Is Mental Illness a Choice?

On the 11th of October 2022, Cristian passed away after a long battle with alcohol addiction. He was sick, worried about losing his job, overwhelmed by a demanding boss, and lonely. He was only 47. He left behind a 12-year-old daughter who asks me every day, “Why, Mom?”

His experience made me acutely aware of how little we know about mental health. For the last ten years, I’ve immersed myself in the topic, reading studies and connecting with people passionate about advancing mental health.

I invite you to reflect on the realities of mental illness and how society and the insurance industry can help those suffering. I also encourage you to check in with yourself, ask for help when you need it and raise awareness of mental health.

The Beginning of the End

“I think I have an alcohol addiction,” he said in 2013. I denied it. He was highly educated and deeply passionate about the automotive industry. He loved his family. He was balanced and positive. He had all he wanted. How wrong I was! I blamed, judged, suffered, and hoped. I learned step by step, alongside him, how monstrous this illness is.

His life became a rollercoaster, alternating between rehabs, moments of hope, relapse, and desperation. He went to the hospital a dozen times, entered rehab twice, and tried several therapies. Towards the end, he told me: “I have drunk since I was a teenager; there is no way back for me.”

I still wonder if I could have done anything else to save him. The close relatives tried hopelessly to find a way to help but to no avail. The more we tried, the more he would hide and isolate himself.

Mental illness is not a choice

A glass of wine at a party is a choice. Addiction is not. It is a beast that takes away your balance, your joy, and finally, your life. It does not discriminate. It affects CEOs and their assistants, stay-at-home moms, children, and grandparents. It devastates the lives of PhDs and illiterates alike.

How is the system supporting people affected by mental illness?

“What am I going to do after rehab?” Cristian asked me this, and it haunts me to this day. He had been to long-term rehab twice and benefited from psychological support and medication. But once out, his problems were the same. He was feeling lonely and still had no job.

Here’s the reality: recovery doesn’t end when someone leaves a psychiatric hospital or a rehab facility. For many, it’s just the beginning of an uphill battle. People are thrown back into the same environment they struggled in before—with the same stresses, triggers, and lack of support. They’re often unemployed, financially unstable, and emotionally fragile. And yet, society expects them to “just stay clean.”

But recovery doesn’t happen in isolation. The World Health Organization strongly advocates for community support, and for a good reason—people who suffer need communities to make progress. Society as a whole is responsible for caring for those who suffer. There are a few aspects I reflected upon. Here is what we can do:

1. Create pathways to employment: A stable job gives people in recovery a purpose, routine, and financial independence. We need more employers willing to offer second chances because getting back into the workforce is crucial for long-term recovery.
2. Ongoing mental health support: Rehab is just the start. People need access to therapy, counselling, and peer support long after they leave the facility. Mental health is a lifelong journey requiring consistent care, not short-term fixes.
3. Build a stronger community: People in recovery need support systems—friends, family, and community programs that provide encouragement and accountability. By creating more inclusive, understanding communities, we can lower the risk of relapse.
4. Address the root causes: Many turn to addiction as a way to cope with underlying issues like trauma, violence, or poverty. Until we tackle these problems head-on, rehab alone won’t be enough to break the cycle.

Recovery isn’t just about getting clean. It’s about rebuilding a life—which takes more than a few weeks in rehab. It takes ongoing support from all of us.

How can insurance help?

Mental health crises often build over time, yet insurance tends to step in too late, focusing on treatment rather than prevention. I dare to ask you: how many times have you felt abandoned, isolated, or overwhelmed?

Our industry can do more. Here is what I believe insurance companies need to change if we want to truly support mental health:

1. Include mental health in primary care: Each time I go to my primary care physician, I get blood tests and questions about my lifestyle. Never about mental health. The World Health Organization recommends including mental health in primary care. This is only possible with insurance support.
2. Treat mental health care like any other medical condition: Therapy, medication, and inpatient care should be fully covered. People should never have to choose between getting help or going into debt.
3. Preventive mental health care: Insurance must invest in prevention, covering regular mental health checkups, early intervention programs, and support before a crisis occurs. Technology allows for cost-effective solutions. For example, did you know some platforms can detect early signs of mental illness based on voice, fine motor reactions, or facial micro-expressions? What about integrating them via APIs into health insurance apps? 
4. Support for families: Life with a person suffering from addiction is challenging, to say the least. You cannot rely on them for essential support; sometimes, their actions are a liability. The emotional toll on partners, parents, and children is enormous. Mental illness impacts everyone in the family, yet most policies don’t cover family therapy or caregiver support. Insurance companies should provide resources that help families, not leave them overwhelmed and unsupported.
5. Simplified access to care: Mental health crises don’t wait for approvals or paperwork. Insurance must remove the red tape: no delays or limited provider networks. People need fast, direct access to mental health professionals when they need it most. If that is a remote care provider abroad, let them get help. 
6. Flexible treatment options: Everyone’s path to healing is different. Insurance should cover a variety of treatment options, from therapy and medication to alternative treatments. People need personalised care to heal, not cookie-cutter solutions.
7. Collaborate with other institutions to raise awareness: I denied that my husband had a problem. Not because I did not care but because I was utterly unaware of addiction or other mental illnesses. We still judge and blame people for “making the wrong choices” when science proves that addiction is a complex, difficult-to-treat disease. Insurers should collaborate with non-profit organisations that raise awareness on mental health.

Insurance has the power to be a catalyst for change. It can bring hope and healing to millions of lives affected by mental illness and addiction. When we genuinely care for the most vulnerable, we build a better, stronger society for everyone.

How do you move on after losing someone you love?

I wish I had a perfect answer. I don’t.

Cristian`s parents joined support communities, speaking about their pain with other people who went through the same experience. Together, we decided to share his story to raise awareness and break the stigma surrounding mental illness and addiction.

My parents organise religious ceremonies for his soul. They pray and cook, go to church and light candles in his memory. I believe those prayers are for the souls of the ones left behind.

Most of our daughter’s classmates don’t know that she no longer has a father. She buried the pain deep, along with the memories of their seaside holidays. She asked me to spend a few days by the coast this summer. I watched her stare at the waves for a long time without saying a word.

I’m a tough cookie, but his loss changed me more than I could have expected. I focus on doing things I believe in and fulfilling my purpose. I speak up against the stigma surrounding mental health in a society that labels addicts, the depressed or the anxious as “weak”.

This year, I founded Mind Healing with a few passionate people. It is a mental health association dedicated to advocating for and building partnerships to support children’s and youth’s mental health. If Cristian or his parents had known how it would end, they would have made different choices. Millions of young people and their families remain uninformed about mental health, and we are determined to change that.

Sometimes, I melt when I see a firefly, remembering how he used to call me that. I find relief in knowing that pain is just another form of love.

Mirela Dimofte

Also read and see: Video #4: Florence von Gunten, psychologist