How Does Your State Rank When it Comes to Mental Health?

I don’t want this entry to get political, but I feel many people are going to interpret it that way. That’s the problem with providing data these days. There are no such things as facts if people don’t want to believe objective information, and most people take their talking points from whatever cable news channel fits their political party’s agenda.

Mental Health America, a well-respected, non-profit, non-political organization that is now 111 years old released their annual status of the country report that ranks states (and Washington DC) in very specific areas of cases of mental health and access to care.

I can only encapsulate their results, so I urge you to check out their full overall rankings at: https://mhanational.org/issues/ranking-states

I also don’t want this to become too ridiculously dry, so I’ll highlight only a few areas and if you don’t see your state listed, you can find it at the link above.

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Adult Mental Health

The MHA ranked adult mental health using seven metrics, including adults who: have diagnosed mental illness, serious thoughts of suicide, are uninsured, have disabilities who could not see a doctor due to costs and a few others. States that ranked highest have lower prevalence of mental illness and highest rates of access to care for adults. The lowest ranked have higher cases of mental illness and lower access to care.

The Top 5:

  1. Hawaii
  2. Iowa
  3. Minnesota
  4. New York
  5. Maryland

The Bottom 5:

  1. Oregon
  2. Utah
  3. Idaho
  4. Wyoming
  5. Nevada

Youth Mental Health

The MHA also used seven measures to determine the state of youth mental health in America. Among them were youth who: had a substance use disorder in the last year, were diagnosed with mental illness but did not receive services, had private insurance that did not cover mental or emotional problems and had at least one major depressive episode in the last year.  As with adults, the highest ranked have a combination of the least cases and best access to care, while the lowest have a combination of most cases and worst access.

The Top 5:

  1. Washington DC
  2. Pennsylvania
  3. North Dakota
  4. Rhode Island
  5. Massachussets

The Bottom 5:

  1. Nevada
  2. Wyoming
  3. Alaska
  4. South Carolina
  5. Oregon

Access to Care

The MHA goes deeper with many of their categories, and I’m not listing several here for space reasons, but one of the lists I found quite compelling was about overall access to care. The list is comprised of nine metrics covering both adult and youth needs, including quality and cost of insurance, access to special education and mental health service both available and rendered.

The top states have the best access to mental health care while the bottom have the worse.

The Top 5:

  1. Vermont
  2. Massachusetts
  3. Rhode Island
  4. Iowa
  5. Maine

The Bottom 5:

  1. Texas
  2. Georgia
  3. Nevada
  4. Mississippi
  5. South Carolina

Now here comes the bugaboo that I’m hoping doesn’t draw the ire of those from mostly conservative states.

I’ve given you just a snapshot here. I urge you to go look at the rest of the lists. If you look at the Top 10 or Top 20 and their bottom counterparts, along with the maps they provide, one of which I included here, you’re going to see some patterns emerge. The southeast, south and northwest sections of the U.S. tend to score lower than those in the Northeast, Great Lakes area, and California. What does this remind you of?

Looking at the maps and their color-coding, it reminds me of the electoral map of US presidential elections. Those states that are traditionally states that cast their vote for the Democrat candidate are those that have the combination of the lowest cases of mental health issues and the best access to care. The states that traditionally cast their votes for Republic candidates are the ones that consistently have the most cases of mental health issues and worst access to care.

Did I make a fair generalization? Is there any connection between political affiliation and opinions/priority place on mental health care? Is this just a coincidence?

I’m not going to wade into that debate here. I just wanted to provide you with the information and let you draw an informed conclusion.

The term ‘Gaslighting’ Comes From a 1944 Best Picture Nominee, And I Can See Why

It’s been somewhat of an every-few-years tradition of mine to listen to War of the Worlds on Halloween night, ever since I stumbled upon it on the radio when I came back from an eighth-grade party where I kissed a girl for the first time. BTW, the mass hysteria we all have been retroactively led to believe happened that night, didn’t actually take place. The original broadcast of War of the Worlds, I mean. Not me kissing a girl. Although it was a phenomenon rarely duplicated in the next few years.  The War of the Worlds “hysteria” is a fascinating story, but you know how to use the Internet and I’m not wasting space here. Instead, for the first time, I watched a nominee for the 1944 Best Picture Oscar (based on a 1938 British play and remake of a 1940 British movie) that is probably better known for creating a key piece of the Addiction/Recovery/Betrayal Trauma lexicon: Gaslight.

Starring Charles Boyer and Ingrid Bergman, it’s quite a far-fetched story, even for early cinema standards, and I’m not talking about the actual gaslighting that takes place. Any plot that involves assuming another person’s identity and jewel thieves automatically goes into the “ya, sure, whatever” category for me. That must be why I don’t like Nicholas Cage films.

