Saturday, December 15, 2012


In Connecticut an entire community tries to console children who will never understand why a man they never met killed their friends, their principal, their teachers. My guess is that most of the child survivors of this catastrophic event do not know that the killer also murdered his own mother. That's one of those details that just adds a whole extra layer of despair to the event and would likely be even more upsetting to children who need to believe now more than ever that their parents love them and that their homes are safe places.

It's hard for me to remember when I stopped believing in being safe. There is a turn most people make during growth and development when you acknowledge that bad things happen and life isn't fair, no matter what anyone else tells you. A grandparent dies, a pet gets hit by a car, parents divorce, some event or diagnosis changes the fundamental composition of your childhood and you are forever changed. For my own sons reality came calling cruelly when they were quite small and their papa died in the front yard of our little house. That loss fundamentally changed their childhoods and removed the pretense of fairness from their lives.

As the years have passed I have struggled as a single working parent and as a working parent with a blended family trying to find the balance between being present for every moment of their childhoods and acknowledging that I cannot do it all. That I can love them fiercely, but I cannot make it to every school event and that's ok. Is it fair? I don't know. It's honest and true. I'm not a good mom when I try to be Wonder Woman. I'm a better mom when I acknowledge I need rest, exercise, work that challenges me, friendships, and my own mental health breaks. I'm also a better mom when I take my antidepressant medication. The choice I made to seek help and take medication has made it possible for me to experience success in my professional life and make progress in my personal relationships as well. It's also allowed me to be a loving, devoted mom and not be incapacitated by depression and the darkness that accompanied it for me.

When I sought help for my depression I had health insurance, could afford the copayments for my medications, and I was educated about how the medicines worked, what side effects to expect, and how to cope with them, or who to call for help. But I am in the minority. There is a vast number of Americans who are coping with mental illness everyday with little or no help from anyone. No insurance, no medication, no therapy. no understanding of the fact that what is happening to them is an illness, not a failing. For many years my dearest friend worked in mental health social work managing the care of adults with severe mental illness who had been released from state hospitals after extended hospitalizations. She and her staff would provide these folks with case management, daily medication management and every kind of support they could possibly need to become a part of the community they lived in. Her program enjoyed great success and received an award for the high number of clients who returned to employment in their communities and were able to remain healthy and stable.

It was a lovely award, but the bittersweet part of it was that those clients who experienced great success ended up being forced out of the services they were getting because they got "better."  They didn't get better in the way one recovers from an appendectomy-they got "stable." They had help remembering to take their medications and learning to manage life outside an institution, they had a network of people who were invested in their success, and they had someone they could call 24 hours a day if their illness became too much of a burden. A lot of this sounds like the things most parents do for teenagers as they transition to young adult life-but we all know that lots of people don't have the benefit of those kind of parents. A lot of people with severe mental illness no longer have any family support because their families are worn out, spent, or perhaps fighting their own battles. Some reach middle age successfully and then experience a sharp decline in their mental health status after the death of an aged parent who managed to keep them safe and sound.

So what happened to those clients who got forced out of my friends program? They mostly ended up back in the criminal justice system, psychiatric emergency rooms, or state hospitals after suicide attempts because without the ongoing case management they needed they just couldn't stay healthy. Mind you the cost of helping them keep it together through outpatient case management and necessary psychiatric medications was miniscule compared to the cost of flushing them back through the judicial system, and caring for them 24 hours a day in an institution. Additionally, those who experienced a psychotic episode or another suicide attempt often were never able to rehabilitate to the same level they had previously attained. They would now only be able to rehab to a new lower level of health and stability.

I don't know why Adam Lanza killed his mother or why he took a cache of weapons to an idyllic school building and opened fire on children who had done nothing to him, ever. There is no answer to that question that will be satisfying to anyone. I have to believe that there was a psychological "break" in Adam's mind and that as he slaughtered those human beings he was no longer the boy his parents and brother loved. Whether anyone ever determines if he had a diagnosed mental illness or not, he clearly needed help of some kind-whether that was in the form of the therapy or medication we will never know. What I do know is that he was another mother's son. On the day of his birth a woman very much like me marveled at his tiny fingers and wee small nose, and cried at the joy of his safe arrival.

As we go forward with grieving those killed in Connecticut by Lanza and debate the merits of gun legislation we would be wise to focus on what we are willing to pay as a society for having children believe they are safe. Gun legislation that makes sense and isn't dictated by the NRA, absolutely. But there is more to it than that. There is no point in having stricter gun laws if we are not willing to adequately fund treament for all types of mental illness for all people in the United States, including immigrants, children, veterans, the aging, and the incarcerated. Beyond that there is no point in advocating for further funding for mental health treatment if we are not willing to make sure people with mental illness get the same opportunities for work and life that people with other chronic illnesses receive. No one with diabetes is being blackballed from a new job or advancement-the same cannot be said for someone who acknowledges a history of mental illness.

If we truly want a country where children get to believe they are safe in their kindergarten classrooms and parents can feel safe dropping them off in the carpool line we have to be willing to do the work that is necessary to make our communites safer and get our fellow citizens the help they need and the ability to seek it out without fear of discrimination and the ability to receive it without regard to cost. When we deny individuals who are ill the treatment they need, we all pay a very heavy price indeed. The investment in comprehensive mental health care reform and legislation would provide an opportunity for a kind of safety that is priceless.

No comments:

Post a Comment