Money is just pieces of paper or numbers on the account. But it reallt matters what you convert them into. And, no matter how strange it may seem, these very pieces of paper have a very strong effect on your well-being and mood.

Table of Contents:

1. “The Greatest Wealth Is Health” Meaning
2. How Financial Stress Impacts Health
3. How Mental Health and Money Are Connected
4. The Link Between Financial Wellness and Physical Health
5. Here’s How Financial Education Can Improve Your Health
6. 9 Criteria That Determine Your Financial Well-Being
7. 5 Tips to Improve Your Financial Health

“Your Health Is Your Wealth” Meaning

Health is the greatest wealth and the most precious thing that an individual can have in this world. It typically wins in the “health vs money” battle. Good health provides you with a long and active life, helps achieve your goals and overcome difficulties, and also enables you to successfully solve life’s tasks.

A healthy person can be considered a person who is physically and mentally healthy, always has a good mood and high self-esteem. Human health is formed under the influence of a complex set of internal factors and external influences. In the course of many years of research, scientists have concluded what our health depends on.

The main components of a healthy lifestyle are a healthy diet, the absence of bad habits, personal hygiene, adherence to a regimen, outdoor sports, good mood and a favorable environment. If everything is in order, then the immune system will easily fight back any sore. Do not forget that the immune system loves protein. Therefore, you should eat eggs, nuts, milk, fish and meat. In addition, the immune system is very fond of tempering. To begin with, you should rub the body with a damp warm towel, then cool, then pour over.

When you take care of your health, you choose the best doctors, fresh food, a good social circle. Women can even choose the best beauty salons, which provide a variety of services. They treat it so responsibly that they follow every innovation in the world of beauty.

It should be noted that the more carefully you treat your health, the more likely it is that you will live a long happy life.

Watch a video to find out what is more important: health or wealth. This quick and inspiring talk in the form of whiteboard animation will put it into perspective:

What Impact Can Financial Stress Have on Your Health?

People with low wealth are more at risk of mental illness. True, the big question is what is the cause and what is the effect. Perhaps a person with depression, an anxiety disorder, or other mental disabilities finds it more difficult to get a stable job.

More than a hundred studies have been devoted to this issue, which were conducted in dozens of different countries. 80% of studies have shown that people with low incomes are more likely to have mental disorders, while they are more pronounced and last longer.

The data below shows the strong link between financial and mental wellness:

Of course, blaming poverty alone for psychological difficulties is unfair. “It may be one factor that plays a role in combination with genetics and life events,” says University of Cape Town psychologist Crick Land, who studies mental health policy. But, he says, the most compelling research so far shows that it is poverty that leads to mental illness, not the other way around. First of all, it can threaten depression.

As the scientist explains, there is one difficulty with research in this area: experimenters cannot artificially make the subjects poor for a long time. So it remains to rely on data obtained in a non-experimental way: if in some locality unemployment rises or the average income level falls, the likelihood of depression also increases.

It works the other way around too: A recent study by Swedish scientists found that people who won the lottery or received large unexpected payouts used less anti-anxiety drugs and sleeping pills.

The Relationship Between Mental Health and Wealth

We’ve already talked about how low incomes affect health: poor people are more likely to get heart disease, diabetes, tuberculosis and HIV, seek less help from doctors and die earlier.

And money is also associated with various mental disorders: poor people have them more often. For example, people with low incomes are more likely to get depressed and commit suicide.

It may seem that the connection between money and mental health is obvious: of course, money is linked to our mental health. But how exactly?

80% of workers say money worries affect their performance

Let’s start with the fact that financial problems affect the state during work. The University of Cambridge and research center RAND Europe found that the average employee loses 38 work days per year, less due to absenteeism and more due to presenteeism. This is the name of the state when a person is at the workplace but cannot do anything because he is worried about personal problems.

For employees with financial problems, these figures are twice as high: a person is so worried that his concentration and motivation decrease, he cannot concentrate on a work task.

At the same time, presenteeism can exacerbate illness, burnout, and psychosomatic problems.

Lack of money causes psychological distress

At the end of 2021, 11% of US residents did not have enough money for food, and 14% of Canadians had large debts.

In a 2022 study, researchers noted that women aged 18 to 29 and people with low incomes experience the greatest psychological distress. At the same time, married people feel a little better. At the same time, psychological distress is associated with emotional exhaustion, reduced immune response, heart disease, and increased mortality.

It turns out that millions of people around the world have health problems and die earlier because they have a strong anxiety about money.

At the same time, the prevalence of mental illness is only growing: according to the US National Institute of Health Management, by 8%. And if we talk about serious diseases, then by 24%. And the British Institute of Money and Mental Health believes that the lack of money directly affects mental health.

Financial stress can happen to anyone

Recently, Canada’s Manulife Bank commissioned a study on the relationship between debt and stress. Researchers polled 2003 Canadians aged 20 to 69 and found that half of the people their debts cause stress, depression, and a third of those surveyed do not sleep well at night because they worry about debt.

This is not the only study of the relationship between money and stress in Canada: according to other data, 48% of Canadians do not sleep because of financial problems, and 44% will not be able to meet financial obligations if their paycheck is delayed.

And in the USA, more than 40% of people experience both debt and mental health problems.

At the same time, stress is caused not only by low wages and high debt levels but also by managing household expenses, having to pay bills, unexpected expenses, and the desire to have savings.

Anyone can have this financial stress: residents of different countries, those with different levels of income and expenses.

Rich people are actually happier

It is believed that money and happiness are connected only up to a certain level: in the US it is $75,000 a year. These results were obtained by researchers from Princeton University in 2010.

