Mental Health

Like a Thief in the Night

 “Like a thief in the night” is an idiom that has been used by many in songs, speeches, and documents for thousands of years.  It is quite possible this figurative phrase originated in the Bible where in 1 Thessalonians 5:2 it says, “the Day of the Lord will come like a thief in the night.”  Like authors and songwriters preceding me, I will reuse this idiom.  I have seen how Mental Illness is like a thief in the night, because, like a thief entering a home in the dark of night, Mental Illness unexpectedly robs many of their abilities and skills without warning.

As parents, we can be known to exaggerate our children’s abilities. It is no exaggeration, however, that my oldest son, Aaron, was an extremely good artist.  At the young age of three years old, he was drawing cartoons like a professional cartoonist. He was gifted with the ability to reproduce well-known cartoon figures such as the Mario Brothers characters. His drawings would start off as a few lines and swoops and suddenly a perfectly drawn Mario, Koopa Troopa, Bowser, or Daisy would materialize on his sketch pad. As Aaron grew older his artistic skills matured and he won awards because of them.  As a young teenager, he especially liked to draw pretty girls and baseball players.

Almost immediately after we realized Aaron was suffering from a mental illness, we could see a decline in his ability to draw, and over the past 23 years of suffering from a very difficult-to-treat case of schizophrenia, Aaron can barely draw at all.  Aaron drew the picture on the far left about a year before he started exhibiting symptoms of a mental illness.  He drew the picture in the middle several years ago, and the picture on the far right was drawn in the past couple of years.  Aaron hasn’t picked up a pencil to even attempt to draw a picture in more than four months now.  His mental illness continues to rob him time and again of not only his ability to draw but his ability to write, read and even remember what day of the week it is sometimes.

While Aaron is impacted more than anyone by what he’s lost because of schizophrenia, we’re all impacted indirectly.  Aaron was on a trajectory to becoming a very productive member of society.  He was well above average intellectually, and when he was 13 years old he enjoyed programming computer games.  Now, however, instead of contributing to our society as a software engineer for a computer gaming company, he is one of more than 12,000 people under the age of 65 receiving Social Security Disability benefits.  Aaron wants to work, but schizophrenia has robbed him of this privilege.

Thankfully, mental illness doesn’t impact everyone as significantly as it has Aaron.  However, about 20% of all adults regardless of gender, race, age, or socio-economic background in the United States suffer from a mental health disorder, and the impact on the economy is staggering.  A report commissioned by the American Heart Association CEO Roundtable identifies an annual cost of $210 billion to the American economy due to depression alone.  Because so many mental health disorders go unreported, this cost is undoubtedly far greater than what was identified.

With such staggering costs to the economy and the volumes of adults, not to mention children and adolescents, affected by mental illness it is surprising how little the federal government invests in Mental Health Research.  While the government has increased the budget for the National Institute of Mental Health (NIMH) in 2022 to $2.14B, it is still a fraction of what is allocated to the National Cancer Institute (NCI) during the same time period, $6.9B.  I am not advocating that less should be allocated to NCI, but rather that more attention and resources should be applied to preventing and managing mental illness in the United States, especially because it impacts everyone either directly or indirectly.  This will require an increase in resources from both the public and private sectors.

Minimizing the effects of mental illness for individuals, their families, and the entire nation is something I’m confident most will agree is of the utmost importance.  It is imperative that we come together as a nation to secure mental health care for everyone in our communities so we don’t lose a single mind to this thief in the night, mental illness.

https://www.ssa.gov/

Mental Health

Care or Incarceration?

On a sunny August afternoon, I came home from work to find my 17-year-old son, Aaron, lying on the sofa moaning in pain.  He was very nauseated and running a fever.  That night we took him to the Emergency Room where a CT scan revealed he had appendicitis.  His appendix needed to be removed as soon as possible.  The surgery was scheduled immediately, and gratefully it went smoothly.

The following morning we came back to the hospital to visit Aaron.  Knowing what room he was in, we simply walked through the door of the hospital and took the elevator to the floor where he was staying.  No one stopped us at the hospital entrance and asked who we were visiting.  They never called the nurse’s station on the hospital floor to get permission for us to go to his room, and they most certainly did not request we lock up our personal belongings or go through a metal detector before proceeding to visit him.  It seems absurd, doesn’t it, that you should have to pass through metal detectors to visit your loved one in a hospital?

When Aaron was fifteen he became very ill with a difficult-to-treat case of schizophrenia.  As a result, he has spent a lot of his life passing through different mental health facilities.  EVERY time we visited Aaron at the Milwaukee County Mental Health Complex, we were required to stop at the front desk and tell them who we came to visit.  They called the ward where he was staying to get permission for us to visit him.  Once confirmed that it was Ok for us to proceed, they had us lock up our belongings.  Finally, they took a metal detecting wand and checked our front and back for weapons.  This process caused me to shake my head in wonderment.  Was my son in a hospital or was he in a prison?

