Something new: the hopeworks chatroom

In an effort to make this a more interactive site we are trying something new I hope you will check out. You will notice on the side bar to the blog the “hopeworks chatroom” It can be found right underneath the pages. If you have a comment, a question, a topic you would like to discuss you can do it there. Simply type it in and press enter. We will try this on a trial basis to see how it goes. Hopefully it will enrich your experience of Hopeworks Community.

“Have a little faith”- a Thanksgiving gift.

These videos tell the story of an unusual book I have just read… a masterpiece “Have a little faith” by Mitch Albom. It is the story of two men of different faiths. It is a story of faith and hope. It is a story of rescue and redemption. It is a story about us. It is a story about me and you. Enjoy the videos. I hope you will read the book. May this be the start of a great Thanksgiving for you.

I met a wise man

I met a wise man a couple of days ago.  Hard to find a wise man.

He was old, but had lived longer than his years.  He told me his story and his life to me seemed charted by what had gone wrong.  Most of it seemed about how he had gone wrong.  He had been sober he said for about 10 years.  From the time he was a kid he had drank and used drugs– anything he could find to drink and any drug he could find to take.  He talked about he consequences:  time in jail (many times in jail), broken relationships, lost marriages, jobs lost, possessions lost— hope lost and most important  he was lost.   He talked about how many times he almost died and how many times he had wanted to die.  He talked about “solutions” that had become bigger problems than the problems he was trying to solve.  He talked about trying  to find a way to feel good had left him unable to feel anything at all.

He was alive now, but young  he said in years really lived.  He talked about changes made and lessons learned and one day at a time and trying so hard just to do the next right thing, but what he said at the end is what really hit me between the eyes.  I asked him if there was a secret, a something he thought he could share or wanted people to know.  He was quiet for a minute and then started to speak:

• “I spent most of my life being mad.  I looked around and saw what others had and lived in a fury at what I didnt have.  My entire life was measured by what I had, was trying to get or never seemed to have.  Everything I did was about getting  and keeping others from taking…Everything.  A couple of times I have had a lot of stuff.  But even then it still seemed like nothing….. I dont know how.  Maybe it has been there all along.  Maybe I have always known, but didnt know I knew, but I have learned I think what life is about.  IT IS REALLY SIMPLE.  LIFE IS NOT ABOUT WHAT YOU GOT OR WHAT YOU ARE GOING TO GET— IT IS ABOUT WHO YOU ARE.   When I realized that I knew for the first time I had control over what really mattered.  And then life begin to matter.  When I am with other people my first question is no longer, “What can I get?”  It is almost a prayer now.  “What can they get?”  And I ask God for his help to do the next right thing….”

Sometimes we chart our life, not by the statements we make, but the questions we ask.  Our lives are spent answering questions, but what he pointed out was true:  We cant get the answers to questions unasked, and questions unasked leave us stranded in a life with answers unseen.

 

On being left out in the cold- Mental Health in Tennessee

I listened this afternoon to the broadcast of the Governors budget hearings with the Dept of Mental Health.  Next year looks dimmer than ever.  My assumption is that Tennessee is not the only one in that ballpark.

One  cut is the most dissappointing.  If it holds it will literally leave thousands of Tennesseans out in the cold.

Tennessee has had a behavioral health safety net for adult Tennesseans without insurance.  It has been a bargain with major positive effects.  For roughly $750 a person the state has been able to provide individual counseling, case management, and medication management for over 25,ooo people.  These services have saved people’s lives.  They have decreased the amound inpatient hospitalizations drastically.  By any measure it has been a success, a huge success.

In addition to cutting everything from last years budget that was labeled a one time item the governor is asking for a minimium of an additional 9% budget cut for the Department.  In response that the Department outlined its projected cuts.  One of its proposals was to cut about 5 million dollars from the safety net budget.  If I have done the math right this would about 6666 people out.  These people, all with chronic and serious mental illness, would be left with no resources, no place to turn for the services they need to survive and cope.  The accumulated efffects for our state can only be imagined.  Crime, substance abuse, homelessness, loss of jobs, families destroyed, emergency rooms over-run, an explosion of referrals for inpatient hospitalization– who knows where it might stop.

And this is only one of many, many cuts that were discussed in that meeting.  Many of the others will have just as drastic an effect.  Governor Bredesen to his credit did not seemed pleased by the options given him.  If you live in Tennessee this is the time for you to contact your legislator while things are just in the planning stages.  It is important to be heard now.  If you live in another state it is important that you know what is going on in your state.  The time for action is now.

