our mental health system didn’t fail the Florida shooter -- we did
I'm done with a few things right now.
I'm done with the arguments on social media about why the Parkland, Florida shooting happened. I stayed up late last night watching the CNN Town Hall meeting where kids who had just survived a high school shooting asked Marco Rubio to please ban assault weapons, and parents of now deceased children suggesting that their sons and daughters would still be in a conversation that has mostly shifted to becoming one about gun control. There is place for that, and I absolutely see it as progress. What I'm done with is that along with it, we are potentially doing damage to a cause I care deeply about -- eliminating mental health stigma.
It is obvious to us now that the shooter, Nikolas Cruz, struggled deeply with his mental health. Fault over why that escalated to a school shooting is being dealt out liberally, tied mostly to external factors, while conversations around what it must have been like in his headspace in the weeks and days leading up to day him walking into his high school with an assault weapon are sparse. People around did everything they were supposed to do in terms of protocol. A lot of help attempts, a lot of hands extended, a lot reports. I am sure he sat in chairs across from therapists, and I am sure those therapists did their very best work with what he revealed to them -- and I am also sure that protocol does not catch everything, and that he did not reveal everything, because for whatever reason, he did not feel that it was safe or worthwhile to. After seeing the aftermath of this shooting, I am more than anything willing to bet that the elements of the world around him did not lead him to believe that overcoming the things he was struggling with was a even possibility, and so we are left with these headlines and debates about causation and gun control, and the perceived failures of the mental health community.
As a mental health advocate, these targeted debates allocating blame sadden me to no end. The world, though, doesn't seem to want to absorb the fault this one; we want to push it onto specific agencies. It is being sent to therapists, and hospitals, and the people who were supposed to do something. Guess what? The whole world was supposed to do something by now, and the whole world failed. Let us all absorb that.
I received my first mental health diagnosis at age 19, and another one three years later. I struggled deeply with my mental health in my early twenties as a direct result of reading the world around me and concluding that it was not okay to struggle out loud and that the darkness in my mind was not a safe thing for me to herald -- so I didn't for a long time. The biggest thing that got my butt on a therapist’s couch, and made the actual truth about what was going on in my head come out of my mouth when I got there, was the voices of my peers that told me that the problem I was experiencing was an acceptable and solvable one, and I was worth the work it would take to find it, even if the majority rule of society was to pull myself up by my bootstraps.
Let me tell you something – “pull yourself up by your bootstraps” was not a therapeutic paradigm they went over in either one of the nationally-accredited counselor education programs I attended, and the things you expose when you dump your brain out to a near-stranger at the risk of being hospitalized has a lot more to do with if you think certain revelations will yield something at all worthwhile than if your therapist paid enough attention in school, or prescribes the right drug to you, or anything that even happens in that office. The therapist is a vessel, a facilitator, with great influence, yes – but also a minority of therapeutic responsibility. They are batting last here, after society-at-large has had its way with each of us, only able to hit the pitches that the person on the couch even feels safe to throw out.
My mental health story having some sort of catastrophic ending was prevented because I had a friend named Kaitlin Bailey, who sat on my bed during my sophomore year of college, and when I told her what was going on in my head, and why and how I wanted it to be over, she escorted me over to Health Services and 48 hours later, I was headed home on a medical leave – so I could recover. Hear me say this, loud and freaking clear: I am still alive today because someone gave me the permission, which was lacking from society-at-large, to go get help. What is going on in Florida, and in Washington, in every way needs to also involve mental health stigma. We will make some progress, but not complete headway, without that.
Hear me also say I should have been, according to most agency best practices, hospitalized that day instead of being sent back home for a few months. I was experiencing suicidal thoughts with high frequency, and had opportunities to act on them. But I was also smart enough to know what information to withhold in order to keep from being hospitalized.
As a mandated reporter in a school system years later, I had to watch a couple of high school kids be taken off in an ambulance because of certain keywords they used in front of me, and I stand convinced that it probably hurt them more than it helped them. This is not to say anything about their time in the hospital – I’ve heard beautiful stories of supportive environments there. I’m talking about the life and world they have to return to once their mandatory hold time ended. I didn’t avoid the hospital because I didn't want to be in one; I avoided it because I’d seen how people were treated like absolute pariahs after they came back from one, even if it was paramount toward their healing. You don’t get balloons when you come out of the psych ward; you get whispered about. Someone explain to me how that’s supposed to encourage more people to ask for help. I think Nikolas Cruz would have sought help, had he believed in its efficacy.
