Many mental health clinicians and many people who have mental health issues agree that there is a big difference between how physical health and mental health are treated. In fact, most people agree there is a strong negative bias regarding mental health. The bias is so strong that many people who have mental health issues often do not seek treatment for their condition because they are afraid of the stigma attached to mental health issues. For example, people are afraid if people know they have a mental health issue that they may not be able to get a job or they may not be able to get health insurance. They are also afraid that people in general will not want to socialize with them if people knew they had a mental health issue.

If we look at history it makes sense, why people are concerned about these issues. In the 1800’s people determined to have a mental health issue were locked away in mental health asylums. These places were dirty and filled with numerous physical diseases and the patients were not really treated. Basically it was a place for families to hide a family member with a mental illness until they died. This way it was a secret and the family did not have to bear the negative stigma of having mental illness in their family. The mental illness was viewed as a weakness and wealthy families did not want to marry into families where there was a mental illness. They were afraid of a child being born with a mental illness and ruining their upper class family image.

Now many people may think of course it was the 1800s, but this didn’t happen during modern times. In fact it did and still continues today. Many patients who have mental health issues do not receive adequate treatment for their mental health issues or their physical health either. In the 1960’s the book and film One Flew Over the Kokos Nest was released as a book and movie. The book and movie looked at how patients in mental health hospitals were over medicated and were treated more like animals than people.

In fact some people were becoming aware of the treatment in State Mental Hospitals and states such as California started passing laws in 1950 to close these hospitals. In fact, in 1967, Ronald Regan, the governor of California, passed the Lanterman-Petris-Short (LPS) Act, which virtually made involuntary hospitalization impossible and also resulted in most of the State Mental Hospitals being closed. While the people passing these laws may have thought they were doing something positive, they neglected to establish plans for people with mental health issues once these hospitals were closed.

As a result of there being no planning to very poor planning, many people with mental health issues we’re having even more difficulties finding treatment for their mental and physical health issues along with have severe issues finding housing and food. Many of these people ended up living on the streets and turning to illegal drugs as a way to treat their physical and mental health issues. When people try to establish treatment facilities in their areas, many of the neighbors would protest and object to any mental health treatment being established in their neighborhoods. They were afraid that the patients at these facilities would steal from their homes and that these patients posed a danger to their children. They were still operating under the stigma of the 1800’s. Almost a hundred years had passed but the belief that a mental illness was associated with a diseased, unclean person persisted.

One reason it has persisted is due to the language we use when discussing mental health compared to physical health. We still use the same language today and some people may think how something is phrased is not important, but it is very important. The way we discuss physical and mental health today makes physical health sound legitimate and important and the way we discuss mental health makes it sound like a dangerous condition that should be avoided. Additionally, the way we discuss mental health issues make them sound like no one ever really improves from these issues. They just learn how to cope in society.

Let’s look at some examples. If a patient has cancer, diabetes or even hepatitis, the person is referred to as the patient with cancer, the patient with diabetes or the patient with hepatitis. Now compare this to mental health issues such as depression, anxiety or ADHD. The patients are referred to as the depressed person, the anxious person or the ADHD kid. The mental health diagnosis becomes their identities. With physical health the patient maintains their identity and there is some hope the person can be cured. With mental health issues, the diagnosis becomes the person’s identity. They are not a person struggling to overcome depression, no they are the depressed person. By making the diagnosis part of their identity many people including the patient assume they will always be depressed. The best they can do is to learn to cope with it.

If we make the mental health issue, the person’s identity we are treating them as less than human and giving up on a cure. I have seen this many times in my 25 years as a psychotherapist. Patients and their families assume they are the diagnosis and any thoughts or feelings they have are due to the diagnosis. This is very degrading and makes it very easy to place mental health at the bottom of the ladder. Therefore, less money is spent on research, patients and mental health clinicians are treated with less respect. Why pay attention to the patient or clinicians? They are not doing anything serious such as treating acne or allergies. If we continue to label patients with mental health issues as their diagnosis, how will we ever change the stigma. A patient dealing with depression is still a person, they are not their diagnosis. If a close family member dies and the person becomes sad, this is a normal human reaction. They are grieving the death just like other family members who do not deal with depression. Therefore, there sadness is not due to the depression, it is a normal emotional reaction.

Also if we look at research on depression, the antidepressants are designed to increase the amount of serotonin in the patient’s brain. The theory is the lack of serotonin creates the depression. We see the same thing in other medical conditions such as diabetes. In diabetes the patient’s body is not regulating the body’s insulin correctly. Therefore, if medical research is showing there is a similarity between how certain physical health issues and mental health issues occur and respond to medication in similar ways, why do we treat physical and mental health differently? More and more research is showing the bond between physical and mental health issues. Therefore, why do we continue to treat them differently? Mental health is equal to physical health and we should treat patients with physical and mental health issues the same. We also need to put the same amount of money into research and ensure insurance companies start treating physical and mental health issues the same. They can start by paying to treat both.

Bottom line the language we use regarding mental and physical health has a big impact how mental health and physical health issues are treated. We need to remember this fact and insist that everyone starts to treat mental and physical health issues equally.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children, teenagers, trauma victims and first responders. If you would like more information regarding Dr. Rubino’s work and private practice visit his website at or his Facebook page at or his podcasts on Spotify or Apple.

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