David Shern, PhD

David Shern Ph.D.

Minding the Nation's Health

Mental Health and the Spill: Let's Stop Discriminating

Denying Compensation to Gulf Residents is Wrong

Posted Aug 25, 2010

As BP claims administrator Kenneth Feinberg begins this week to compensate victims for injuries caused by the catastrophic oil spill, mental health and substance use conditions won't be included unless they are directly related to a physical injury sustained as a result of the spill.

That's discriminatory and continues to perpetuate a damaging and incorrect notion that mental health and addiction conditions are not real diseases with an organic basis. Mr. Feinberg said last month that mental health claims would only be paid if they were caused as a result of a physical injury. While that view may be supported by centuries-old principles of common law, it is inconsistent with our current understanding of the organic correlates of mental health and addiction conditions.

We know mental illnesses are physical illnesses. Disorders related to toxic stress cause measurable changes in brain function and architecture. Brain damage is a physical injury. There is no meaningful distinction between other somatic injuries and brain damage resulting from the toxic stress of trauma. Stressful and traumatic events like the oil spill, its resulting loss of livelihood and a very uncertain future can lead to the emergence or worsening of Post-Traumatic Stress Disorder (PTSD) and other related illnesses.

Mr. Feinberg should also recognize recent policy changes regarding compensation of mental health conditions. The Department of Veterans Affairs (VA) has historically given less credence to the 'invisible' psychological injuries of war than to the physical injuries endured during combat, recently the VA modified its policy regarding health care and disability compensation. Based on the overwhelming evidence that a service member deployed in a war zone is at an increased risk of PTSD, the VA no longer requires the service member to have experienced a specific instance of trauma in order to receive compensation.

When Congress passed the mental health parity law and included mental health and substance use services as a benefit in the new health care law, it was acknowledging that we can longer view mental health conditions as somehow separate or distinct from overall health. We have to stop relying on historical patterns of discrimination enshrined in archaic laws and recognize the science of today.

BP last month agreed to give $52 million to federal and state agencies for mental health and substance abuse programs in the gulf region because of the toll the spill will take on the lives of residents. It recognizes the severe health problems that will continue to impact the residents of the gulf.
Researchers reporting in The Journal of the American Medical Association say there will likely be a long-term effect on residents' mental health similar to what occurred after the Exxon Valdez and other spills. In examining the health records of clean-up workers from the Valdez and other spills, they found that people involved in those efforts reported trouble breathing, as well as depression, Post-traumatic Stress Disorder, anxiety, stress, and brain damage.

And remember Katrina? Five years after hurricane, a new study reports children displaced by the storm are nearly five times more likely than other kids to have severe mental health problems. The BP oil spill has added to their trauma, researchers say.

We owe them more help than they are receiving from Mr. Feinberg.