Around and Around We Go

What if I told you preventative care saves billions of dollar per year and countless lives?

I think most of us could imagine that would be true. Of course, if you screen for something early and prevent it from happening or catch it early at a very treatable stage, the outcome will be better. It just makes good logical sense.

Some of you may be too young to remember. If you are, you may not participate in your health insurance’s free preventative care services. Most of us, when we are young, tend not to think about high blood pressure, cholesterol, colon cancer or breast cancer screenings for ourselves. However, for those of you who have reached the age to think about those things regularly- do you realize it’s only been 11 years that we have had this available to us without increased cost?

For all the years before that, we only were told we should have x test at x age. The cost for many of the tests were ridiculous if we weren’t having symptoms. When the system operated like that, many, many people lost their lives to diseases, which could have been prevented if caught early. When you think about it in that specific way, the cost to patients was great, they were losing their lives or their livelihood by get treated for advanced diseases way too late. The cost to insurance companies, well, they were losing money hand over fist by having to pay for medications, hospitalizations and losing customers who were no longer able to have private insurance, because they were either deceased or unable to work. It seems absurd with all the brilliant minds we have in medicine and financial positions that we waited until 2010 to add preventative medicine to the list of services provided by insurance.

Flash forward to 2021. We are addressing the preventable diseases for almost every body system, to prevent unnecessary deaths. Way to go people in charge!!!!! Almost. Every. Body. System. Annual screenings are the norm for cardiovascular, endocrine, urinary and respiratory systems. It is every 3-5 years for the digestive and reproductive systems. But what about the system that is in charge of it all? How often is this thorough screening done on our nervous system?

In 2021, we understand the brain is a complex organ. We understand that many functions of the brain are automatic, meaning we do not tell our brain to do things like breath, make our heart beat, blink our eyes, even chewing and swallowing are mostly automatic functions. We have researched and studied and reported many times about the brain’s amazing capacity to affect our heart, lungs, cellular structure, endocrine and digestive systems based on how it is functioning. We also know, generally mental illness symptoms begin between the ages of 14-24. What screening do we have for a brain disorder that is conducted regularly? Depression screening. That’s what we have, in the year 2021, with all the medical marvels and intelligence available to us, we have a depression screening.

A depression screening is done by your regular physician during your regular visit. Your teeth are screened by someone who is an expert on teeth, your eyes are screened by someone who is an expert on eyes, your reproductive system is mostly screened by someone specializing in that area, your digestive screening is done by a surgeon or GI specialist. But your brain, the organ that runs the whole shebang….. it is gifted to the providers who have a patient on their schedule every 15 minutes. The screening in my personal experience has went like this, “Have you felt depressed, anxious or suicidal recently?”. That’s it. Yes or no questions, not a lot of room for exploration and discovery there.

Since I am merely a nurse, a lowly citizen at the mercy of insurance companies and societal norms, I have no power to change this system. But, just for a moment, I would like you to imagine a world where “I need to make my annual mental health exam with my psychologist” is just as common as saying “I need to schedule my dental cleaning”. No eye rolls, no sideways glances happen, no judgement or gossip occurs. We just use our common sense to know an annual mental health screening is a necessary part of life, from the age of 10 up. Imagine the abusive situations that could be stopped. Imagine the suicides that could be prevented. Imagine for a moment that people don’t wait the average of 11 years to see a provider for symptoms, because their provider was able to spot them at the time of onset. Can you imagine the schizophrenic patient being treated at age 16 instead of 26, the bipolar patient receiving care at 15 instead of 35, the person with bpd or narcissistic personality disorder being treated at an early age, before their behaviors damage their lives or the lives of others. Imagine a world where many underlying mental health conditions were addressed and people did not self medicate to control the symptoms.

For a civilized country with many brilliant minds in it, we are missing a huge piece of the puzzle right now. For a country that is concerned with excellence and freedom and thriving, we are not doing a great job with a huge part of the population. It is estimated that untreated mental health conditions cost our nation $113 billion per year. I may be oversimplifying things. It seems to me, including an annual mental health screening with someone who specializes in the brain, would be a top priority for insurance companies and public health officials.

Round and round and round we go. It is impossible to get off the ride, if the harness is still fastened and there is no exit in sight.

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