Can you see in the dark—in the silent night of a new moon?
William Styron saw it. Although acclaim followed the brilliant author of The Confessions of Nat Turner and Sophie’s Choice, a shadow stalked then swallowed him. Depression. Styron movingly penned his descent into hell and struggle for peace of mind in Darkness Visible: A Memoir of Madness:
. . . a patient who felt similar devastation would by lying flat in bed, possibly sedated and hooked up to the tubes and wires of life-support systems. . . . His invalidism would be necessary, unquestioned and honorably attained. However, the sufferer from depression has no such option. . . . There he must, despite the anguish devouring his brain, present a face approximating the one that is associated with ordinary events and companionship. He must try to utter small talk, and be responsive to questions, and knowingly nod and frown and, God help him, even smile. But it is a fierce trial attempting to speak a few simple words.
It is all too easy to turn away from stark facts.
In March 2014, the National Alliance on Mental Illness (NAMI) released figures on this epidemic:
—Approximately 60 percent of adults and almost one-half of youth ages 8 to 15 with mental illness received no mental health services in the previous year.
—Although military members comprise less than 1 percent of the U.S. population, veterans represent 20 percent of suicides nationally. Each day, about 22 veterans commit suicide.
—The numbers are staggering for mental health issues affecting the homeless, addicts, juveniles in detention, and prisoners in the criminal justice system.
—Serious mental illness costs America $193.2 billion in lost earnings per year.
Already overwhelmed emergency rooms are often the only refuge for some stricken Americans. A temporary fix—and then the insidious cycle renews.
The 2008 recession hit hard, according to Medical News in 2008. Alarmed by “recession depression,” NAMI partnered with Mental Health America to survey adults nationwide. “The unemployed were found to be four times as likely as those with jobs to report symptoms consistent with severe mental illness.”
Depression rips apart families and communities, with relationships often unrepaired. Anger, ignorance, intolerance, neglect, denial, isolation, fear, sorrow, and anxiety affect both the depressed and their loved ones.
Nonetheless, courageous Americans speak through action. Mere lip service is a mockery.
On November 19, 2013, in Millboro, Virginia, an American tragedy played out. Twenty-four-year-old Austin “Gus” Deeds stabbed his father, Creigh Deeds, before taking his own life. Only hours before—after a psychiatric evaluation—an emergency custody order expired. There was no bed space for Gus.
Deeds, a Virginia state senator, went public and pushed for legislation. Omnibus bill SB260 unanimously passed the Virginia Assembly this past March. State hospitals must provide a “bed of last resort” space for temporarily detained patients when deemed necessary. SB260 mandates the completion of a web-based psychiatric bed registry.
It is a modest start, “the tip of the iceberg,” Creigh Deeds said.
Gus Deeds was a son, a brother, a friend, a classmate, a musician—not a faceless statistic.
In her groundbreaking book—An Unquiet Mind: A Memoir of Mood and Madness—Kay Redfield Jamison, Ph.D. charted the disruptive illness that threatened her life. Diagnosed early with bipolar disorder, she found a rich path and career in the Department of Psychiatry and Behavioral Sciences at Johns Hopkins Medicine.
Attention must be paid. No more whispers in the dark.
Folk singer Dar Williams tells a too-familiar story about pain, withdrawal, and joyless getting by.
Parity and Crisis: Quotes of Note
“We have replaced the hospital bed with the jail cell, the homeless shelter, and the coffin. How is that compassionate?”—Representative Tim Murphy, Republican, Pennsylvania. Source: “The Cost of Not Caring: No Place to Go,” Liz Szabo, USA Today, May 12, 2014
“Some of our instincts on treating mental health are good, but our implementation is a failure.”—State Senator Creigh Deeds, Democrat, Virginia. Source: “Out of Sight, Out of Mind,” editorial board, Newsleader, April 5, 2014
As of January 1, 2014, more Americans can purchase insurance that covers mental health and substance abuse disorder. As of April 29, 2014, 21 states refused to extend Medicaid coverage for citizens. Source: “Mental Health Now Covered under ACA, but Not for Everyone,” Susan Brink, U.S. News and World Report.
“In the past few weeks, serious allegations of misconduct have arisen from several VA medical facilities, indicating that records are being intentionally doctored in order to falsely portray patient wait times as reasonable and satisfactory. Recently, several VA employees have come forward and alleged what IAVA members have been reporting anecdotally for some time: that wait times at some VA medical facilities are far longer than reported.
“Disturbingly, long wait times are alleged to have resulted in the deaths of 40 veterans who perished while waiting for care at the Phoenix VA medical facility alone. It has been alleged that those and many other veterans at the Phoenix VA were placed on a ‘secret waiting list’ in order to hide actual wait times so VA officials could report that department goals were being achieved. Since the Phoenix VA story broke, more allegations of misconduct by VA personnel at other facilities from coast to coast are painting a similar picture. Unfortunately, these types of incidents are not new, nor apparently are they unique. “
Source: Statement of Tom Tarantino, Chief Policy Officer, Iraq & Afghanistan Veterans of America (IAVA) before the Senate Committee on Veterans’ Affairs for the hearing on the State of VA Health Care, May 15, 2014
Where to Turn
National Suicide Prevention Lifeline (with Veterans Crisis Line), 1-800-273-TALK (8255)
Bring Change to Mind (Glenn Close founded this organization to fight stigma. Her sister Jessie, a poet, lives with bipolar illness. Her nephew, Calen Pick, leads a productive life as an artist and furniture maker, although he has schizoaffective disorder.)
Out of the Darkened Room: When a Parent Is Depressed by William R. Beardslee, M.D.
Judge Baker Children’s Center (An affiliate of Harvard Medical School, the center focuses on children ages 3 to 17. The organization promotes the best possible mental health by integrating research, intervention, training, and advocacy. Parents can access treatment programs and resources on the website. Dr. William R. Beardslee directs the Preventive Intervention Project and the Prevention of Depression Study.)
Veterans on Trial: The Coming Court Battles over PTSD by Barry Shaller and Todd Brewster (Note: The book includes a history of PTSD in previous wars.)
Nocturne in Black and Gold by James Abbott McNeill Whistler, Detroit Institute of Art
In the Corner by Carl Larsson, National Museum, Stockholm, Sweden
Femme Assise (Melancholy Woman) by Pablo Picasso, Detroit Museum of Art
Entombment of Christ (Lady with Tears), Saint Martin Church in Arc-en-Barrois (Author: Vassil. User: AnkhMorPork)
Sketch by Vincent Van Gogh to his brother Theo, Van Gogh Museum, Amsterdam
The Sick Woman by Jan Steen, city of Amsterdam
Homeless Man in Los Angeles by Terabass