But according to a new study from 2022, there may not be a monetary threshold at which the importance of money decreases. And people with higher earnings experience an increased sense of control over their lives and therefore may feel happier than others.

Poverty is a risk factor for mental health conditions in childhood

Mental and financial problems start in the family: young people from poor families or survivors of childhood trauma are more likely to experience financial and mental vulnerability. It is also believed that childhood poverty can lead to poor mental health in adulthood. The story is similar in older people: if a person experienced financial difficulties most of his life, then in old age he is more likely to experience depression.

The connection between money and mental health works in two directions: financial problems cause mental disorders and, conversely, people with mental disorders are more likely to have money problems.

Scientists believe that people with debt are three times more likely to develop depression and anxiety. And there is an even stronger connection between suicide and debt: people who decide to commit suicide are eight times more likely to be in debt.

Because of this duality, scientists cannot agree on which comes first: mental problems or financial ones. Like chicken and egg. Some believe that worrying about debt leads to increased stress and reduced mental stability, while others believe that mental health problems interfere with financial management, reduce self-control and increase spending. In addition, mental problems can interfere with work, which significantly affects well-being.

It is possible that the truth is somewhere in between: debt increases the risk of mental problems, and mental problems can drag you even deeper into debt. This can be sorted out if you contact a psychiatrist for help: when a person is mentally healthy, it is easier for him to improve his life and pay off debts.

If you have temporary financial problems and feel overwhelmed, try to continue living as usual: make your bed in the morning, walk the dog, meet friends, not skip meals and not get addicted to alcohol. This will help at least not aggravate the mental state.

How Financial & Physical Health Are Connected

As we have already found out, money affects the human psyche. This fact is easily confirmed by personal experience. For example, when a job is lost, the level of security decreases and anxiety appears. But the body can also change under the influence of money and respond to the financial condition.

How is the body related to the mind?

The body is the subconscious turned inside out. It reflects everything that happens at the level of emotions, feelings, situations, events in the external life and in the inner world of a person. The body stores information about the first love, conflicts and disappointments. All our ailments, features of the constitution, wrinkles on the face are a reflection of our experience.

The body is the material manifestation of a person in this world. Money is also materialized energy. They are connected with the body through the subconscious, or certain programs, installations. If there is a need to improve your financial situation, you must first take care of your health, exercise and eat right because the first thing we can influence is our body.

Of course, income will not grow you just start going to the gym or treat chronic diseases. Other targeted actions will also be required. When you correct your well-being, you improve the flow of energy in the body. If you have blocks or clamps somewhere inside, then the body cannot withstand a large amount of money, which is also energy.

Disease and money: how are they related?

Constant money problems can be associated with negative attitudes. Some people have attitudes that are held subconsciously and affect the way individuals feel and think about others around them. These includes:

• “money is evil”;
• “money equals death”;
• “the rich are thieves”;
• “you have to work hard to have a lot of money”;
• “big money spoils people”, etc.

If there are such beliefs, the body simply cannot physically carry big money. The body reacts to such a situation with diseases, a general deterioration in the condition. And the person cannot explain what it is connected with. So the subconscious protects us from negativity because we recognized that “money equals death.” A person subconsciously seeks to get rid of money in order to feel better, through squandering, uncontrolled shopping and more.

Sometimes people have a belief that you can earn money only by hard work, sacrificing your body. These can be generic attitudes, if the ancestors from generation to generation worked in the field, in heavy industries. The result of such programs are diseases when trying to earn big money.

Money & Your Mental Health: Why Financial Literacy Matters

At Creighton University (USA), scientists investigated how financial literacy can affect health. The conclusions turned out to be interesting.

Principal Investigator and Associate Professor of Pharmacy at Creighton University, Nicole White, noted that increasing literacy reduces financial stress. Ultimately, overall health improves. The results are published in the American Journal of Lifestyle Medicine.

The study was attended by 345 working, low-income, single mothers from Omaha. Age ranged from 19 to 55 years. The participants were divided into two groups.

The first is those who completed the nine-week financial success course. The second is women who have not received any financial literacy training.

The study tracked participants’ health status. The researchers assessed blood pressure, cholesterol levels, weight, and perceived quality of life. The study found that participants who completed a financial education course exhibited a range of healthier behaviors compared to those who did not.

They knew how to set goals and prioritize, plan a budget and record expenses, save money on purchases wisely, and pay bills on time. They borrowed less, used credit cards less often, and did not overspend money in bank accounts.

In addition, health has improved. Financial stress lowered, tobacco consumption was reduced by 5%. People became more attentive to health and did not refuse the necessary medical care.

What Determines Financial Wellbeing?

Criterion 1. You have a financial goal

Financial goals answer the question: “What do I really want from life?” This is the first link between financial health and mental health. Any psychologist will tell you: you need to be able to want something big. Choose a direction in life and move in that direction.

If this is still difficult for you, you may use a financial goal which is suitable for everyone: find a source of passive income for retirement.

Calculate how much capital you need. The main thing is that it “ignites” you. Then it will be easier for you to concentrate on money management.

Criterion 2. Your expenses are less than your income

There is a misconception: “When I start earning more, than I will save. Right now I’m living from paycheck to paycheck.” That doesn’t work. If you already have a habit of spending everything, then it will stay with you for ever, no matter how much you earn.

Try the “pay yourself first” trick: if you get the money, save it right away. And adjust your needs according to the remaining amount.

There are many life hacks to spend less. First, learn to let go of emotional buying. And again we return to mental health. If you buy things to feel better, it’s worth working with a psychologist.

