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From the Coalition Report
Summer 2000


Obituaries--Dying of Mental Illness

by Deborah Peel, MD

I sometimes find myself glancing through the obituary columns of the Austin newspaper.  I now know a few people who have died.  Mostly I find what I expect to see, stories of people who lived long full lives and were well loved by their families.  This year I've seen something very different.  Heartbreaking narratives from families whose loved ones have died of mental illnesses.  The words were too moving even for those pages where sad words belong:

A 17 year old, whose family attributed her suicide to Manic-depressive Illness.  Two years ago, Jaime gave birth to Kyla and in spite of this challenge she worked very hard to graduate from high school a year early.  She was a wonderful Mommy.  She most recently attended junior college and wanted to get her degree in advertising.  Jaime was diagnosed with bipolar disorder and fought very hard to control this debilitating disease.  She always wore her heart on her sleeve and was an easy target for people who wanted to hurt her. She never quite recovered from a past abusive relationship and decided that she could not take it anymore.  No one can hurt you now our angel.    

A 22 year-old, whose story started with our precious Ginny died of a probable heroin overdose.  She was often the champion of the underdog, and always the champion of our four-legged friends.  While drugs stole this beautiful, vibrant, courageous, loving young lady from her family and friends, she has been freed from the pain and suffering she felt in this life.  

A 27 year-old man, whose mother wrote, "Your illness, depression, those manic days, with little help from the doctors.  So you opted to end your life.  Your place was so dark and deep, your pain was so overpowering, it's no wonder you could not consider the devastation you would leave behind.  All but the first four years of your life, you struggled with this debilitating condition.  It robbed you of necessary sleep, hindered your understanding of life, distorted your options, and sabotaged your dreams.  How could we think you'd just snap out of it?  

A 12 year-old girl committed suicide.  She had been very depressed, her parents had their own serious medical problems, and managed care and some of her physicians seemed unresponsive.  Returning to school after brief hospitalizations, she was taunted by her classmates for being crazy.  According to the article which appeared in the "life style" section of the local newspaper, her parents blamed the "stigma" of mental illness for her death.

In all my years as a practicing psychiatrist, working with thousands of people with mental illnesses and/or addictive disorders through 23 years of practice after medical school and residency, only 3 of my patients have taken their own life.  Many of you may know the pain of losing a person you hoped you could help recover.  Even though some of us work with people whose illnesses carry great risk of death, I suspect we haven't lost very many.  With access to comprehensive and effective treatment, we save lives and help people recover.

But people are dying and suffering now at a frequency I never saw earlier in my career.  Children, teenagers, and young adults are dying from mental illnesses and addictive disorders that are highly treatable.  These people I read about should have lived.  They should have had access to high quality comprehensive care for as long as they needed to be well.  Without children's units, adolescent units, or drug rehabilitation units and without access to protective inpatient settings for long enough to become stable and not a danger to themselves, children and adults are dying.

This is a tragedy in my state of Texas, where 40% of the psychiatric inpatient beds have closed in the last four years, according to a study conducted by the Texas Society of Psychiatric Physicians.  Loss of inpatient treatment beds is a national crisis and disgrace as well.  It has occurred because insurers are no longer willing to pay for treatment of mental illness.  According to the recently commissioned Hay Group Report (www.naphs.org), the funding for treating mental illness has been cut 50% during the past 11 years.  No other field of medical treatment has been cut more than 10%.

Discrimination against people with mental illnesses and addictive illnesses is routine corporate policy for managed care and is causing the deaths of our precious children and young people.  These amoral and destructive managed care policies are why NCMHPC exists.  What can we do as professionals or as individuals to stop this carnage?  Each of us must look at what we can do.  Each of us must fight along with NCMHPC to oppose the devastation managed care has perpetrated on people with mental illness or addictive disorders.  Rescue Health Care Day was a powerful way the NCMHPC put the spotlight on the systemic abuses of managed care across this country.  Now it is time to lobby, before the next election, to restore the mental heath care system to the quality and excellence our citizens deserve.

The public and policy makers have a poor understanding of mental illnesses, effective treatments, and the role of mental heath professionals.  These sad deaths and family tragedies go on because the public and legislators do not recognize mental illnesses and addictive disorders as the serious medical diseases they are.  People with these diseases are invisible and mental health professionals are invisible too

If policy makers do not know what depression is, how in the world can they be convinced that changes must be made to ensure access to quality treatment?  If the public doesn't know there are mental health professionals highly trained to treat mental illnesses and addictive disorders, again, how can we expect the public to truly recognize the need for quick access to high quality mental health care?  We must educate everyone.

Each of us must become an advocate, and do at least one of these five things

1. Join NCMHPC now. Learn to lobby with our help and our new Election 2000 kit. Learn to educate those with the power to fix our nationís devastated mental health care system.  
2. Write one op-ed piece for your newspaper about something you are an expert about: what you know from your own life about mental illnesses or about the tremendous value of quality treatment.
3. Give one talk to a community group or school about what you know.  Talk with your friends and neighbors about the suffering and deaths that are occurring now and how unnecessary they are.  
4. Go meet with your state representative and senator.  Go meet with your Representative to the US House and your two US Senators.  Who else will tell them about the suffering and deaths?  Who else can tell them about the saved lives when people have access to excellent treatment from mental health professionals?  
5. Join PSYCH-GRASSROOTS to get updates on federal legislative issues and how you can intervene, send an E-mail to <grassroots@psychmd.net> and write that you want to SUBSCRIBE  in the body of your message, then add your state so that you can  receive targeted information specific to your state.  

Make the year 2000 be the year we each become strong advocates for high quality mental health treatment.  It is time to stop being invisible.  The knowledge to heal and save, the scientific base for effective care, the techniques and treatments that are effective and cost-effective for mental illness are available if people can only get access to care.  If we don't tell the story, who will?  Each of us must do his or her part.  People are dying.

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