ON wounds- old and new

Probably the most traumatic event of  mine and Linda’s life was her brain surgery.  She had gotten to the point where she was having 10-15 grand mal seizures a day.  She had been in status epilepticus more than once.  Her qualityof life was zero and I was terrified that her life itself was in danger.

After a lot of prayer she decided that she wanted to go on with the surgery.  I dont think either of us saw any options at the time.  They took out her hippocampus and her amygdala.  We hoped that it meant seizures were gone.  It didnt.  4 years later she was in Vanderbilt Hospital having  over 100 seizures a day.  With lots of help and finally finding the right medication the seizures are under control.  They are still there.  But they no longer define our days. 

But the operation took us into another world…. one we had no idea was coming.

Linda found she had a whole host of disabilities she never had before.  Her short term memory was devastated.  Small things like reading a book become major operations.  At times she had a hard time getting the words she wanted to say out.  Little stresses became big huge stresses.  Concentration became an effort  and no longer a given.  At times her brain would in her words “shut down.”  She just couldnt process.  She could get lost walking around the block.  She got lost in Walmart one day after we became seperated.  I searched the store for over an hour finally finding her in the layaway department on a bench crying.  She told me “I knew that if I just stayed still you would find me….”

Linda is a hero.  She is a “Stephen Minister” in a local hospital.  She volunteers at a local nonprofit dental clinic.  We do groups with a group of Alzheimers patients in a local nursing home.  She is an intergral part of Hopeworks and all the work we do. 

But her most heroic act is in coping with what she has lost.  And that has been her hardest battle.  This past week was one of her worst.  She had to take a psychological testing for Voc. Rehab and all the wounds of her cognitive losses were opened fresh.  And she felt sorely diminished and so limited.  She told me towards the end of the week, “I felt violated.”

We all have wounds.  Much of life is how we recover.  And much of the hardest part of life is when they are reopened.  But know you can get by.  Know you can  go on.  Know that no hurt, no wound need define who you ae or what your life is. 

I hope you are not alone.  All of us need to know who are hugs are.  And if you are  someones hug God bless you.  Take care and know you can make it.  We know we can.

ON the limits of diagnosis

A diagnosis is not a death sentence.  It is not a ticket telling you the limitations of life you are entitled to.  It is simply a label.  It means you have been placed in a group with other people who are in some way similiar to you and this is the name for that group of people.  In the words of social psycholigist Ellen Langer, “A diagnosis describes the averaged experiences of many individuals, but it may not speak to a single individuals experience at any one point.”

In an incredible book called, “Counter Clockwise”, Langer speaks to this issue.  Two concepts she uses, certainity and variability, are particularly important. 

 Certainity means just what it says.  It means that, if  for example, you have bipolar disorder, that there is a “point” on which you stand, a point that you do not move past.  It is a limitation of possibility,  a terminal statement.  It means here is the wall.  Live with it and accept it.  People who say they have gotten past that wall or that the wall is not real are resistant, in denial, blind, or simply crazy.

Variability is a range.  It addresses the question of  possibility.  It does not like certainity say, “This will happen.”  Instead it asks, “What can happen?’  It recognizes that ranges are not infinite, that they have limits.  But within that range there are differences in where you can be. 

 Langer talks a lot about the “psychology of possibility.”    Knowing what is and what can be are not the same thing.   If you look at diagnosis as a statement of certainity then you can only occupy one point and everything is about adjustment.  If  as Langer says diagnosis is “…the average experience of many individuals….” the question then is not what you have to adjust to, but where you want to go.  Life is about improvement and recovery and thriving— not about maintanence and adjustment. 

Diagnosis for most people is the end of the discussion.  Once you “got it” the only question is how to adjust to it.  But it is possible that diagnosis it only the beginning of the discussion.  There is ample evidence that people can make extraordinary recovery from “mental illness.”  If there is this variance in the experience of  “mental illness” what has to happen to move toward the upper end of the spectrum.  Where do you want to go and what do you need to do to start the process are the operative questions.

If you accept the idea of variability it means that because something hasnt happened it doesnt prove it cant.  It just means you havent discovered how.  One of the best stories in Langer’s book is how she taught the paralyzed old lady how to blow her own nose.  It means hope is real.  Certainity is a cruel mindset.  It closes the door to hope.  It makes choice an illusion.  It leaves life as something to be suffered, rather than be celebrated.

You are more than what you are called.  Even if you are a “member of a group” you are more than what that group is called.  A description of what it means to be a member of that group is not a description of what it means to be you.  If you believe in possiblity the first question is not what is, but what do I want it to be.  Langer has a strategy she calls the “reverse Zeno strategy.”  “There is always a step small enough from where we are to begin to get us to where we want to be…..”

