Experts say mental illness affects millions of lives each year and yet it often goes ignored and untreated. There's no national mental health campaign urging people to be screened or to seek help. Accessing needed care can be hard due to a provider shortage. On top of that, many folks avoid psychiatric care because of the stigma attached to mental illness.
A 2013 documentary from Oscar-winning filmmaker Barbara Kopple (Harlan County USA) making its Omaha premiere, Running from Crazy, uses the history of mental illness in one iconic family, the Hemingways, as the prism for examining a subject whose denial sometimes has tragic results. The film follows actress-author Mariel Hemingway's (Manhattan, Personal Best, Star 80) search for why suicide runs in her family – seven relatives have taken their own lives – and the impact it's made on her clan. The Hemingway curse extends from her grandfather Ernest, that lion of American literature, to her model sister Margaux, with whom she made her film debut in Lipstick.
Mariel's struggled with depression herself and has become a mental health advocate in line with holistic living books she's written.
The Kim Foundation, which supports mental health efforts and serves as a resource for families affected by mental illness, is partnering with Film Streams on the 7 p.m. Oct. 7 screening at the Ruth Sokolof Theatre and on the panel discussion to follow. The discussion will focus on the state of mental health care in Neb, and will share personal stories on what happens when mental illness goes unchecked. Panelists will include Dr. Howard Liu, director of the Behavioral Health Education Center of Nebraska (BHECN) at the University of Nebraska Medical Center, and Mindy Eggert, who lost a son to suicide.
The Foundation's also making Hemingway the keynote speaker at its Oct. 22 A Time for Hope and Healing luncheon, 11:30 a.m. to 1:30 p.m., at the Embassy Suites Hotel and Conference Center in La Vista.
Liu, whose center grows and trains the mental health provider pool, describes a challenging landscape in which 88 of Neb.'s 93 counties are designated federal mental health shortage areas. "That means families who experience a loved one in crisis often have to wait weeks or months to get access to a psychiatrist, psychologist or other mental health practitioner," he says. "There is a crisis in access to mental health services, particularly in rural and underserved areas. BHECN was created to help fill the gap."
The problem, he adds, "is projected to get worse as the majority of psychiatrists, psychologists and psychiatric nurse practitioners in Neb. are age 50 and over." Meanwhile, he says, "nearly one in five Neb. adults will experience a mental health issue this year, ranging from mild anxiety to bipolar disorder."
The care infrastructure to meet this need may be lacking.
"The state of mental health care in the U.S. and in Neb. isn’t great," Liu says. "Starting in the 1960s, we began to move away from housing people with mental illness in institutions and toward community-based care, but for the most part we’ve failed to re-invest the resources saved from closing institutions into community resources. As a result, mental illness either goes untreated or we rely entirely too much on jails and emergency rooms to house people. Nationally, we are starting to see a recognition that putting people with mental illness in jail isn’t really the answer, and some communities are starting to shift resources from law enforcement to treatment.
"Nationally, there are 4,000 mental health professional shortage areas – meaning there are not enough professionals (particularly psychiatrists) to meet the needs in the local community."
As for solutions, he recommends some basic action steps.
"We need to invest in training more mental health providers, particularly in rural and underserved communities. We also need to invest in more treatment facilities to support individuals in their recovery from mental illness. This ranges from outpatient treatment facilities to day treatment programs to inpatient facilities for those in crisis. It also requires training existing mental health providers to effectively liaison with primary care providers in an integrated fashion."
Liu says the Foundation's education efforts help raise awareness of mental health issues by "leading conversations aimed at ending the stigma of mental illness." He says people need to know mental illness doesn't equate to crazy or weak. He appreciates the foundation's funding and facilitation for behavioral health collaboration to achieve best practices.
Foundation executive director Julia Hebenstreit says as long as people are embarrassed to confront mental illness it will go unheeded.
"Mental illness is one of those things very difficult for people to talk about. It's also one of those things people view as something that impacts other people – never them. Our hope is they will realize mental illness is truly an indiscriminate disease that impacts people from all walks of life, backgrounds, ethnicities, economic background, age or profession. It is something happening to that individual, not something they did. They need your support. If you're not impacted by it directly, you can certainly serve as an advocate for someone."
In 2012 Mindy Eggert's life irrevocably changed when her 20-year-old son, Cameron Michael Molitor, hanged himself in the garage of his family's home. He'd attempted suicide three months earlier, which led to him receiving in-patient care at a local psych before returning home.
Eggert searched for answers after Cameron's death. She says she and the boy's father both asked what they missed as potential symptoms.
"In hindsight we think things started to change around late junior high-early high school. Self-doubt, more withdrawn, independent."
Isolation is a key marker.
Liu says most of us don't know how to identify specific mental health disorders and therefore don't pick up possible signs. Complicating matters, he says, "many individuals struggle in silence." Often, the first time family members know there's trouble is after a suicide attempt.
"Even those brave enough to admit to their symptoms sometimes do not get access to care," he says. "A significant number of individuals who screen positive for a mental health disorder in a primary care office do not follow through with a referral to see a therapist or psychiatric prescriber. That is why integrating a mental health practitioner into a primary care office is more successful in getting patients to follow through with the recommended treatment plan. This removes the most barriers in access to care."
He says some mental disorders do run in families but genes are only one predictor along with environment and exposure to trauma.
Experts say it's important people know recovery is possible with the right support.
"Many individuals can lead normal, productive and happy lives with mental illness," Liu says. "The goal is to achieve recovery, which is the ability to manage one’s symptoms and carry on with dignity and independence."
Hebenstreit likes that Running from Crazy has a hopeful message.
"The film and Mariel's story show that one can turn a tragic story into something positive" she says. "Mariel has overcome a strong family history of suicide and depression to now live a successful, positive life where she makes a huge difference telling her story and serving as a mental health advocate."
Eggert's plea to anyone with suicidal thoughts is to "get help, talk, even if it's just to a friend," adding, "We have to keep talking, otherwise we feel alone. The pain of that individual feeling of being unlike anyone else is what often leads to suicide." Eggert says, "We should not be so proud or ashamed of the condition. If we all spoke more of it, the stigma would be reduced."
For film details, visit www.filmstreams.org. For tickets to Hemingway's talk, visit www.thekimfoundation.org.
Read more of Leo Adam Biga's work at leoadambiga.wordpress.com.