Criterion 3. Your income grows at least 10% per year

It is worth increasing your income up to 10% per year (or even up to 15%, if possible). It is normal for any professional to get better year by year and earn more.

Successful people usually think about whether they are doing it and whether they want to continue. To earn more, you need to delve into the profession. This is another money question that isn’t really about money.

Criterion 4. You save money regularly

Saving money regularly is the only sensible way to build big capital and achieve financial goals. You can look for a way to get guaranteed 200% per year or hope for a lottery. But it’s better to rely on yourself. Saving regularly means relying on yourself.

For example, you have a child, and you save up for a college. If you have just started saving and are saving $300 every month for 17 years to an account with 12% per annum, then by the time your child enters a college, you will have $200,000. For only $300 per month!

Learn more about how to save money regularly.

Criterion 5. You have an emergency fund

An emergency fund is needed in case of loss of income. To calculate it, multiply your family’s monthly expenses by 3.

This money should not be spent on current consumption, impulsive purchases, early loan repayments, down payments on mortgages and investments.

Take a look below to see how you could benefit from building your emergency fund with $7 a day:

Criterion 6. You get the maximum return on assets, and your assets grow

Approximately 90% of people have unused assets that could generate income. Assets are bank accounts and deposits, securities, real estate, land, property, transport, precious metals, shares in business, funds lent.

On the Internet, you can find many ideas of income producing assets that supposedly bring a lot of money with almost no investment of time and effort.

In any case, you must first understand what assets you have and how much they bring. The most unprofitable assets should be sold. And then later find new ways to acquire assets.

Criterion 7. Your debt load is less than a third of your income

The topic of loans is the most painful. Why do people with high incomes take out new loans to pay off old ones? This is a topic for a conversation with a psychologist.

But loans are also good if:

• they are taken for asset acquisition, not consumption;
• the return on these assets is greater than the cost of servicing loans.

Financial experts recommend doing this with loans. If the interest rate is more than 12%, direct all resources to close the loan as quickly as possible. If the rate is from 6 to 12%, pay off early and invest in parallel. If the rate is less than 6%, make payments according to the schedule and do not rush anywhere.

How are the things going with credit cards? If you can’t stop using a credit card, and the interest-free period has long ended, then reduce the limit on the card with each payment. This is how you break the vicious circle. To do this, inform the bank that you want to reduce the limit. Reduce it gradually until you completely stop living on credit money.

Criterion 8. Your health and property are insured

You need to insure yourself and property. If something bad happens, you will have to spend money to fix everything (for example, you were flooded by a neighbor) or to help yourself get out (for example, an injury). Since these expenses are unplanned, you pull money out of brokerage accounts or “bite off” capital to achieve a financial goal. Or you may need to take out a loan. Thus, you throw yourself a few steps back. Insurance programs will protect you from this.

Criterion 9. You invest, but do it wisely

With investments, you can earn more than 12% return on invested capital. For private investors, we recommend a portfolio strategy. Create an investment portfolio and try to twitch less. Create an information vacuum around you: no investment ideas, no “market signals”. In this regard, it is useful to work with a financial advisor: it filters all market information and suggests actions that are right for you.

5 Simple Ways to Improve Your Financial Health

1. Decide what money means to you. What does finance mean to you? Is it just a goal or a tool to do something with your life? Do you have plans? Check your list of values ​​and maybe this will clear things up for you.
2. Find out how much you are worth. Open your bank statement, look at your payroll, check your retirement savings, find out what your credit score is. Don’t be afraid to find out the answer to these questions. Know where you are. This will help you determine how you can improve the situation.
3. Track how you spend money. Look at your behavior regarding money. We overpay not only when we buy the necessary sofa or the desired car. Often our expenses are small things that add up to substantial amounts. Do you have spending habits that are inconsistent with your values ​​and are they healthy? Answer these questions honestly
4. Discuss money with your partner, family, friends. We recommend talking about money with your partner, family and friends, suggesting that you study relevant literature together and ask for their opinion. By the way, discussing finances in a couple can have a fruitful effect on the relationship.
5. Think ahead. Focus on the long term. Once you’ve sorted out your short-term savings and emergency fund, you can start thinking about where you might be in 30 years. How do you want your life to look like? By answering this question, you can start saving money for this person and this future.

To attract more money into your life, you can also use these money affirmations. Listen to this every night:

Now you now why health is wealth and how health and money are connected. We wish you financial, mental and all other types of health that are important to you!

The post Health and Wealth: How Your Finances Affect Your Health first appeared on Healthcare information portal - an online tool for your health.

As a kid in the 1970s, I looked forward to each episode as much, if not more so, than the Saturday morning cartoons that surrounded them… with my parents taking in a few in between the chores that I would soon partake in as well. With a budding interest in math and science, these short three-minute videos were effective enough to this author that not only do I remember the topics decades later, but can readily recite them to unfortunate ears on chosen long distance bike rides.

How does this relate to health care? Recently, there has been some excellent discourse on how to heighten the diffusion of health services research into public policy. This author strongly supports the concepts of these postings, but believes an additional approach would be necessary to ultimately fulfill the constructs of bolstering public policy – that of promoting health literacy and health services research to the public in such a manner which would transcend and span generations.

This is where the Schoolhouse Rock! concept would come into play. The method of employing cartoons or videos to inform on health care concepts is not a novel one. In order to nudge public health knowledge and healthy behaviors, Schoolhouse Rock!-esque creations could encapsulate general health literacy notions and health services research outcomes in an amusing, self-promoting and efficacious format which could be easily digestible to children and adults alike. Perhaps even a follow-up album of such health care related topics could be produced with additional artists of the day.