This is the part where I could throw a lot of statistics at you, but if you would like to review my research findings and citations, click here. But what you need to know is that between 2009 and 2014, the prevalence of depression and anxiety symptoms in adolescents jumped 31%, and suicide rates jumped even more dramatically (and got even worse after 13 Reasons Why was let loose in the world). In that same timeframe, do you know what didn’t budge? The number of adolescents seeking treatment for those symptoms.
This is not a mental health system problem – those therapists and hospitals are doing the best they can. This is a stigma problem.
We’re all human beings, and we are all wired for connection. As it stands in the world today, the stigma against people with a mental illness is a straight-up toxin. I can tell you from experience that nothing fans the flames of depression more powerfully than feeling isolated from the people around you, and nothing is doing that more powerfully than the arguments floating around headlines this week about how Nikolas Cruz shot his classmates because the mental healthcare system didn't do its job. What gross oversimplification.
People get angry at the goalkeeper in a soccer game for missing a save when that ball got through ten other players on that team before it hit that net. Mental healthcare wasn’t the weak link; it was society as a whole. It was the way we have made it acceptable to shove struggling people to the outskirts, and turn a blind eye, and say, “Well that’s someone else’s problem.” The mental healthcare system did not fail Nikolas Cruz; it was the entire world at the same time, and we as its inhabitants will continue to allow darkness to fester in the minds of our friends and family members and neighbors, even unintentionally, until we bolster a societal overhaul that changes the way we treat and talk about people who experience mental illnesses and give them the freedom to step into healing.
In my graduate research, what I discovered is that there is an empirically-based way to reduce stigma and get rid of the barriers that prevent people from getting help. And, it is not just talking about it. It is talking about it A CERTAIN WAY. A research group in California piloted a program that got a person living with a mental illness to talk about their struggles and successes -- what they were dealt, and how they fought back, and lived with it, and sought continual help -- and it dramatically reduced the audience's perceived stigma over time
It doesn't matter that we talk about mental illness; it matters deeply HOW. We have to get all of these things in the discussion:
A) the rock bottom part of the story – the horrible parts
B) how the person got out
C) local and global resources they used to do it
Transparency. Honesty. Risky bravery. Shame eradication. Things that will lead other people out of isolation.
My favorite thing to tell people is that I have a bipolar type II diagnosis, because you would never know that about me if you examined my life on paper. That was not always a safe thing for me to voice, like when I worked in a public school as a counselor. As a result of a lot of love and support and daily self care and medication and great therapists who were not mind readers, I live in a stable place and could easily keep my illness hidden, but I wear it proudly to show the people who are still figuring out how to overcome theirs that we absolutely can have a mental illness and a normal life at the same time. My diagnosis is a major one, and people did not react with kindness to it, but with fear, including the professors in my first counseling masters’ degree program, who told me that I would never be a good therapist or advocate or presence in the mental health field because of it. They told me to draw back, and stand down, and retreat.
If I had yielded to those voices then, I don’t know what would have happened to me, but I know it wouldn’t have been good with the things that were in my headspace at the time, and it’s not a stretch for me to imagine that a terrible headline in the news wouldn’t have been in the equation – but the voices that tried to ostracize me, for whatever reason or fortune was with me at the time, didn’t stand a a chance against the ones that gave me permission to fight.
We, the fighters, have to give others the permission to fight back, too. I didn’t understand depression or bipolar disorder until I was suffocating in the throes of it. If you have never been there, it is not your job to put words in a person’s mouth who is; it is, in fact, disrespectful and audacious to try. If you have been there, I think it is your duty to speak about it as you can, validation and understanding can grow. We have to clear the toxins from the air, because if one thing will take down mental health stigma – it is permission for people who are depressed or are in awful headspaces to feel that way and look it in the eye so that they can deal with it without judgment or restriction, or fear of being let go from their jobs and shunned from their families, and with connection and space and time to heal. Feeling like you have to keep your darkness hidden can be a death sentence, and I am not just talking about for the person in the darkness – I mean for the people around them, too. I mean for the students of Steadman Douglas. And when we do or don't resolve gun control, I mean whatever medium is next. There will be one -- I promise you that.
You could put me in a room of the best and brightest, most empathic and caring psychologists in the world, and it dead ass would not make a difference how much healing I found in those four walls if the rest of the world wasn't willing to change, too. We have to be that. We have to use our voices as we can. We have to change the entire world, and we have to do it now.
The whole world was supposed to do something by now, and the whole world has failed together. Let us all absorb that together, and fix it together. We still have so much time, and let us begin right now.