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May is Mental Health Awareness Month, an important opportunity to recognize the needs of those with mental health issues and the ways in which those who struggle with them, both affected individuals and loved ones, can access help. Unfortunately, the mental health-related information and advice that circulates in May is often overwhelmingly focused on short-term mental health conditions like anxiety and depression, issues that today are highly treatable and far less stigmatized than they were even a few years ago.

However, there is a small subset of those experiencing mental health issues that are often overlooked, even during Mental Health Awareness Month. This includes the 10 million adults in the US living with serious mental illness, meaning a mental, behavioral or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. Serious mental health diagnoses include schizophrenia, bipolar disorder, major depression, acute anxiety and related illnesses.

As a mental health attorney who counsels families of loved ones with serious mental health issues, I always seek to advocate for these individuals, whose needs and realities too often go unseen and/or are misunderstood. With that in mind, and in honor of Mental Health Awareness Month, I’m sharing the following 10 often-overlooked realities of those struggling with serious mental illness.

These include:

1. They often lack insight into their condition, which can make it challenging for them to accept they have a mental illness and need treatment. This reality is a major factor in the debate regarding involuntary treatment versus personal autonomy. Among those creating and reforming policies affecting those with serious mental illness, insight must always be top of mind.
2. They are statistically more likely to be the victims of crime than perpetrators. Such a tragic reality is well worth reiterating given the enormous spotlight on occasions in which those suffering from mental illness have been involved in incidents of violence, often provoking feelings of fear and prejudice.
3. They are overrepresented among our nation’s homeless population and among those incarcerated. Since the large-scale closing of state-run mental health facilities, a vast number of mentally ill individuals have found themselves living on the streets or in jail, where they lack needed medication and other forms of treatment, and the stability often required to make clinical progress. But serious mental illness does not equal homelessness.
4. They are entitled to mental health care under the federal Mental Health Parity and Addiction Equity Act, which requires insurance coverage for mental health and substance use disorder treatment to be “no more restrictive” than coverage for physical health conditions. Yet despite these laws, our healthcare system is rife with persistent bias against mental health, adding challenges to individuals and families coping with diagnoses.
5. They are further entitled to Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) to help cover the costs of their basic needs. To qualify, a person’s mental illness must be severe enough to prevent them from performing substantial gainful activity (SGA) for at least 12 months or result in death.
6. They are too often left out of today’s discourse concerning mental health and mental wellness. Not just during Mental Health Awareness Month but all year long, those struggling with serious mental illness simply aren’t part of the ongoing dialogue that routinely emphasizes help like self-care.
7. They will likely require lifelong care. While there is often hope and progress for those experiencing serious mental illness, no cure exists, meaning they and their loved ones live with diagnoses all their lives.
8. They often have family members who urgently need respite to take care of their own needs and those of other loved ones. Our country’s dire lack of mental health treatment and supportive housing has put family members on the front lines, all but forcing them to make enormous sacrifices in order to protect the health and wellness of their loved ones.
9. They are represented across all demographics. Like all mental health issues, serious mental health illness does not discriminate, but generally first surfaces in young people ages 18-22 across racial identities, socioeconomics, geographies, etc.
10. They, along with their families, often require legal advocacy to best ensure someone with their best interests at heart is involved in their treatment plan. The mental health legal system is notoriously complex, frequently necessitating the involvement of attorneys with real expertise in how to navigate it.

While the complexities inherent in serious mental health illnesses—and the fear often surrounding them—make the conditions incredibly challenging to discuss, silence does a tremendous disservice to those who are contending with these conditions day in and day out. This May, let’s make sure our conversations include those with these hard-to-discuss, challenging issues so that they, and their families, know they aren’t alone.