Stepping Up

It’s impossible to write a blog about mental illness without confronting the violence that has descended on this country all too often.  Too many innocent victims have fallen at the hands of too many offenders to set the issue aside.  My heart bleeds for the victims lost and the loved ones remaining.  Nothing written can take away the pain of the survivors.  But a call to action may help to prevent such crimes from continuing.

The offenders in these incidents are often troubled and plagued by recurrent mental illness.  The tragedy begins when our mental health system fails these individuals and their families as they seek help that is sometimes unavailable.  It layers as so many people who do not have direct experience with mental illness find their only exposure to people with serious mental illness in these stories.  This adds to an already daunting stigma against those with psychiatric disease, and too many of those who need help avoid it for fear of being labeled or ostracized.  Every incidence of violence leaves me heartbroken, and waiting for the inevitable story about someone with mental illness gone wrong.

The result of a broken mental health system and the stigma that drives people with serious mental illness into the shadows is fewer people getting treated than need treatment.  Some people (a very small percentage of the population with mental illness, but a disturbingly large real number) with untreated mental illness act out and sometimes violence occurs.  In addition to the senseless tragedy that results, this adds to the stigma placed on those with psychiatric challenges as the general population hears the stories of mentally ill offenders who were “off their meds,” or otherwise refusing treatment.  Or being refused treatment.

In truth, even though sensationalized in the media, very few people know anyone with mental illness and violent tendencies.  However, almost everyone knows someone with mental illness who is managing life well.  Yet because of the stigma, more often than not few know that those managing well have a mental illness at all.  There is so much to risk in stepping from the shadows and saying “I have bipolar disorder, or schizophrenia, or anxiety disorder, or major depression or…”   Jobs and relationships could become tenuous.  Still, until those of us who have a mental illness and do cope well stand up and act as role models for those who are not currently able to deal with disease, the stigma will hold, people will avoid treatment, and society will view the mentally ill as disturbed, demented, or violent.  Those of us who do well owe it to those who are suffering to light a path toward recovery.  Only we can testify that treatment often works, and only we can tell our stories and reveal to the larger population that those with mental illness are not miscreants, vagrants, and criminals.  We are your teachers, your accountants, your child’s playdate’s parents, your boss, your mechanic, your kid’s soccer coach, your favorite musician, actor, or writer, your doctor, your council person.

Treatment is difficult and access is often limited.  But there is no denying that even when treatment is readily available, many refuse it for fear of the stigma.  These same people often get worse.  Some do stupid or reprehensible things.  This can be avoided if we can chip away at the stigma.  And we can chip away at the stigma by taking a stand and showing our neighbors that mental illness does not mean maladaptation.  There is much pain in knowing that in all of these incidents of violence we could not be there to intervene or help.  But we can help avoid the next one by testifying to the very ill that:  “I did it.  I overcame this.  You can, too, and I can help show you how.”  If more of us act as responsible role models the stigma will erode.  As the stigma falls away, more people will seek help.  Examples of people who have been successfully treated may open up access to treatment for others, as policymakers see that dollars spent on psychiatric care are well spent.  As more people seek and receive care, fewer incidences of mindless violence will occur.

It’s our responsibility to let society know that those with mental illness can lead peaceful, productive, creative, and meaningful lives.  We are examples of this.  The stigma against people with mental illness is one factor that leads to so many bad outcomes.  We owe it to those who have lost loved ones, and to those suffering from illness as we surely once did, to stand up and be seen as examples of how things can turn out well.