People magazine recently covered Jane Pauley, former NBC new anchor, and her new book Skywriting. In the book, Pauley talks about her struggle with bipolar disorder, and People emphasizes the care and treatment she has received.
Dr. Mark Komrad wrote a letter to People applauding them for helping, along with the book, to decrease the stigma attached to mental illness, but explaining there is still much mor work to do. We reproduce the letter here in its entirety.
To: The Editor of PEOPLE Magazine
re: Article on Jane Pauley's new autobiography
Jane Pauley's new book SKYWRITING is a wonderful addition to the always-appreciated collection of celebrity books about mental illness. These books go a long way to help decrease the stigma against these ravaging illnesses. However, the excerpts from this book in the last PEOPLE magazine issue present the good news and bad news about the contemporary treatment of mental illness. The good news is that these illness ARE treatable, once they are properly diagnosed. In fact, data shows that illnesses like bipolar disorder,which afflicted Ms. Pauley, are even MORE responsive to treatment than common conditions like hypertension or heart disease. Her case demonstrates that responsiveness.
The bad news is that there is still a major division between treatment accessible to those who are wealthy and those who are not. This difference is not between the insured and uninsured. The average person, WITH insurance would not be permitted an inpatient level of treatment without an extremely severe level of illness. Nor would the average person be admitted to a medical ward instead of a psychiatric ward, let alone have such a luxurious, spacious, private hospital room as Ms. Pauley enjoyed. If ill enough to be hospitalized, not only would the typical person be required to be in a psychiatric unit, with other psychiatric patients, but they would also be required to participate in a range of therapeutic activities, with other patients, during the day, unlike Ms. Pauley who was exempt from such requirements.
I do not know Ms. Pauley's case well enough to say whether she benefitted or lost by her exemption from such standard psychiatric inpatient treatment, or whether the severity of her illness was severe enough for an insurance company to authorize hospital care. But, her experience was certainly quite different than is typical. Though different medical treatment for different socioeconomic classes is not unique to psychiatry, such a gap is probably more profound in psychiatry than in any other area of health care today.
Mark S. Komrad M.D.
Senior Psychiatrist
Sheppard Pratt Hospital
Baltimore, Maryland