The psychological part of the movie, however, is very well done, and it is indeed the place that we get the term “gaslighting” from. Boyer hatches a plan to make his wife, Bergman, think she’s going crazy, hoping it eventually results in eventual financial gain. He does this slowly by setting her up to believe she’s a kleptomaniac when in fact, he’s taking things and planting them on her. For good measure, he also deliberately dims the gas in the lights in their house. He insists he never touches them and claims they are always the same brightness, yet they get darker, night-by-night, contributing to Bergman’s self-doubt and belief she is losing her mind. Finally, Boyer flirts with the maid (played by Angela Lansbury, about 300 years before Murder She Wrote) in front of Bergman. Lansbury develops a bit of a disdain for Bergman because she reciprocates the flirting, but when Bergman brings it up to her husband, he again tells her that it’s all in her head.

You’ve had 75 years to see the movie, so I’m going to slightly ruin it. In the end, the husband is tied to a chair by police and Bergman’s learned about his deception…however, he can’t stop. When the police briefly leave the scene, Boyer tells Bergman to untie him so they can escape and be free together. She comes to her senses and lets the police take him away.

While it’s the Hollywood ending the viewer wants and can somewhat see coming a mile away, real life often doesn’t end like that and the gaslighting takes place over may years, not months. It’s not just pornography or sex addiction either. If there’s an addict in your life, there’s a gaslighter in your life.

I heard of cases much more worse than me when I was in rehab and recovery, but I think that’s because I had my hand involved in so many different things I didn’t have to convince any single person of anything too ridiculous. I didn’t spend enough time with any one person for them to get too close to my addictions.

My wife – just like with every couple that has a male addict – was the biggest victim of my gaslighting. Most of the time, it was convincing her that I wasn’t nearly as drunk as I was and fully capable of driving.

Occasionally, she would say things like, “I guess you don’t like us anymore” or “Nobody has to work that much.” I didn’t like anybody, especially myself, at that point, which is why I wanted to be alone. And she was right about how much I worked, but it was the only place I felt like I was in control of my life until the end. I always convinced her she was wrong and acted offended she’d even bring up such things. I even surprised myself  how often I was successful. The last person to say “sorry” loses and I was never the last person. Like I said, not the worst gaslighting stories, but I certainly knew the drill.

Manipulating someone into believing they’re the crazy one, to the point it becomes second nature: Yep, that’s gaslighting and now you know where the term came from.

While none of the Q&As I sometimes post on the site are in the Top 10 most popular you can find on the right side, the one that I wrote a while back about gaslighting is by far the most popular and talks more about the nuts-and-bolts of what it is. If you’d like to take a look at it, click HERE.

If You’re Not Willing to Ask For Help, You’re Not Going to Overcome Addiction

I think there are three basic steps in achieving recovery: 1) Admitting to yourself have a problem, 2) Asking a professional for help, 3) Following through with treatment. I think the second step is the toughest part for most people and where recovery either happens, or doesn’t.

I don’t think admitting you have an addiction problem is difficult. Sure, it’s the first step, and I can only speak for myself, but even with mild denials I provided my brain, I always knew something was different and abnormal with my pornography use and alcohol consumption compared to most people. When I reached the critical point, it was clear something was wrong, even if I had no idea exactly what was going on with me.

Treatment comes in all forms and sizes, but if you follow through with it, you’ll achieve some level of recovery. I have met plenty of people who think they are the special one who can’t recover, but in reality, I have only met one person I ever thought to myself, “I don’t know if they’re constitutionally capable of long-term recovery.” Thankfully, I was wrong. They have been sober for 5 years now. I’ll tell that story in a few days. My point here is that if you are committed to recovery, you will recover. It’s not a complex recipe.

As some of you know, I have a side hustle giving specific one-on-one advice to addicts and/or their loved ones. It’s featured in the ad on the side of the homepage of the website, and you can access it HERE.

I always tell people that it’s a big step they asked me for help, but at the end of the day, I’m not a professional. I’m somebody who can be the first person they talk to who isn’t going to judge and will create a safe space. I can be the person who lets them know what the next several steps could/should be. Talking to me is like easing your toe into the water. It’s asking for help, but the sugar-free, “light” version.

One of the reasons I started this consulting/advisement service is because I know just how hard it is to ask for help. I usually work with someone for 3-6 major interactions (phone calls/skype/email) and it’s all about getting them to recognize they need real help. They can practice telling their story with me and I can get them ready for a therapist or a 12-step meeting. If I can remove any of the fear, it’s not as big a leap to getting the help.

The biggest pushback I get is not in somebody feeling that they don’t have a problem, but feeling that their problem doesn’t rise to the level of needing professional help, or being too proud to take that leap and becoming the kind of person who “has to get help.”

I try to kill both of these birds with one stone. I tell them that if their doctor referred them to cardiologist because of a heart issue, they wouldn’t compare themselves to other heart patients, they’d just go. If you need glasses, you go to the eye doctor. You don’t worry about people with better or worse vision. If you see an oncologist and they give you one year to live, you don’t stop seeing them because they give some people only three months.

I also try to address their pride. I have to admit, I’ve never been a prideful person. It probably has to do with my imposter syndrome. I’ve worn so many masks, pride doesn’t phase me all that much. I think it’s just another mask I never wore. But I’ll point out the fact that Pride, much like Lust, is one of the seven deadly sins. Also, I’ve never heard of anybody on their death bed complain that they didn’t have enough pride or were glad they didn’t ask people for help. The deathbed is for regret and never getting professional help will be a huge regret.

