Mental Health Became Behavioral Health: We Lost Our Mind!
Posted by Dr. Vollmer on February 23, 2015
Changing terminology with the hopes of changing expectations is an old trick. If we use the word “behavior” we think of quick fixes of change, of making new, healthier habits. If we use the word “mental” then we acknowledge the vast uncertainty and confusion involved in understanding a human being. The small name change in my field from mental health care to behavioral health care parallels the changing intervention from exploring with a deep respect for uncertainty to the more concrete, more certain intervention of behavioral training. Certainty feels better on the one hand, but on the other hand, it does not mirror the patients who are fearful, vulnerable and/or traumatized and who want to be understood, even if understanding means there is a shared confusion about their mental state. The love of certainty is a sucker’s game in that certainty implies knowledge, and since there is no way to understand the deep workings of the human brain, then the one who screams the loudest, who promotes the most certainty will have temporary appeal, until the glow of idealization wears off and the feeling change to despair and hopelessness. By contrast, beginning with humility, with a position of uncertainty, gives way to healthy exploration and thoughtfulness which downstream results in a more stable, considered, examined existence. In other words, behavioral health promises short-term gains, but it does not account for the long-term disappointment and despair which may follow from the unfulfilled expectations. Mental health, by contrast suggests that there is a vague notion of mental balance and that through much hard work and contemplation, mental health can slowly improve, to create more lasting change and maturity. As parents, we want our children to grow slowly, to have baby steps of change to cement a solid adulthood, and so too with mental health, we want our patients to slowly step up their frustration tolerance in order to build a solid foundation to weather future storms. Mental health suggests a slow and deliberate intervention, whereas behavioral health suggests short-term habit change. I do not know how this change in terminology happened, but I can’t help but wonder whether a marketing genius changed the name to create a new brand of health care. If my theory is correct, I do think it is marketing genius, but at the expense of human suffering and low professional morale.