Cruise's rants set back cause of psychiatry

The Harrisburg Patriot
10.7.2005

Tom Cruise once again is in our living rooms with his toothy smile, boyish charm and a new fiancee to go along with his new movie about aliens attacking us.

He has grabbed headlines, though, touting Scientology's antipsychiatry stance. While his manager would prefer he use his airtime describing fighting martians in his new movie, he vehemently lectures Matt Lauer on the "Today Show" about the evils of psychiatry or psychopharmacology. The man fighting the "War of the Worlds" says, "You don't know the history of psychiatry, I do." He attacks those who treat mental illness, and those who go to doctors seeking help for their suffering.

While it may be laughable that a movie star lectures us on the "history of psychiatry," the tragedy is that some people will listen. Those who do, already burdened by the stigma of mental illness still carried in much of society, will look at those gleaming teeth, that tousled hair, and will think twice about getting help for the burden of mental diseases.

Some will wait longer dealing with the despair of depression, or the torment of hallucinations wracking their brain.

Some will die, choosing death through suicide rather than face the stigma of obtaining treatment.

The shame of Cruise's latest tirades is that some will listen. We will all pay.

The President's New Freedom Commission on Mental Health comes to the conclusion that mental illness is the second-leading cause of disability and premature death in the United States.

Depression alone costs the U.S. economy $28.8 billion a year in lost productivity and worker absenteeism, according to a 1999 MIT- Sloan School of Management study.

Yet, care for a psychiatric disorder is hard to find. The shortage of psychiatrists is growing, and even if you can find one, it is difficult to convince your insurance company to pay.

Insurance coverage for psychiatric disorders are often "carved out" to another for-profit company that has different rules for coverage than your other medical insurance.

Coverage for psychiatric disorders is less than for other disorders.

Psychiatric disorders can disable some. But, there again, you pay.

Tax-funded programs of medical assistance are now the largest payers of mental health care in the country.

Psychiatric treatment is effective. The advances of science and brain research are yielding encouraging results with new medications and clues to the etiology of these disorders.

Psychotherapy is also improving, with growing evidence of its efficacy.

Psychiatric treatment for depression is far more effective than treatment for heart disease or arthritis.

Psychiatric diagnosis follows rules in place now for 25 years, and is reliable and effective.

Clinical diagnoses for many disorders are more reliable than the EKG is for heart disease.

Still, Mr. Cruise rants on national TV about his "expertise."

Because he's a national figure, and because he is so cute, some people will listen.

Some people will avoid treatment. Some will be disabled. Some will die by suicide.

We all will pay through our taxes and insurance costs. But that's show business.

PAUL KETTL, M.D., M.H.A., is a professor of psychiatry at the Penn State College of Medicine, and staff member at Harrisburg State Hospital.

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