The approach to encouraging healthy behaviors and fostering health services research need not be limited to animation shorts. Recently at the University of Louisville, an all-day symposium was hosted on “Crossing the Divide: On the Adventure of Getting Science Across to the Public”. One of the esteemed speakers was Paul Zaloom, the host of Beakman’s World. Did this show empower both the host and the viewing public in cultivating an interest in science? Well, I will let his quotes answer that principal question.

Equipping the public in this manner could create a cultural and national momentum of health that would advance its own cause… and remember, “It’s great to learn, ‘cause knowledge is power”.

The post Knowledge is power first appeared on Healthcare information portal - an online tool for your health.

rad·i·cal

adj \ˈra-di-kəl\

3a : very different from the usual or traditional : extreme b : favoring extreme changes in existing views, habits, conditions, or institutions c : associated with political views, practices, and policies of extreme change d : advocating extreme measures to retain or restore a political state of affairs <the radical right>

re·al·ism

noun \ˈrē-ə-ˌli-zəm\

1: concern for fact or reality and rejection of the impractical and visionary

Breaking from the usual tradition in healthcare is not a rare thing. In fact, we see this happening more and more in our communities.

In an excellent series on innovation in healthcare, the Harvard Business Review wrote a story on “Radically rethinking healthcare delivery”. An excerpt from that piece really spoke to why radical thinking in redesigning healthcare was appropriate:

“What we describe as a “health care system” is no system at all. It’s a collection of fragmented, non-communicating parts, implicitly dangerous in design. During an average four day hospital stay, a patient sees 24 different clinicians and administrators; when a physician places an order for medications in a hospital, there are seventeen steps between when that order is given and when the medication reaches the patient’s bedside – all opportunities for error. And this complexity happens within a single health care delivery organization. When multiple physicians, clinics, hospitals – and insurance companies – are involved in the care of a patient, the complexity can be overwhelming, both for the patient and clinicians.”

Everywhere we look in healthcare there seems to be opportunities for radical change. When electronic medical records rolled on to the scene, they were viewed as disruptive and radical. Now look at where we are with the adoption of these tools. One needs to look no further than the wonderful website and resource put out by AHRQ on innovations in healthcare. But the question remains – are these ideas radical?

For a moment let’s compare healthcare and radicalism to a biological system.

Biological systems function smoothly in homeostasis – they are self regulating and static. Frequently something perturbs that biological system, throws it out of homeostasis, and creates an imbalance. While homeostasis most often is used to describe biological creatures, the message is applicable to healthcare.

When someone in the healthcare system identifies a threat, a perturbation, and attempts to reset to achieve homeostasis, or a balance (read status quo), they “fight” the change. Active perturbation is not comfortable if you are the person being disrupted. Radicalism in healthcare often is disruptive.

Now consider making a change in healthcare on level with a perturbation that is so strong it forces change. Is it possible to have this change be so significant that in essence it creates a new balance, a new baseline for homeostasis?

“Supposedly, everyone working in health care wants the same thing: to help people get and stay healthy. “Everyone” includes primary care doctors, medical specialists, nurses, hospital administrators, health insurance providers, nutritionists, pharmaceutical companies, medical technology manufacturers, fitness gurus, paraprofessionals, public health commissioners, and charities dedicated to a disease The problem is that everyone can have a different view of the meaning of getting and staying healthy. Lack of consensus among players in a complex system is one of the biggest barriers to innovation. One subgroup’s innovation is another subgroup’s loss of control.”

The above quote is another piece from the Harvard Business Review and really hits the nail on the head for radical change in healthcare – for healthcare to change, one “subgroup” will need to lose control. Not everyone can be a winner when you are redesigning a system like healthcare, someone is bound to lose. The problem now, with the current system, is that it is often the community that loses.

Isn’t it time we start to think slightly more radical in how we can redesign healthcare? Do we want to incrementally play it safe through a piecemeal approach to redesign? Are we bound by realism and therefore unable to be radical? Where is the line?

After all, the IOM said it best: “the healthcare system is incapable of meeting the present, let alone future needs of the American public”

What do we really have to lose through being radical that we haven’t already lost?

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“Making matters worse, participants in the health care system do not even agree on what they mean by costs. When politicians and policy makers talk about cost reduction and “bending the cost curve,” they are typically referring to how much the government or insurers pay to providers—not to the costs incurred by providers to deliver health care services. Cutting payor reimbursement does reduce the bill paid by insurers and lowers providers’ revenues, but it does nothing to reduce the actual costs of delivering care. Providers share in this confusion. They often allocate their costs to procedures, departments, and services based not on the actual resources used to deliver care but on how much they are reimbursed. But reimbursement itself is based on arbitrary and inaccurate assumptions about the intensity of care.”

Wow.

Let’s take this issue of money and cost a bit further.

A write up from the New York Times summarizes the recent release of the 2011 Employer Health Benefits Annual Survey conducted by the Kaiser Family Foundation.

“…the average annual premium for family coverage through an employer reached $15,073 in 2011, an increase of 9 percent over the previous year.”

Yes, the cost of healthcare, no matter how you define it, continues to rise. Often the public must take on these additional costs as purchasers of health insurance like employers are running out of places to find the money to pay for this benefit. So despite the inability for “participants” in healthcare to agree on what cost means, the community continues to struggle.

And the scariest part – what happens if nothing changes? What happens if healthcare costs continue to rise?

Consider the following graph from the Robert Graham Center and is an example of what could happen:

Essentially this graph shows that by the year 2025 the annual household income in the US will be surpassed by the average health insurance premiums.

