Posts Tagged: mental health

Caring For The Caregivers: The State of Mental Illness


This is a reprint from an earlier blog. I thought with Thanksgiving and other holidays so near, it would be the perfect time to highlight the work of so many that goes unnoticed so often. —Katy

As the nation held its breath, waiting for news about health care, violence has occurred to caregivers of mental health and from them. The psychiatrist in Fort Hood who shot military men and women was pre-ceded by a more intimate tragedy. At Mass General Hospital a bi-polar man, in an outpatient appointment, attacked his psychiatrist, a female doctor and was killed by a security guard who happened on the scene. The following day I sat in my office and wondered, not for the first time, if I might get killed by a patient or have a death on my hands. And I thought, how amazing it is that these events do not happen daily.

Mental illness shows no prejudice: It is invisible and slippery. Progress is difficult to measure and the care is given by people who are tired, severely underpaid, suffer compassion fatigue, and vicarious traumatization. We live in two worlds—often at the boundary of madness. Then we walk back onto the bright well-lighted rooms of our homes or children’s school and try to forget what we know. 

But at such an important moment of change, as we contemplate our American “system,” we need to review the state of mental illness. Thirteen years ago I began treating young women who were dying from eating disorders. I was tremendously optimistic, then, about change in my field. Taboos were lifted and therapy became widely acceptable as did new and effective psychotropic medication.

Yet, in fact, the opposite has happened. I see more and younger women, succumb to eating disorders. We know what treatment is but there are fewer places for this treatment. I also see the power of our culture, as it speeds up its demands and feeds us less.

Mental illness, the invisible dark cloak of depression, the shaking hands of the anxious, the rude voices of schizophrenia are one of America’s untouched frontiers. We believe that people with cancer are due every bit of bone marrow they can find. Yet we leave our ill to sit in squalor with demons in their heads and no one visits or calls. Loneliness is the chief complaint of most of my patients. Something in us still dares not name mental illness when we see it. Others of us trust everyday that the relationship we have formed with our patients—the web of connection thrown over an abyss, will hold. The anxiety, depression, and psychosis caregivers metabolize is staggering. We do it because we are curious, compassionate, and believe there we are not doing hospice work. I remain deeply troubled as to why this profession goes undervalued when it is lifesaving and life-affirming. Our country is still adolescent, We believe death will not happen to us. We believe that unattractive aging is optional. We believe there is an ‘us’ and a ‘them.’ Until that prejudice is dropped and we understand that mental illness is often a cruel accident of birth, we will never provide adequately for mental illness in those we care for or those who give care. The valedictorian of the class, the doctor’s wife who seems a bit ‘off,’ the college roommate who kills himself writing and in love … all of these are just the a few cracks in the pavement away from us. There is nothing especially ‘other’ about mental illness. Perhaps that is why it scares us so.