Monday, September 21, 2015

Fighting the stigma of mental illness

Patrick Kennedy and Peter O'Brien

     Four hours before Republican presidential candidates faced off for the second GOP debate in California last Wednesday, a Democrat, former U.S. Rep. Patrick Kennedy, stood before a small gathering at the Chicago Community Trust headquarters and talked about something people don't like to talk about: mental illness.
     He was introduced by Peter O'Brien, owner of O'Brien's Restaurant on Wells, who began by remembering his son, Peter Jr., who struggled for years before dying at age 32.
     "Peter just couldn't accept that he had a mental illness because of the stigma and shame of mental illness," O'Brien said, explaining why he had started Kennedy Forum Illinois, the local branch of Kennedy's national organization that is trying to reduce the disgrace associated with mental illness and addiction.
     "A lot of Americans run away from it because they don't want to deal with the pain," said Kennedy, who has been public about his own battles with bipolar disorder, alcoholism and drug addiction, though brushing aside O'Brien's suggestion he had done so out of courage. "I got in a car accident that put me on the front page of every newspaper in American in 2006, and at that point I had no choice but finally acknowledge that I had a problem."
     Kennedy went from being an addict in denial to becoming the sponsor of the Mental Health Parity and Addiction Equity Act, which requires insurance companies cover the treatment of mental illnesses to the same degree as physical ones and not impose different, inevitably lesser standards of care. He thought he would be one of hundreds of co-sponsors, but found his colleagues reluctant to attach their names to the law.
     "They worried people would say, 'You're sponsoring this bill,'" Kennedy said, extending an accusing finger, "Do you have a mental illness?"
     Treatment for mental illness or addiction still can be difficult to find or pay for, and most addicts never get help.
     "That's the law of the land but unfortunately no one knows about it, and the insurance industry is counting on you not knowing about it," he said.
     I sure didn't. Though, being a recovering alcoholic myself, I am keenly aware of the stigma, sadly familiar that there is a swath of people convinced that the whole thing is a sham cooked up to cover bad behavior, which I only wish were true. But it isn't. Addiction is a kind of mental illness, an obsessive-compulsive disorder that can be managed but never cured. Treatment can be life-saving.
     Kennedy's talk came back to me later that day, during the third hour of the Republican debate. New Jersey Gov. Chris Christie, trying to project a tough guy image to counter his Squiggy hairdo, promised that as president he would go charging into Colorado and use federal law to bust the pot industry. Rand Paul, who seems to have embraced rational thought as his latest campaign strategy, pointed out Christie's hypocrisy: the GOP is all for state's rights when it comes to putting dinosaurs alongside humans in Alabama biology textbooks, but when whiffing pot from the Rocky Mountain State, Christie grabs the big stick of federal power.
     At which point former Hewlett-Packard boss Carly Fiorina invoked her experience.
     “My husband, Frank, and I buried a child to drug addiction," she said of her 35-year-old step-daughter who died in 2009. "We must invest more in the treatment of drugs. ... Drug addiction is an epidemic, and it is taking too many of our young people."
     When Patrick Kennedy, the youngest son of Ted Kennedy, and Carly Fiorina start saying the same thing, that's significant. Betty Ford revealing her alcoholism was an earthquake because first ladies didn't suffer from that kind of thing or, at least didn't admit it. That Fiorina's comment was almost lost in the cacophony is progress of a sort. The stigma is lessening.
     Not that it will crumble on its own. Kennedy quoted Frederick Douglass:
     "Power concedes nothing without a demand. It never did and it never will."
     "We're citizens as well, in a country facing a growing epidemic of addiction," Kennedy said, calling on people to lobby their officials and put pressure on providers, and get involved. Chicago has a Recovery Walk in Garfield Park Sept. 26, and a national The Day the Silence Ends march in Washington, D.C., on Oct. 4.
     "We have no political power. Stigma eviscerates our political power," Kennedy said. "Twenty-three million Americans are in long-term recovery, but we're not organized; we're anonymous people, meeting in church basements. This is 2015, and we must talk about the most important issue for public health in our country."


  1. I'm afraid the stigma will never go away. After all, nobody in his right mind wants to hang around with crazy people. Drunks can be fun, but you have to be one to enjoy another. Treatment and reasonable accommodation should be available, but I don't expect such to be increase any time soon.


  2. This is a good overview of a complex subject. It can be difficult for someone without first hand experience to comprehend the nature of the problem. The stigma derives from ignorance, and in the absence of physical disabilities, outsiders believe that a person is faking it and family members are enabling the behavior, to the ridiculous idea that parents are at fault because of poor child rearing practices.

  3. Neil, thank you for this.

    John, I hope that you are wrong about the stigma and speaking with your tongue firmly in your cheek about crazy people. You really never know who is walking around fighting mental illness.

  4. I didn't find Fiorina's comments as sympathetic as you did. She was basically saying, I lost a family member to alcohol and prescription meds, therefore pot should be illegal. I'm sorry for her tragedy, but don't feel that the rest of us should have to bear the consequences.

    1. I didn't find them sympathetic, I was noting the ease with which she said them, and the lack of ripples afterward. Not so long ago a presidential candidate admitting their child, or even step-child, was a drug addict who died from her addiction, would have been a bigger deal.

  5. Wonderful journalism. I absolutely despise your politics but it's stories like this that I can't get enough of, I wish you'd stay off the presidential campaigns. If we took 10% of the money we pay to lock up addicts we could pay for free 28 day rehab for every addict in the nation.


  6. It strikes me that a problem with terming everything from alcoholism to absolutely around the bend psychosis as "mental illness" is the difficulty in describing the many issues and disparate treatments involved. It can also cause confusion because the degrees of impairment are so variable. I've known quite a few high-performing drunks, and many historical movers and shakers exhibited what would now be considered bi-polar tendencies.

    Stigma is certainly a problem, and Representative Kennedy's efforts to address it as one is admirable, but I would like to see more about specific legislation aimed at clearly defined problems.

    Tom Evans

    1. It's an odd qualm, Tom. I could say, "You know, 'heart disease' is such a nebulous term. It could mean from the slightest murmur to a full-blown heart attack...." There are all sorts of more specific terms, but having an umbrella phrase helps because all share common problems, such as stigma. It seems splitting hairs.

    2. Also, I for one don't want legislators making these distinctions. Too many of them have shown their grasp on scientific matters to be tenuous, at best.

    3. I guess my problem is that putting a name on the addiction or mental condition that still allows one to function in society adds to the stigma problem if it is a name that in the popular mind equates to "crazy." Perhaps I'm asking more than the English language is capable of. Or am addicted to odd qualms. Where can I seek treatment?.

      I share your dismay at what emerges from the mouths of some benighted legislators Coey, but if there are problems that can be addressed through governmental action the only hope is that the intelligent ones, through a legislative process involving expert fact finding propose and vote on specific programs.


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