Recently I was getting on the highway to run errands. There is a bridge there. It is close to 150 feet above a dry wash. It is a known site for suicides.
I saw a woman walking along the side of the roadway near the edge of the bridge. There was no car that I could see and I knew the bridge’s reputation. We had lost a son who died having jumped from a parking structure. I immediately stopped and got out of my truck. I walked back and began to talk with the woman.
She was disoriented. She said her car had broken down, but there was no car to be seen. She seemed to be out of it. We spoke for a few minutes and then a sheriff’s car came down the on ramp at high speed with the lights on. Two deputies jumped out and escorted her into the back of the car. I then left, figuring they had the situation under control. But did they?
Dealing with people in mental health crisis is not easy. Most people run away at the thought. Families are in denial about a member’s condition because the stigma is so strong. Many of our first responders have little training, and empathy for someone in crisis is a tall order sometimes. But actually, we are all first responders.
The family members are the most common first responders. They see their child or parent or sibling in crisis or see the symptoms of mental illness before anyone. Sometimes they don’t want to admit it and most times it takes a crisis to seek help. I work regularly with family members in these crises as a NAMI instructor.
Our clergy and staff are also deeply engaged. The first place most families go in crisis is to their faith community. Compassion is a large contributor to the healing process. And walking side by side in this difficult journey can make all the difference in the world.
The police are the next line of defense. Sometimes officers have extensive training, but many don’t. They may get anywhere from 8-24 hours of education, depending upon locale. And yet if you talk to most law enforcement officers they will tell you that up to half of their calls today have a mental health component. They were never trained to be social workers or clinicians, but law enforcement is the imperfect option when things get out of hand. Maybe someone gets help or in some cases; maybe someone dies.
I have heard the stories. In one case a family member was found by a relative with a gun to his head. The police were called and were faced with an armed person. What to do? In that case shots were fired and the individual lived, but was faced with a long prison sentence for assault with a deadly weapon. Does prison solve the root cause? Our jails and prisons are in fact our mental health warehouses.
Some of our most heinous crimes have been committed by people with severe mental illness. As a culture it seems that we have become numbed to this terrible fallout. We turn and look away and change the subject. But the reality is that in the vast majority of cases it is those with mental illnesses who are the victims.
Most MD’s and nurses in emergency rooms have an acquaintance with mental illness. But general practitioners and internists get little training on the various diseases of the brain. And these are diseases, just like cancer and diabetes or heart disease. The average person with mental illness lives 20 years less than the rest of us.
And in most emergency rooms there is no effective mental health treatment. Patients wait for a bed in a psychiatric unit, and if the individual has been admitted in a psychotic state you can bet that most ER staff don’t want to deal with it. And yet they are first responders as well.
In our education system some leaders are recognizing the impact. The fastest growing suicide rate is in teenagers, especially girls. Teachers and administrators are in most cases woefully under equipped to deal with students in crisis. Some school districts are adding therapists and teaching teachers to know the signs and direct individuals to resources, but when budgets and programs are being cut, where will the resources come from?
Science has discovered some of the pathways, causes and effects, but unless you are involved and informed, most people don’t understand that these are biological illnesses of the brain. It is not about your mother or because you didn’t get the ice cream you thought you deserved when you were 10. There are psychological and spiritual components to these illnesses as well. But at the root there is a chemical imbalance or physiological cause.
We do know that the earlier we catch the symptoms, the better the outcome. We know that mental illness is often linked to addiction, homelessness, and incarceration. We know that the social and economic costs to our society are huge.
Consider the fact that one in five of us will have a diagnosable mental health condition in our lifetimes. It is the largest and scariest group of illnesses. People have a good shot against most cancers. Diabetes can be treated and even prevented. Heart diseases have a good chance for remission. And this is just as true with mental illnesses.
We know that early intervention works. We know that educating the families works. There are a number of reports that show that family education reduces readmission rates by over 85%!
But it begins with stigma reduction and education. Patience and compassion work. Mental health care is perhaps the most intimate and yet simple of health care pathways. Sometimes it takes just listening. Sometimes it is just asking if someone is okay. Maybe then you can direct them to resources.
Mental illness affects us all. It is all around us much as some of us want to ignore it. Abraham Lincoln had it. Winston Churchill had it. Darwin, Hemingway, Tolstoy and Jack Kerouac had it. Glenn Close has it. Audrey Hepburn, Barbara Streisand, Brian Wilson and Princess Diana are on that list. And you know, it doesn’t matter. We can all reach for the stars.
It is not a barrier to achievement surely. Nor should we stigmatize those who have this spectrum of diseases. That is the beginning. Jesus Christ, the Buddha, Mohammed, and all of our greatest teachers and leaders have preached compassion. That is a first step.
Education is the next step. We are not afraid of the familiar. I once watched my daughter tend to a friend who was having an epileptic fit. She calmly cleared away anything that might hurt her friend and then made sure that she was not going to swallow her tongue. They were 12 years old at the time. Knowing the signs and knowing what to do helps both the individual and those around them to weather the storm.
And correcting the falsehoods, the assumptions, and eliminating the shame will go a very long way in helping us to be better first responders.
Mental illness knows no boundaries. Gender, race, ethnicity, economic status; none of that matters. It affects us all, and all of us are first responders. Educate yourself, have compassion, separate the individual from the illness, help when you can, and remain calm.
Matt Holzmann, Chair – Government Relations for NAMI – Orange County firstname.lastname@example.org
Opinions expressed in editorials belong to the authors and not Voice of OC.
Voice of OC is interested in hearing different perspectives and voices. If you want to weigh in on this issue or others please contact Voice of OC Involvement Editor Theresa Sears at TSears@voiceofoc.org