They conclude: “Shifting health care coverage from a commodity to a social good could reduce disparities and produce better population health. Changes in health care coverage will require more equitable and sustainable models of health care delivery and aligned advocacy to support them. The instability of health care financing and delivery provides an opportunity for family physician leaders to develop new models of efficient practice, with care that is accessible to everyone.”

So in the face of statistics like the ones mentioned above, how will we respond? Healthcare expenditures and premiums are growing at an uncontrollable rate. When cells do this we call it cancer – when healthcare does this, what do we call it?

Now is the time to start to demonstrate that there are indeed innovative models of healthcare that are out there that can bend the cost curve, improve quality and enhance overall healthcare. Where are they? What are they?

So no matter which way you look at healthcare, the money is a big deal.

How can we begin to change this? One thing is clear – we must.

Back to the Harvard Business Review for one recommendation:

“Accurately measuring costs and outcomes is the single most powerful lever we have today for transforming the economics of health care. As health care leaders obtain more accurate and appropriate costing numbers, they can make bold and politically difficult decisions to lower costs while sustaining or improving outcomes”

Unfortunately no matter how you cut it in healthcare, a lot of the change talk comes down to money. So what are we (you) going to do about it?

The post Money matters first appeared on Healthcare information portal - an online tool for your health.

The point of the contagion post was to think through ways the community can begin to work together and spread their message. While this remains the challenge, let’s take this a step further. Let’s begin to consider the role of engaging the community and community empowerment.

According to the World Health Organization (WHO):

“Community empowerment refers to the process of enabling communities to increase control over their lives. “Communities” are groups of people that may or may not be spatially connected, but who share common interests, concerns or identities. These communities could be local, national or international, with specific or broad interests. ‘Empowerment’ refers to the process by which people gain control over the factors and decisions that shape their lives. It is the process by which they increase their assets and attributes and build capacities to gain access, partners, networks and/or a voice, in order to gain control.”

How often is the community empowered in healthcare? How often is the community voice heard?

While there are ample studies on community empowerment (e.g. May, 1995, Eng, 1992, Rose, 2002), how often do we hear of the community stepping up to do demand more from healthcare?

Could it be that the community, as the WHO defines it, does not have a common “interest, concern or identity” as it relates to healthcare? Surely there are some communities that have made healthcare their mission to change. It is hard to imagine that after hearing stories of healthcare failing communities that more is not done. Just pick a story. Any story.

Is it that “we” have failed to actively engage the community in changing healthcare?

Rather than describe here examples of community empowerment for healthcare, let me pose the question – what have you seen? What are examples from your community where the community, feeling empowered, have demanded change in healthcare?

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Those of us that require opiate medication for pain are treated like criminals.  We must sign away our privacy and allow our medical records to be scrutinized by law enforcement, the DEA, or any third party private contractor working as a “drug warrior”.  If we don’t sign, we don’t get treatment–this is blatant coercion.

Already struggling to make life worthwhile in my painfully broken body, I must now face additional hardship, expense, and obstacles legislated by my government.

Pain Patients Vilified

The ultimate goal of the current media-fueled anti-opioid frenzy seems to be zero tolerance. Such simplistic thinking legitimizes only the suffering that results from the abuse of these medications, ignoring the equal suffering that results from their absence.

The media indiscriminately vilifies all opioid use, making the legitimate use for pain a shameful secret for many pain patients. This serves to keep many of us fearfully silent, even as our rights to privacy and proper medical care are trampled.

Devastating consequences for pain patients

We now face increasing suspicion from medical staff (doctors, pharmacists, other health care workers) and condemnation by society (family, friends, co-workers).  Our voices have been drowned out by a relentless media campaign against opioids, spreading uninformed and misguided anti-opioid sentiment.

Those of us who rely on opioids for some remaining quality of life are in despair. We take opioids reluctantly because we must, if we are to retain any quality of life at all. Too often, we are judged to be addicts with suspicious motives, and are forced to defend ourselves against this media-fueled stigma.

Some patients are giving up the fight and succumbing to hopelessness.

The increasing difficulty of getting effective pain relief has inspired a rash of postings on pain patient support forums asking about assisted suicide, with titles like “Death is appealing”. Patients are anticipating the increasing pain they will face as legislation restricts access to opioids, and are contemplating moves to countries and states where assisted suicide is legal.

Some pain patients see no medical hope, and feel they have the right to end their suffering if and when they choose. Some imagine of how happy they’ll be when they can finally get out of pain, for good.

They are tired of waiting, trying, hoping, and feeling lied to. They’ve been through years of going to doctors, submitting themselves to countless tests, scans, and treatments, only to find their pain is essentially permanent: not curable and often without even a known cause.

In some cases, after a lifetime of coping relatively well, a pain patient’s health goes into free fall and pain becomes intractable.  It becomes first difficult, and then impossible, for them to walk, feed themselves, and perform other basic self care. Many had previously enjoyed a good life, but now would rather die with dignity than be a burden to family.

From Lynn Webster, MD, past president of the American Academy of Pain Medicine: “I’ve had a number a people send me obituaries for people who have not been able to access their medications and decided to kill themselves. So this is not a trivial issue. There are unintended consequences that are occurring. No one wants anybody to commit suicide and no one wants more suffering, but that is occurring.”

Our pain and suffering is deemed irrelevant

In the uninformed and misguided effort to prevent addiction, we pain patients feel that our country and society simply don’t care about our suffering. With our bodies broken and lives derailed by chronic pain, these additional hardships exhaust our inner resources.

Without opioids, many of us will lose our remaining functionality and quality of life. We have been abandoned and shamed, left to suffer permanent pain despite having the means to relieve it. The message implicit in the new policies is that our pain, our suffering, our very existence, is irrelevant to the rest of society.

