the intense effects of their illness, they also have to fight battles over whether to “disclose” what they are dealing with and the repercussions that can accompany that.

This is why we and so many others commend Naomi Osaka, the No. 2 ranked woman in the French Open for speaking out about her years-long experiences with recurrent depression and social anxiety. She may not have won the Roland-Garros, but she’s taken her place as a champion of mental health advocacy, and we can’t have enough winners in our corner.

But what Ms. Osaka’s announcement has shown is that there still very much exists a profound discrepancy in how mental health and physical health are regarded. Just days after Ms. Osaka left the tournament with an ensuing flurry of media coverage, speculation and commentary, the women’s No. 1 seed Ashleigh Barty withdrew due to a hip injury with little to no scrutiny. It’s not an even playing field.

This is often how mental and physical health are regarded. Heart disease, migraine disorders, epilepsy, arthritis and many other physical health problems are serious, and they are discussed with little taboo. Meanwhile, 56% of individuals report discomfort talking to even friends and family about mental health-related issues. That number skyrockets to 84% when talking to an employer, according to MentalHelp.

One reason for the reluctance to open up is that individuals are put in the position to prove the legitimacy of what they are going through, especially if time off work is needed. A sprained ankle is visible; an inner struggle with depression is not. While 45 million Americans battle mental health conditions, less than half seek treatment, according to the National Alliance on Mental Illness.

Let’s use Ms. Osaka’s example as a watershed moment. Instead of saying mental health is just as important as physical health, it’s time that we understand that mental health is physical health. Or as the Greek philosopher Thales said thousands of years ago, “A sound mind in a sound body.” The brain is just another part of the body, and it is susceptible to illness like any other organ. Most importantly: It can be treated with great success, too. Mental illnesses can be managed by lifestyle changes and medications very similar to how physicians care for high blood pressure, and metabolic and inflammatory illness.

Mental illnesses are often physical in nature, and health care shouldn’t be organized into two separate, noncommunicative practices. In our specific agency, treatment teams always include therapists, primary care physicians, dentists and prescribing physicians, at minimum, to ensure a holistic and successful approach to patient care.

Health and illness do not live in a vacuum, and effects to the brain and body are bidirectional. Poor mental health leads to poor physical health outcomes and vice versa. Patients with diabetes are twice as likely to experience depression, according to World Health Organization. People battling depression more often become cigarette smokers. Treating the symptoms of depression after a heart attack has been shown to reduce both mortality and re-hospitalization.

And in all health cases, promotion, prevention and early intervention lead to better outcomes. Most health plans must now cover preventive services like depression screening for adults and behavioral health assessments for children at no cost. But their prevalence in regular checkups isn’t always routine. Just as measuring height, weight and blood pressure, all yearly checkups should include depression and anxiety screening, which can be highly predictive as a “first-step” approach.

One of the biggest hurdles we work to overcome every day as a mental health agency is helping clients accept where they are and what they are fighting. Decades of institutionalized stigma and an overwhelming reluctance as a society to talk about mental health has gotten us to this place. Imagine if we were so reticent to seek care for a broken arm. It’s a system that needs fixing.