My first contact with a tangible mental illness and its implications occurred as a young lawyer trying a murder case in which my client, assigned to me by the court, was accused of murdering his wife. In the normal course, I sought a mental health evaluation of my client. I called one of the most prominent forensic psychiatrists in Detroit and asked him if he would evaluate this individual to determine if he could stand trial or if there was a mental health defense to his criminal actions. The psychiatrist visited the individual at the county jail and conducted an evaluation of the man’s mental status. The doctor called me and indicated that he was willing to testify that this individual had experienced a dissociative reaction, and during that reaction his wife had expired. The court heard this testimony and determined my client was not guilty by reason of insanity. To this day, that case and the court’s decision still resonates with me. I was young and naïve and quite uncertain as to the legitimacy of the psychiatrist’s conclusion. However, in our criminal justice system, asserting the best defense available was my ultimate responsibility.
Today, when we see statistics that indicate 1 in 5 adults in the United States experiences mental illness in a given year and that one in 25 adults experience a serious mental illness in a given year, we are confronted with an illness that has daily impact on the fabric of American society. We allow suffering in silence as family members view mental illness from a completely different prism then they view physical illnesses such as cancer or heart disease. Our society reacts similarly by ignoring the plight of those who are facing mental illness. I recall some years ago, I was walking back to my office from lunch with a couple of associates and we were approached by someone in a distraught state asking for money for food. I gave this gentleman some money. My associates ignored him. When we were out of hearing distance I asked them why they had ignored; and the response I got was – because if we treat him with respect, “more of them will show up.” My response was, “So if we don’t know about people who are suffering from mental illness we can pretend that they don’t exist.” The fact is 26% of homeless adults staying in shelters live with serious mental illness, and an estimated 46% of those in supportive housing live with severe mental illness and/or substance abuse disorders.
Our ability to ignore this crisis has long passed. We face an epidemic of young adults seeking meaning in their life for whom the stresses of our society have been overwhelming. We have seen the expansion of depression, suicidal tendencies and fear of success overtake our youngsters. We have witnessed a generation of seniors who physically are able to live deep into their 90s; yet they experience significant erosion in their cognitive skills.
For a society that prides itself in the quality of our healthcare services, we still let the mentally ill live in the shadows. We need the courage and the commitment to bring this illness into the sunlight. We spend over $3.3 trillion annually on the delivery of healthcare. On a per capita basis, we spend, on average, more than twice the second most expensive country in the industrialized world. Still, obtaining mental health services remains a major challenge in both access and cost. There is little doubt that the explosion of technology and tethering of ourselves to smart phones has significantly exacerbated the problem. We have ceased to communicate with each other especially face-to-face. There are so many electronic communications services beginning with Facebook, Twitter, Instagram and all of the permutations that are coming down the pike that our ability to hear each other and really understand continues to diminish.
The greatness of America has always been our ability to overcome what appeared to be insurmountable challenges. If you read the history books about World War II, you know that this country was unprepared to fight a war on one front, let alone two or three, when Pearl Harbor was attacked. However, the grit, tenacity and can-do attitude of the American people accomplished the unthinkable and led the world to victory over tyranny. Now we face another challenge that appears to be insurmountable. Yet again, our society has the capacity, if it has the will, to bring the mental health crisis to its knees. We need to develop a mental health “Marshall Plan“. We need to recognize the necessity to dramatically expand the number of mental health professionals we train. We need to recognize mental health illness is an illness without shame or condescension.
If we have the will, as a nation, to confront the mental health crisis head-on, we will prevail. We can and we must reallocate the resources in healthcare; this illness not only attacks the individual and the family, but it also attacks the fabric of our society.
We at Curus recognize those whom we care for must be sound of mind as well as of body.