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Mental health vs. mental Illness: a conversation with Dr. Bill Howatt (part 5 / 6)

Published on April, 12th 2018
By Greg Wells

This Q&A was adapted from my podcast conversation with Dr. Bill Howatt that aired on March 8th, 2018. You can listen to the interview here: As Chief Research and Development Officer at Morneau Shepell, Bill is an internationally recognized expert in mental health who has spent 25 years helping employees, patients and leaders achieve their potential. Bill has a PhD in Organizational Psychology, did post-doctoral training at UCLA, has developed programs with organizations like the Conference Board of Canada and the University of New Brunswick, and is author of numerous books and articles, including regular contributions to The Globe and Mail.

Dr. Greg Wells: I have noticed that in the educational and corporate settings I work in, people tend to see mental health and mental illness as versions of the same thing, with mental health viewed as the more positive term. How do you break those two apart and what relationship do they have to each other?

Dr. Bill Howatt: People confuse mental illness with mental health. You can think of mental illness as one axis – from low to high – and mental health as another axis. I have seen lots of patients and employees with severe mental illness who achieve excellent mental health through supports and treatment. And vice versa; people without any kind of mental illness can be dealing with poor mental health, stress and negativity that have a significant impact on their quality of life.

GW: That is a really important distinction. 

BH: Yes. I can’t take the credit for the idea. I got it when the CEO of the Mental Health Commission, Louise Bradley, and I wrote an article together. We used Keyes Research and they did a nice job of splitting the two concepts apart.

If we think about physical health, we can ask ourselves what we do with our intention to have good physical health. The big ones are exercise, diet, and rest. Most of us know there’s something we can do for our physical health. And even if a person doesn’t do anything about it, they know how an absence of those actions or decisions can lead to a chronic disease, obesity or some other health issue. We tend to accept that something bad can happen if you’re not paying attention to your body.

GW: And that idea can be applied to mental health.

BH: Exactly. When I ask people what they did today to support and build their mental health, many of them look at me like I have three heads. I get the same response if I ask them what they did today to build their resiliency. So I try to simplify it. What did you do this morning to wake up and guarantee that you’re going to be happy and have a wonderful day?

We know happiness is an ideal state of feeling well about yourself. It’s a state of wellbeing. So, clearly there’s a thermometer where we can be negative or positive, feel happy or sad. It’s the emotional version of the weather. Sunny, rainy, cloudy, rainy. That’s your mental health.

The catch is that most people don’t realize that when they get stuck in negative emotions, there is a good chance they may not ask for help. One out of every five Canadians ends up with a mental health issue, but only one out of every three of those five will ask for help, despite the fact that reaching out for help has an 89% success rate for people struggling with their mental health. That’s partly why it is the biggest chronic disease on the planet right now. It’s a $2.5 trillion problem globally. Bigger than all cancers and cardiovascular diseases combined.

GW: So what’s the link to mental illness?

BH: In general, if a person has had mental health symptoms for more than six months, the medical criteria indicate they now have a mental illness. If people don’t get help early with their challenging depression or anxiety before it hits that point, their situation usually progresses to becoming a mental illness. The root cause may not be genetic. It could be psycho-social.

The way I try to explain the importance of getting help is to point out that delaying messes around with brain chemistry. If you don’t deal with how you’re actually feeling and thinking about the world, it can change your brain chemistry to the point where your neurotransmitters are altered. For example, a person who has severe depression is in a very difficult situation because their levels of serotonin are so low. It’s chemistry.

GW: What do you advise in terms of being proactive about mental health?

BH: I try to get people to be aware that they can deal with mental health through their daily outlook on life. I try to show them that we can protect ourselves a great deal by learning how to deal with how we think and process the world. When that doesn’t happen, that’s when people begin to face all the challenges around mental illness. It’s not all just genetic. I think that’s what people need to know. In fact, probably 35% of all the short-term disabilities happening in workplaces are basically adjustment disorders, which is a form of psycho-social stress such as how people deal with home and work.

So that’s it. I try to make sure people understand that mental health and mental illness are not the same thing, but that one can actually lead to the other.