—————

Until she was disabled by chronic pain from Ehlers-Danlos Syndrome and Fibromyalgia, Angelika Byczkowski was a high-tech IT maven at Apple and Yahoo. She lives in a cabin in the redwood forests of the Santa Cruz Mountains in California with her husband and four-legged kids. Her essays have been published on several healthcare blogs, including Stanford’s Scope, Kevin MD, Occupy Healthcare and Substance.com. Her informational blog is at EDSinfo.wordpress.com.

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Whatever the initial cause, pain can take on a life of its own in our nervous systems and persist even after its source has healed (as in Complex Regional Pain Syndrome).  Pain becomes a “primary symptom” in itself, requiring the same aggressive treatment as any other debilitating illness.  The longer pain is allowed to last, the more deeply its paths are worn into our nervous systems and the more likely it is to persist.

Opiates have been used for thousands of years and have proven to be safe, even for long term, use when taken as directed.  They are more effective and have fewer side effects than any other medication currently used for pain – including Tylenol.  There is no evidence that opiate pain management “causes” addiction either, as it’s statistically unlikely for people to get addicted to opiates they are taking for real pain as directed by their doctor.

Addiction is a separate illness and unrelated to chronic pain.  Addiction is not drug-specific and addicts will use whichever drug is available, usually abusing other drugs or alcohol as well.  Most overdoses involve multiple drugs, especially alcohol, which is deadly when combined with opiates.  When their drug of choice is no longer available or too expensive, they don’t just stop.  They are addicts, so they move on to another drug – heroin, in the case of opiate addicts.

Until people *with* chronic pain are involved in policies calling for an end to opioid use, the restrictions are coming from people who are clearly *not* experts in chronic pain.  Since pain cannot be visualized or quantified in any objective manner, people without pain cannot possibly understand what we’re dealing with.

The biggest problem is when our pain is invisible.  If the public could really see us, they would learn that we are more like them than like addicts.  The public perception of pain patients is ridiculously negative, fueled by the relentless propaganda of the failed “War on Drugs”.  Because we have to conceal our use of opiates from the public, we are hiding the benefits of opiate use – a truth the public should know before they consider denying us these medications.

How about a National Pain Day, where we all “come out” to our family, friends, co-workers (that’s where the real risk lies) and the general public?  If people could see, meet, and get to know all the opioid users with chronic pain in their midst, they would sympathize more.  It worked for gay people, perhaps it could work for us as well.

Until she was disabled by the progressive pain and fatigue from Ehlers-Danlos Syndrome, Angelika Byczkowski was a high-tech IT maven at Apple and Yahoo.  She lives in a rustic cabin in the Santa Cruz Mountains with her husband and two dogs.

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This post has been kicking around in my head for nearly a month now, the product of conversations with clients, chats with friends, and a professional life in the mental health field. When we are talking about the intersection of physical and mental health, we need to include a discussion about health stigma and healthy privilege. I realized as I started writing that I have a lot to say about this topic, so what started as a post will actually be a series.

This post will be to establish some basic definitions, so that we are on the same page. Let’s start with a definition of stigma:

stig·ma

noun \ˈstig-mə\: a: archaic: a scar left by a hot iron :brand; b: a mark of shame or discredit :stain; c: an identifying mark or characteristic; specifically: a specific diagnostic sign of a disease –Merriam-Webster Dictionary

Now let me share my own definition:

health stigma

The feelings of shame, isolation, self-blame and invisibility that many people facing physical or mental illness feel when others make assumptions or judgments about their ability, willpower, character, motivation, or work ethic (to name a few)–Ann Becker-Schutte’s personal & professional experiences

You may have noticed that I used language that includes physical and mental health under one umbrella. I did that on purpose, because many physical health conditions and all mental health conditions fall into the category of “invisible illness.” That means someone who is casually looking at you might not be able to see the level of pain you experience. And they probably don’t understand the effort that goes into a “normal” day. They don’t see or understand because they have some degree of what I am calling “healthy privilege.”

This definition is an adaptation from Kendall Clark’s definition of white privilege:

healthy privilege

1. a. A right, advantage, or immunity granted to or enjoyed by healthy persons beyond the common advantage of all others; an exemption in many particular cases from certain burdens or liabilities. b. A special advantage or benefit of healthy persons; explained by reference to divine dispensations, natural advantages, gifts of fortune, genetic endowments, social relations, etc.

2. A privileged position; the possession of an advantage healthy persons enjoy over persons with illness.

3. a. The special right or immunity attaching to healthy persons as a social relation; prerogative.

In addition to the formal definition, I would add this:

Healthy people enjoy the privilege of bodies that work in the ways that they expect, free from regular pain or suffering, without extraordinary effort. Healthy privilege allows healthy people to assume that their experience is “normal,” and to be unaware that coping strategies that work for them will not work for someone dealing with illness.

Here is an example of what I am talking about when I talk about healthy privilege. I have a good friend who is dealing with fatigue after chemotherapy. Some well-meaning healthy friends have told her that the response to fatigue is just to “get more sleep.” This response ignores the fact that chemotherapy puts the entire body under strain, and that strain may not be remedied with a few more hours of rest.

In the next post, I will talk a bit more about the impact of stigma, and how it can derail the effort to improve health. For now, I would love to hear more from you. The idea of healthy privilege is one that I am just starting to play around with. How do you feel about these definitions? What would you add or subtract? What experiences have you had with health stigma or healthy privilege?

This post was originally published on my practice blog and is shared here in the hopes of stimulating discussion.

The post Hi There Mr. Elephant–Let’s Talk about Health Stigma & Privilege first appeared on Healthcare information portal - an online tool for your health.

