America’s long-standing mental health crisis

In 1956, my uncle John F. Kennedy, then a US senator, wrote a book that is probably more famous for its great title than its content. It Was Called Profiles of courage. And there were about eight US senators who JFK considered to have made particularly courageous contributions to American history.

I’ve been thinking about what courage means to me for a while now. Growing up with my father, Ted Kennedy, in the Senate, and then serving in the House of Representatives for many years, I saw a lot of courage in politics. But the truth is that the bravest people I know qualify not by what they do in public, but by what they are able to endure and overcome in private. This is especially true for people who struggle every day with mental illness, or addiction, or both, or who help loved ones or family members with their struggles.

The details and daily dramas of these struggles often remain private, hidden. And even when people do discuss them publicly, it is often very briefly or very cautiously – enough to admit to having a diagnosis or a problem, or “issues,” in order to support advocacy, but rarely enough to inform an audience that wants and it needs to understand what it is like to live with these diseases every day. When I was younger and was first exposed to substance use disorder treatment in the tabloids by someone I was in rehab with, I thought this was all harder for people in the public eye. But since then I’ve learned better: we all live with the same stigma and pay the same price for our silence.

We often cite the statistic that, at any given time, at least a quarter of all Americans struggle with mental illness, substance use disorders, or both. And while these are still sometimes seen as two separate illnesses – because two distinct worlds have evolved to treat them – I can tell you, as someone who has both, that they are best understood and treated together as a complex continuum of brain illnesses. and the mind. .

See more information: America has reached peak therapy. Why is our mental health getting worse?

Unfortunately, the percentage of people affected by these diseases is probably just over 25%. And the percentage of those who don’t feel comfortable and supported enough to be open about their experiences is a lot, very is higher, as is the percentage of those who do not have access to or cannot afford evidence-based care and support.

This is an old problem. Just look at the historic numbers JFK wrote about in Profiles of courage to see this. At least half of them, from the earliest days of post-revolutionary America, were known to have struggled with mental illness or addiction, or had the struggle for mental well-being profoundly affected their families.

John Quincy Adams – whose story first inspired JFK and his co-author, Ted Sorenson, to write Profiles of courage—was nine years old when his father signed the Declaration of Independence, 29 when his father became president, and 35 when he himself became a US senator. John Quincy lost his two younger brothers to alcoholism, starting with Charles at age 30. His father also suffered from depression, especially after the trauma of losing Charles and losing the presidential election to his friend Thomas Jefferson – all during the same week in the late 1800s. John Quincy’s eldest son, George Washington Adams, suffered from depression and committed suicide at age 28—just two months after the end of his father’s presidency in 1829. Shortly after learning of his son’s death, John Quincy promised to use his “remaining days” for good works “tributable to the welfare of the others” and soon became the first former president to return to government as a deputy. But he continued to experience the tragedy caused by mental illness. In 1832, his remaining brother, Thomas, died of complications from alcoholism at the age of 59. And two years later, his own son John died of the same thing, aged 31.

Among the other seven JFK profiles, Massachusetts lawyer and politician Daniel Webster suffered from alcoholism and died of cirrhosis of the liver in 1852.

Sam Houston, a key figure in Texas’ independence — and the state’s first president before becoming a senator — had a well-known battle with alcoholism and depression or bipolar disorder. It may be qualified as the first case of political mental health stigma in the country. His nickname among the Cherokee, with whom he was close since childhood, was Oo-tse-tee Ar-dee-tah-skee, or “Big Drunkard,” and his drinking was an open and caustic issue in his public life. . His third wife – whom he married when she was twenty-one and he was forty-seven – made it her mission to help him stay sober, but his political opponents continued to publicly shame him.

Lucius Lamar, the U.S. senator from Mississippi, was just nine years old when his namesake father, a prominent Georgia judge, took his own life, just days before his 37th birthday in 1834. He is said to have “entered his house, written a Brief farewell note to his family, he went to the garden and shot himself in the head with his pistol.

And these are just the ones we know about and can begin to document.

Every time a new statistic is released about the state of diagnoses of mental illness, drug or alcohol addiction, overdoses, suicide attempts, and completed suicides, it is followed by a call for a “new appreciation” of these illnesses, a “change paradigm”. .” But part of the paradigm that we need to change is the idea that these are new problems. If there’s anything truly new about them, it’s how much worse they succeeded because we did not do enough as a society to confront them. We also do not guarantee that the treatments we already have, which are not perfect but can still save lives, will be delivered to the majority of people who need them. These treatments – which work, but are proven to work better together – are medical therapies, psychotherapies, and healing relationships (everything from recovery and support groups to religious groups). Even those who receive some form of treatment may not be receiving the most evidence-based or complete treatment, and there is often a big difference between what is “approved” or “legal” and what is ideal.

None of this should be surprising. But somehow it still is. Our nation is experiencing perhaps the most pronounced crisis of mental illness and substance use disorders in history; already high rates of depression and anxiety increased by an additional 25% worldwide after the first year of the COVID-19 pandemic. However, many of us still don’t understand what the experience of having or treating these illnesses is like.

In our society, it is not necessary to have cancer, heart disease or diabetes to understand the basic dynamics and challenges of living with these diseases. Its treatment has become part of our culture, openly discussed and encouraged. But when it comes to diseases that affect the brain – cognition, mood, thinking, impulsivity, self-destructiveness – we are repeatedly surprised, or ignorant in a way that is not only unfavorable, but can be downright dangerous.

If you or someone you know may be experiencing a mental health crisis or thinking about suicide, call or text 988. In emergencies, call 911 or seek care at a local hospital or mental health professional.

Reprinted from PROFILES IN MENTAL HEALTH COURAGE by Patrick J Kennedy, to be published 4/30/2024 by Dutton, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright (c) 2024 by Patrick J. Kennedy.