So why do the naysayers point to inpatient rehabs and 12-step groups as having historically low success rates? Having been to a couple, I can tell you that those who are forced to go, either by their family or the law, never actually asked for the help. You can’t skip to step three without step two. I’d guess between 50% and 75% of the people at both my rehabs didn’t want to be there. And if you’re at an AA or NA meeting, watch how many people only show up once or twice — likely pushed by family — or need to have their “court card” signed by the leader at the end of the meeting. A judge told them to be there. They aren’t there because they are seeking help.

As far as the self-imposed stigma of being one of “those people” who are in the minority of asking for professional help, you’re actually in the minority if you aren’t wiling. According to a 2018 study by the Barna Group, 42% of American adults have seen a counselor at some point, 13% are in active therapy and 36% haven’t seen a therapist but are open to it. Not being willing to see a therapist actually makes you one of the few, not many.

You know you have a problem. If you want it bad enough, you can get through the treatment. You just have to be willing to ask for the help. Don’t let fear hold you up.

Therapy and Fellowship, not Online Forums, are the Key to Pornography Addiction Recovery

I know anything is possible and there are people who have done it different ways, but I firmly believe that if you are seeking to permanently eliminate your pornography addiction, you can only do it with professional help, often bolstered by the (real-life) interaction with other addicts. Anything short of this and you’re setting yourself up for failure.

You know when you do something that irritates you, but you can’t help it, like letting the dishes pile up in the sink or watching mindless reality TV? I do this with online forums where guys talk to each other about their pornography and masturbation problems.

I find it frustrating because it feels like 95% of these men will never understand that they are statistically unlikely to beat their addiction on their own. Many include “counters” in their signature that show how many days they’ve been without porn or masturbation. It’s rare that they ever get above 20 days. They relapse and relapse and relapse again.

Their solutions?

“I need to try harder. I need to put filters on my computer. I need to try yoga. I need to distract myself when I feel the urge. I need to get out and meet people. I need to turn off my phone. I need to meditate. I need a girlfriend.”

Usually less than a week later, they’re singing the same song. It’s clear that they feel guilt and shame about their addiction, but there are other men like me on the site who have years of recovery who talk about how we got to this point, but almost all of it falls on deaf ears. I sometimes wonder if they want to do something about their addiction, or they want to do just enough to convince themselves they are trying, but somehow they are the special snowflake who is just never going to be able to get into recovery.

There are others who remind me of people who consider themselves political, but really just regurgitate the talking points they hear on TV. These are the ones who try to tell you that they can “re-wire” their brains, but when you ask them about the science behind what they’re doing, they mumble-write something about dopamine and usually admit to not knowing everything, but knowing it’s true, much like climate change deniers.

I can give you a dissertation in how brain chemistry works with addiction, but I’ll save it. Bottom line is you’re never going to rewire yourself out of that childhood trauma causing the addiction.

The lazy, ignorant and stubborn don’t recover. That’s just a fact.

If it’s not one of those things, I think it boils down to fear. Sitting across from a real person, face-to-face, and having a conversation is much different than typing essays on a computer and waiting hours to read equally one-side responses. It’s scary to be that vulnerable and ultimately, intimate, with another person if you’re not used to it.

The main excuse I hear when it comes to avoiding therapy is that somebody doesn’t have the money or the time. First, the time excuse is BS. Send me a copy of your schedule and I’ll find plenty of time for you to get help. You just make it a priority. As for money, there are plenty of mental health treatment programs funded by local, state and national sources that will pay for, or at least help you out, with the cost. In my part of Maine, there’s an agency that covers three counties and offers steep discounts depending on your income. And if you don’t qualify for an income break, your lack of funds is just another excuse. Put your mental health in front of the big movie package on your cable system.

The only other way I’ve seen people recover – and many of these people don’t have loads of pre-existing trauma – is through a form of group therapy. It can be a 12-step group like Sex Addicts Anonymous, a spiritual approach like Recovery Today or a secular approach like SMART. I’ve been to all three and while none were the ultimate answer for me, it’s clear based on the people who are deep into recovery in all three groups that communal fellowship plays a big role in recovery.

I’d still urge people who go this route to get some professional help just to make sure they’re not missing anything, but I am confident that this is a way for some to achieve successful recovery.

This does not mean that blogs like this, online forums and bulletin boards are a communal fellowship approach. They’re not. They exist on a screen, not in real life. I believe that they can be secondary or tertiary levels of support, much like researching in books or watching YouTube videos, but the amount of people failing again and again seems proof enough that anything you find on a computer or telephone screen cannot be the sole solution.

I’ve said this plenty of times: Any route to recovery is the right route to recovery. The key word in that sentence is “recovery” not “any.”

If you’re reading this and you’ve failed again and again and again, it’s time to stop doing what isn’t working and try something new, or step-up and own it: you don’t really want recovery bad enough.