This post was written by Dr. Misty Hook, and was originally published on the Counselling Resource website. It is a followup to her post, The Pay is the Thing. A licensed clinical psychologist in private practice in Texas, Dr Misty Hook received her PhD in counseling psychology from Ball State University. She was a professor of counseling psychology at Texas Woman’s University for five years where she taught classes in counseling, family psychology, social psychology, the psychology of mothering and gender issues. Her areas of specialization include families, couples, gender issues and giftedness and she has several publications in these areas.

The government is a major player in the future of healthcare, so mental health professionals must engage it if we want to make a larger difference. In order to do this, we must let go of our differences and unite so that we can speak with a loud voice.

My post on mental health reimbursement got a lot of buzz. While the response was more than I thought it would be, the intensity of it isn’t surprising. Most of the mental health professionals I’ve had contact with are confused and upset and rightfully so. Just at a time in which we thought we may finally get our due and be able to help in the ways we know we can, insurance reimbursement has gone down and that may only be the beginning of the changes negatively affecting our field. That was the rationale for my blog.

So what are we to do? Many of the commenters suggested that mental health professionals should simply stop accepting third party reimbursements and no longer work with insurance companies. Not participating in insurance panels is a very valid vocational option. People who work outside of the insurance system make excellent points about confidentiality, being paid what we’re worth, and the freedom to make clinical decisions based on what is best for the patient instead of what’s good for an insurance company’s bottom line.

However, as valid a choice as it is, let’s not pretend that having an exclusive fee for service practice is something that will solve the mental health crisis we have in this country. Fee for service is a system that addresses the mental health needs of patients who can afford it. Sure, many of us can and do offer pro bono services but, if we are to make a decent living, those patients cannot be the lion’s share of our practice. Thus, in such a system, the vast majority of people who may not even be able to afford copays – you know, the ones who probably need mental health services the most – will not get served. The same would be true for people living in rural communities which could not sustain a fee for service practice due to the low numbers.

Leaving a broken system is indeed an option but it is akin to one partner leaving a contentious argument and never returning. Sure, it stops the fighting and one person is happier but it never resolves the conflict. So, if we want things to get better for everyone – for mental health professionals and the public who needs our services – then we must figure out how to coexist in a healthy way with our partner. And that leads us to the partner with whom we must engage: the government.

A lot of people seem to believe that the government has little to do with our healthcare system but I do not believe that is the case. If anything, government is actually the driving force behind most of what we do.

The amount insurance companies reimburse for services is largely built around the program that pays for a huge share of health care in every region of the country and that is Medicare. Guess who oversees the delivery of and reimbursement for Medicare? That’s right: the government. We really started having trouble with healthcare in this country when insurance companies moved from being non-profit to more profit oriented businesses. Guess who set that plan in motion? President Richard Nixon (the government). And if the insurance companies were more regulated, we might see some different practices. And who is in charge of regulations? Give yourself a cookie if you said the government! Finally, the recently passed Affordable Care Act (ACA) is going to significantly change the way we deliver and pay for healthcare services. And, the entity in charge of the ACA’s conception and implementation is (wait for it) the government!

When the people running this country think it is advisable for the population at large to change our behavior, they start campaigns and initiatives to educate people, like they’ve done with litter prevention (remember the crying Native American?), forest fires (Smoky the Bear anyone?), and various public health crises. They pass laws and pour money toward the problem. My original post started with the Obama administration’s plan to help increase access to mental health services. Guess who is planning on implementing this program? Yep, the government! So please don’t tell me that government doesn’t contain most if not all of the answer to our healthcare woes. Besides, we have a much larger chance of persuading the government – an entity created by and for the people – than we do insurance companies whose motivating factor is profit. Consequently, we need to start working with the government and the sooner we need to wrap our minds around that idea, the better.

For example, the ACA is going to dictate what a large portion of our future healthcare services will look like and mental health professionals, particularly psychologists, need to have a seat at that table. If we don’t, the government may decide that what we do can easily be done by nurses and other non-mental health professionals. Unfortunately, I don’t believe that the mental health profession in general and psychologists in particular have done a good job of making others aware of how vital we are. As I’ve written about before (Psychology Gets No Respect), we need a psychology rock star so that people can understand just how much we have to offer. Another post (Let’s Make Psychology Roar) talked about how we need to take back the services we have allowed other professions to take over (I’m looking at you, family lawyers and mediators!). Thus, we must start making noise and talk up just what it is we do now and can do in the future to make a positive difference in people’s lives.

In short, we need to raise awareness about the importance of mental health. People need to know that talk therapy is 32 times more cost effective at increasing happiness than monetary compensation and that mental health factors are sometimes even more important than physical ones in overall health. The general public needs to realize that we are the ones on the front lines dealing with those suffering from chronic mental illness, substance abuse, and violence. As bad as things are, they would be worse without us. And we also must point out that we are the ones who can prevent some of these problems and increase happiness and well-being by providing the right interventions early.

There are things both we and the government can do to not only increase access to mental health but also make sure that it is effective and skimping on our pay is not the answer. That will only guarantee less access to qualified providers who are experienced enough to take on those with the highest risk profiles. I have lots of ideas, like putting mental health strategies into academic curricula, funding more free standing mental health facilities, and integrating mental health professionals more thoroughly into our educational, legal and healthcare systems but people need to be ready to listen. And if we want them to do that, we need to unify our voices so that they’re loud enough to hear.

The post Come Together Right Now: The Mental Health Field Must Unite first appeared on Healthcare information portal - an online tool for your health.

