Monday, October 26, 2009

A book whose time has come

I’m beginning to think the time has come for the subject of my book. Whether it will help motivate an agent and a publisher is another story, but just in the last week two pieces have come out discussing mental illness and dealing with it. One was an article by Glenn Close in The Huffington Post about eliminating the stigma of silence about mental health. Another article was on NPR this morning about helping college students with mental illness and the need for more counselors so their needs can be responded to quickly. Akin to a broken leg that gets immediate attention, a mental break or deep depression also needs immediate attention. This has become more prevalent in the last 10 years because more students with mental illness are attending college – enabled by the availability of the anti mania, anti depression, and anti psychotic new medications.

So, looking back at the response Paul had when he had his first psychotic break when he was in college. Someone from the school’s medical office walked him to a hospital nearby and left him there, and within minutes he left. The only concern the school seemed to have was that he have a signed note from a doctor stating he was healthy enough to return to school. No one was there to monitor his progress and check in on him during and after his break. If more attention had been paid at the outset would the outcome have been different? He always felt stigmatized by his disease. Perhaps had it been dealt with openly he would have been more willing to get help and not feel like he had to hide it.

Oh, I know there is no way to know. Yet, I do know that that was a different time. People’s attitudes and awareness are changing about mental illness. And the more articles about it in the media, the more it will continue to change. Like a parent whose son killed himself said on NPR this morning, perhaps more attention will save lives. Yes, that’s the ultimate goal.

Here’s Glenn Close’s article:

Mental Illness: The Stigma of Silence
by Glenn Close

"Mental illness and I are no strangers.

From Alex Forrest in Fatal Attraction to Blanche Dubois in A Streetcar Named Desire to Norma Desmond in Andrew Lloyd Weber's Sunset Boulevard, I've had the challenge -- and the privilege -- of playing characters who have deep psychological wounds. Some people think that Alex is a borderline personality. I think Blanche suffers from post-traumatic stress disorder and everyone knows that Norma is delusional.

I also have the challenge of confronting the far less entertaining reality of mental illness in my own family. As I've written and spoken about before, my sister suffers from a bipolar disorder and my nephew from schizoaffective disorder. There has, in fact, been a lot of depression and alcoholism in my family and, traditionally, no one ever spoke about it. It just wasn't done. The stigma is toxic. And, like millions of others who live with mental illness in their families, I've seen what they endure: the struggle of just getting through the day, and the hurt caused every time someone casually describes someone as "crazy," "nuts," or "psycho".

Even as the medicine and therapy for mental health disorders have made remarkable progress, the ancient social stigma of psychological illness remains largely intact. Families are loath to talk about it and, in movies and the media, stereotypes about the mentally ill still reign.

Whether it is Norman Bates in Psycho, Jack Torrance in The Shining, or Kathy Bates' portrayal of Annie Wilkes in Misery, scriptwriters invariably tell us that the mentally ill are dangerous threats who must be contained, if not destroyed. It makes for thrilling entertainment.

There are some notable exceptions, of course -- Dustin Hoffman in Rainman, or Russell Crowe's portrayal of John Nash in A Beautiful Mind. But more often than not, the movie or TV version of someone suffering from a mental disorder is a sociopath who must be stopped.

Alex Forrest is considered by most people to be evil incarnate. People still come up to me saying how much she terrified them. Yet in my research into her behavior, I only ended up empathizing with her. She was a human being in great psychological pain who definitely needed meds. I consulted with several psychiatrists to better understand the "whys" of what she did and learned that she was far more dangerous to herself than to others.

The original ending of Fatal Attraction actually had Alex commit suicide. But that didn't "test" well. Alex had terrified the audiences and they wanted her punished for it. A tortured and self-destructive Alex was too upsetting. She had to be blown away.

So, we went back and shot the now famous bathroom scene. A knife was put into Alex's hand, making her a dangerous psychopath. When the wife shot her in self-defense, the audience was given catharsis through bloodshed -- Alex's blood. And everyone felt safe again.

The ending worked. It was thrilling and the movie was a big hit. But it sent a misleading message about the reality of mental illness.

It is an odd paradox that a society, which can now speak openly and unabashedly about topics that were once unspeakable, still remains largely silent when it comes to mental illness. This month, for example, NFL players are rumbling onto the field in pink cleats and sweatbands to raise awareness about breast cancer. On December 1st, World AIDS Day will engage political and health care leaders from every part of the globe. Illnesses that were once discussed only in hushed tones are now part of healthy conversation and activism.

Yet when it comes to bipolar disorder, post-traumatic stress, schizophrenia or depression, an uncharacteristic coyness takes over. We often say nothing. The mentally ill frighten and embarrass us. And so we marginalize the people who most need our acceptance.

What mental health needs is more sunlight, more candor, more unashamed conversation about illnesses that affect not only individuals, but their families as well. Our society ought to understand that many people with mental illness, given the right treatment, can be full participants in our society. Anyone who doubts it ought to listen to Kay Redfield Jamison, a psychiatry professor at Johns Hopkins, vividly describe her own battles with bipolar disorder.

Over the last year, I have worked with some visionary groups to start, an organization that strives to inspire people to start talking openly about mental illness, to break through the silence and fear. We have the support of every major, American mental health organization and numerous others.

I have no illusions that is a cure for mental illness. Yet I am sure it will help us along the road to understanding and constructive dialogue. It will help deconstruct and eliminate stigma.

The World Health Organization (WHO) estimates that by the year 2020 mental illness will be the second leading cause of death and disability. Every society will have to confront the issue. The question is, will we face it with open honesty or silence?"

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