That's what it's like to be chronically mentally ill, always on guard against the specter of suicide and making compromises in a quest to remain a functional contributor to society.
NOT LISTENING TO PROZAC
In the early 1990s, I thought America had matured, that we were about to turn the corner on mental illness. The antidepressant Prozac was all over the news. Best sellers like Darkness Visible and Listening to Prozac hit bookstores. Celebrities major and minor publicly declared that they suffered from depression or were bipolar. Most dramatically, Kurt Cobain shot himself in 1994. It was the signal suicide of my generation, as Ernest Hemingway's had been for a previous one. Surely, I thought, mental illness and suicide will be pulled out of the closet and onto the table of public policy. I was wrong.
Lisa Stone
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2004 MENTAL-HEALTH COVERAGE
- One suicide too many (1/14/2004). MORE
- Mentality challenged in Olympia (3/3/2004). MORE
- Give them shelter (5/5/2004). MORE
- Mental-health purgatory at Western State Hospital (8/11/2004). MORE
- Psyched out and fighting for normalcy. (11/17/2004) MORE
Philip Dawdy joined Sue Eastgard, Director of the Youth Suicide Prevention Program, to discuss suicide on KUOW's Weekday. Listen to an archived recording.
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In 1998, then-U.S. Surgeon Gen. David Satcher issued a lengthy, passionate call for suicide to be recognized as a major public-health problem. He was virtually ignored. In 2001, President Bush proposed that health insurance cover mental illness the same as it does physical ailments. (Don't get me started on the inequities of health insurance.) That hasn't happened at the federal level. Thirty-three states have insurance-parity laws; Washington does not. And while everyone ignored Bush and Satcher, in 2001 another 30,622 people killed themselves. Data for 2002 are not available yet.
There is cause for some hope, however small. In the early 1990s, suicide among teens surged to 14 deaths per 100,000 people per year, triple what it had been three decades before. A concerted public-health campaign was begun. Teens were screened for mental illness at every opportunity?upon visits to the school nurse, at annual physical examinations, whenever they intersected the health care system. Psychiatrists actually began diagnosing mental illness in youth. Previously, mental illness among teens was brushed aside; I'm living proof of how stupid that was. Suicide-prevention programs geared toward teens were begun. Schools were blanketed with literature. When appropriate, teens took meds. (Today, a debate rages between American and British doctors over what meds ought to be given to youth and whether the meds work.) And, perhaps most important, teens talked somewhat openly about mental illness and suicide on the Internet, at school, and among friends?and not always in a black-humor, Heathers kind of way.
By 2001, the suicide rate among teens had dropped by 30 percent, to 9.9 per 100,000. The solution was remarkably low-tech. It just required society getting over its fear and permitting the public-health system to do its job.
There has been dramatic improvement in the suicide rate among senior citizens in the past decade, as well, again the result of a public-health push. (Seniors 65 and older have the highest suicide rate of any group, at 17.5 per 100,000.)
MOST ATTENTION has been directed at suicide among teens and, to a lesser degree, seniors. At times, I've had mental-health experts insist to me that America's suicide problem lies among those two groups. Mortality statistics do not support such a conclusion. Roughly two-thirds of suicides in this country (about 20,000 people) are committed by those 25 to 64. And in 2001 the suicide rate in this group far exceeded that of American youths?approximately 14 people per 100,000, versus 9.9 people per 100,000 for the group aged 15 to 24.
I assume that someday soon health officials and mental-health researchers will recognize that attention must be paid elsewhere as well. But part of me is tired of expecting everyone to take a reasoned approach to suicide and mental illness. As I age, I get increasingly pissed-off at the open discrimination against the mentally ill. When I can calm down enough to reflect, it makes me think of where gays were in the late 1980s?marginalized, with tens of thousands of perfectly wonderful young men dying each year from a virus whose name the president wouldn't mouth publicly, while drug companies and the Food and Drug Administration twiddled their thumbs. Thanks to full-scale pressure on government and industry by gays and others, dollars eventually flowed to HIV/AIDS research. Many are alive today as a result of that intelligent fury. The AIDS death rate began to drop in the mid-1990s to where it is now: approximately five per 100,000 people?still too many, but a vast improvement. (Recent spikes in HIV infection rates, locally and nationally, could undo this progress.) In other words, they kicked ass.
Maybe it's our turn. Some mental-health experts say that the majority of suicides in this country can be prevented. That would work out to something on the order of 15,000 to 20,000 lives a year. Does anyone think these people are not worth saving?
I can't say whether a society that regards suicide as a problem to be solved rather than one to be hidden could have saved Cynthia Doyon?or whether it would help people like me. But it wouldn't hurt to try.
Philip Dawdy has been a staff writer for Seattle Weekly since 2002. His phone number is 206-467-4384.
pdawdy@seattleweekly.com