The differences between many Mental Health facilities and hospitals that mainly treat people’s physical issues don’t just stop at the lobby.  Most hospital rooms are outfitted with comfortable beds, televisions and walls painted with pleasant colors intended to calm and comfort the patient.  Many mental health facilities Aaron was admitted to looked like the walls hadn’t been painted for years.  The rooms were often shared with one or more patients, and each patient only had a low platform bed to sleep on.  Patients were lucky if there was one working TV in a common room with more than a few channels for them to choose from, let alone having a TV in their room.  I can understand the stark nature of the furnishings and bed linens might be intentional to keep people safe from personal harm.  Still, shouldn’t the intent also be to create a calm and comforting environment to help the patient heal?  I rarely walked into a calm and comforting environment when walking through the halls of a mental health facility. 

Is it any wonder that many people with mental illness don’t seek help for their disorders?  According to the American Psychiatric Association because of the stigma surrounding mental illness more than half of the people with mental illness don’t receive help for their disorders.  The 3 types of stigma researchers identify are public stigma, self-stigma, and institutional stigma.  It is the institutional stigma that promotes policies that create significant disparities in the environment and care people receive in mental health facilities versus hospitals for the physically ill.

Aaron is 38 now.  I’ve been observing the institutional care he has been receiving for the past 23 years and I have only seen limited positive change if any.  Mental illness is, however, getting more visibility in the past few years due to the impact many have felt from COVID and social policies created because of it.  This is unfortunate, but at the same time, I’m hoping it is a blessing in the long run.  Because the more people talk about mental illness and the more people understand it, the likelihood of positive change will finally be realized.  Institutional stigma can be reversed.

“Stigma, Prejudice and Discrimination against People with Mental Illness.” Psychiatry.org – Stigma, Prejudice and Discrimination Against People with Mental Illness, Jeffrey Borenstein, M.D., Aug. 2020, https://www.psychiatry.org/patients-families/stigma-and-discrimination.

Mental Health

Whole Wellness for our Babies

Aaron was born on Tuesday, April 17, 1984, just before 7:00 am after a 9-hour labor.

As can often be the case, a mother’s delivery of her first child can be a more difficult one. Because Aaron was the first baby, of my four children it was the most difficult delivery for me. It probably took far too long, and they should have considered using forceps, but for some reason unknown to us the doctor did not do that causing Aaron to be in the birth canal for an extended period. When Aaron finally made his appearance, he was blue and quiet. He didn’t start crying for several minutes. His Apgar score was only three. Although not extreme, Aaron was below normal weight – only 6 lbs. 7 oz. He was born 10 days before his due date, but the doctor said he had symptoms of an overdue baby like startling easy and peeling, dry skin.

No one raised any alarms about Aaron’s low Apgar score or the symptoms of being overdue, and while he was less than 6 pounds when he left the hospital, he gained weight quickly and appeared to be completely healthy. In fact, he was better than healthy from what I could see. He was NEVER sick, and he was SO gifted. So, I never gave the events of his birth a second thought, until many years later when he was 15 and he got sick. Though, he wasn’t physically sick.

When the psychiatrist is asking question after question about your child’s health history and social history (i.e. drug use, alcohol use, etc.), all sorts of memories get dislodged, and for me, that was the memory of Aaron’s birth. I started to wonder if the oxygen deprivation at his birth caused a fault in his tiny brain that was festering over the years and was now presenting itself as a mental illness. Why didn’t I see this sooner? Why didn’t our pediatrician see this coming on?

In hindsight, I wish I hadn’t buried the memories of Aaron’s birth so far back into the recesses of my mind. I wish I had discussed it with his pediatrician at his first doctor’s visit, and I wish I would have been more keenly focused on his mental health throughout his entire childhood. Maybe, I could have done something to thwart the mental illness that was now presenting itself.

I don’t know with any certainty that I could have taken action to prevent Aaron from developing a mental illness, but I also don’t know that I couldn’t have. Mental illness is such a difficult thing to treat, and anything parents, caregivers, and pediatricians can do proactively to ensure the health of a child’s mind should be done!

Almost twenty-one years after I gave birth to Aaron, I gave birth to my second son, Kyle. From the time Kyle was born, I have been very attentive to his mental health. I made sure he developed a habit of always wearing a bicycle helmet. I ensure he eats healthy meals and gets plenty of sleep, and I frequently ask him how he’s doing. I will not hesitate to take him to a psychologist or counselor if he says he’s feeling mildly depressed or excessively stressed.

Whatever actions we might take to ensure our children’s minds remain healthy, they need to be deliberate, thoughtful, and specific to each child. We should not be passive about the mental health of our children. We should be managing the complete health of our children, both physical and mental.