This post was written by Dr. Misty Hook, and was originally published on the Counselling Resource website. A licensed clinical psychologist in private practice in Texas, Dr Misty Hook received her PhD in counseling psychology from Ball State University. She was a professor of counseling psychology at Texas Woman’s University for five years where she taught classes in counseling, family psychology, social psychology, the psychology of mothering and gender issues. Her areas of specialization include families, couples, gender issues and giftedness and she has several publications in these areas.

With the new governmental mental health recommendations arriving, it is time for us to think about how paying mental health professionals what they are worth is an important aspect to increasing access to services.

This should have been our moment. After decades of being healthcare’s vastly underfunded red-headed stepchild, mental health was finally getting its due. Many of the talking heads have been discussing the need for better access to mental health and President Obama’s recommendations for gun control even include the need for more mental health services. So this should have been a time of excitement for my field, a time when we eagerly anticipated the ways in which we could reach out and help the communities so direly in need of our skills. Instead, it seems like it’s just going to be more of the same and nothing much will get better. Until we as a nation can truly get behind the value of psychology in general and psychologists in particular, we are headed down the wrong path.

Like many others in my field, I eagerly awaited the Obama administration’s suggestions about increasing access to mental health treatment. There are a variety of them (http://www.scribd.com/doc/120649190/White-House-fact-sheet-on-President-Obama-s-executive-actions-related-to-gun-violence) but, simply put, the mental health initiative involves identifying mental health issues early and getting these individuals into treatment. Specifically, the administration proposes giving a lot of money and training to teachers and schools so they can refer these students for mental health services. They also propose spending $25 million on state-based strategies supporting people 16 to 25 with mental health or substance abuse issues and another $25 million on violence prevention programs in schools. The government would give $50 million in tuition reimbursement and stipends to train 5,000 new mental health professionals because they noted that there are not enough providers. They also will work to make certain that mental health coverage is at parity (or equal to) coverage for physical conditions.

All this is wonderful and I am in favor of these new regulations but there is one thing that was never addressed that is deeply problematic and will negatively affect the implementation of these recommendations: reimbursement. At no point in the proposals did anyone discuss why it is that close to half of the people suffering from mental illness do not receive treatment. Yes, some of it is that they are not identified as such but the larger problem probably has to do more with the lack of mental health facilities and providers. The Obama administration broached that subject by putting in the recommendation about training new mental health professionals but the number of providers is not the issue. The real problem is our level of reimbursement. President Obama can pay to train additional mental health professionals all he wants but if the pay is not commensurate with the demands of the job, then they will not stay in the profession and we’ll be right back where we started.

As a psychologist, I have six years of formal education and training beyond the bachelor’s degree yet I get paid at a rate similar to that of massage therapists and personal trainers, none of whom have much training beyond a four year degree if they even have that. This is not meant to disparage either of those fields but instead to point out the similarity in what we earn despite the disparate skills, training and level of responsibility. Just as a comparison, most lawyers go to school for three years beyond the bachelor’s while the average physician has an additional seven years of education and training beyond the traditional four year degree. So, psychologists generally have double the education and training of lawyers and one year less than the average physician. However, according to a 2011 Bureau of Labor Statistics report on the national annual mean wage, lawyers earn roughly double what psychologists do while the average physician earns about two and a half times our salary. If you look at the top earners in our fields, the disparity is even greater. This seems wrong.

As a counseling and family psychologist, I must be able to listen and communicate effectively with people of all developmental levels, be compassionate and nonjudgmental, assess and evaluate the problem, and then draw up a treatment plan tailored to the needs of the specific person, couple or family. In order to be effective, I have to be both a mediator and a motivator and be able to understand, explain and persuade competently. My treatment plans must include knowledge about how the current systems in people’s lives (e.g., the legal, educational, and medical systems) affect them, what impact demographic variables (e.g., gender, race, socioeconomic status) have, and what the prevailing research is on old and new treatment strategies. Oh yeah, I also have to be able to remain objective, deal with messy emotions, and as a psychologist in private practice, know how to assign diagnoses, deal with insurance companies, handle money and do the required paperwork.

I don’t know about you but I think that is rather a lot of skills and responsibility that we are required to have yet our pay barely reflects this. And if we are not reimbursed at a level that reflects what it is that we do (not to mention helping to pay off student loans and other professional expenses like malpractice insurance, licensure fees and continuing education hours), then many professionals will either leave the field entirely or find other employment – like working for businesses or life coaching – that will not help alleviate the current mental health crisis.

The issue of funding and reimbursement is the same for mental health facilities. There are not nearly enough community mental health treatment facilities around, probably because of money issues. For those that are available, the staff is often composed primarily of interns, practicum students and those professionals who are new to the field and need the experience. I am not being disparaging about community mental health professionals at all because I have the greatest respect for what they accomplish. However, the pay is just not enough to sustain a family, so the vast majority of mental health professionals tend to go elsewhere. And make no mistake, the lack of mental health facilities is a huge problem because if you want people to get the help they need, there has to be some place they actually can go once they are referred (other than private practitioners of course). So again, the government can spend all this money on training people to identify and refer those suffering from mental illness but if there are few places for them to go or if the staff is not experienced enough to truly help, then we are right back where we started.

I understand that the Obama administration was under the gun (so to speak) to make some good recommendations and actually do something about a major public health issue but they need to actually think things through. By not addressing reimbursement, they are putting the cart before the horse and that will get us nowhere fast. It seems to me that what they need is a good psychologist to help them figure it out.

Hey President Obama, call me!

The post The Pay is the Thing: Re-evaluating Mental Health Reimbursement first appeared on Healthcare information portal - an online tool for your health.