Take a step.

 

Second look: On the discipline of getting ready to

Have you ever noticed how some things seem so easy for other people– but never for you?  Have you ever wondered why?  I have.

There are so many times that I am really sincere about doing something and am really determined to try really hard and it still doesn’t happen.  I either beat myself up or find somebody or something else to blame and find myself consumed by either guilt or anger.  Either way I find myself a hard person to be around.  Even when I know what went wrong it is still hard to get it right.

I have begun to understand the problem much better over the last few months and I think I know what is required.  You have to prepare yourself to do things easily.  Consider that phrase for a moment and think about what it means.

Is there really such a thing as the discipline of getting ready to… ?  The answer I think is yes.  There are many things in life I cannot do by direct effort.  I cannot just decide to go out and run a marathon.  I cannot lift a lot of weight.  I cannot program a computer.  I cannot read Greek.  I cannot just do many, many things.

What I can do is to do the things that will make it possible to do these things.  I can, in essence go into training. I can do what I need to do to get ready.   People must train, they must practice to acquire control of their temper.  You may not be able to control your temper, but if you practice the things that will get you ready to control your temper you will eventually be able to. 

The answer to many problems in life- all the way from running farther to making better choices in life to thinking more constructively to almost anything else-is in the preparation, the training to do so.  Practice may not make perfect, but it does make different.

Think about the things in your life that you would like to be able to do.  Do you rely on something other than willpower to prepare to do them?

I know for me when I train for what I want to become my odds are a lot better.

No matter what kind of changes you want to make, no matter how sincere you are– don’t be suprised if the things you want to see happen never do until you make the necessary preparations for them to become reality.

Second look: Till the coming of new day

Till the coming of new day

 

 

                              In the night of life

Hope seems small and quiet

And shivers before the wind

That cuts to the bone

And clings like a tight fitting coat

That cuts off all movement

But never brings enough warmth.

 

Sadness

Brings its own night

Its’ clock seems somehow stilled

And day

A tissue-paper memory

That comes apart in our hands

As we try to bring it close and real

 

Weariness hangs in the air

And is in every breath

As hearts

Grow tired and slow

And wonder at

The absence of the sun

 

Reaching in the dark

For new places

We feel like we are

One mistake from

Being forever lost

And stop fearful

Afraid to move

 

Dear God

Move among the shadows

Of our despair

Show us in Your love

That darkness is

Only of the moment

And that in reaching

To each other there

Is warmth and comfort

And the assurance of

New day and new light

 

God bless us

And leave us assured

That even in the coldest and darkest

Of nights

That You give warmth and shelter

Till the coming of new day

 

 

On disdain and contempt

Much of our public discourse has come down to an argument about who deserves our contempt.  Sometimes it seems that believing anything  means  nurturing a deep personal disdain for those who disagree with us.  Conversation about important things is a matter of who calls the most names in the most convincing fashion.  In our zeal to doubt the integrity of others, we ignore that the labeling and stigma we apply to others leaves our own integrity in sad repair.

All is noise, and in the frantic attempts we make to turn the volume up, the answers we seek seem more illusion than real.  Our “truths” no longer bring us closer together, but seperate us into opposing camps where we comfort ourselves with pretensions of purity and purpose. 

Ideology has replaced ideas and what we believe we know is not important because of what it tells us about the world,  but because of how it defines who we are.  We have become banner people and think in sound bites and slogans.  

This is played out in all kinds of arenas.  Our politics seem to deny the possibility of integrity for anyone.  We are too embroiled in the process of  slander and name calling and the consequences of political actions so often seem of little concern or worry.  It all seems to be about making a point and being right.  I have this vision of all the little Pharisees running around pointing to themselves while their country faces destruction.  We prize those things that polarize us and leave those that pull us together unattended.

I think that I am naive.  I dont think meaness and cruelty in the service of purity is ever okay.  I think we need to be less concerned with what we know or what we believe, and more concerned with who we are.  A truth that obligates me to disdain others and see them at best as stupid, if not immoral doesnt seem to me to much of a truth.

I believe I can stand up for what I believe without insisting that others stay seated.  I believe that Fox News is not the only template for reality.  I believe the difference between Rush Limbaugh and God is that God at least knows he is not Rush Limbaugh.  And I am every so thankful that I am not God.

My faith tells me 2 things above all others.  God is the father of all of us.  And he doesnt make no jokes.  And he doesnt make no junk.  And even people who disagree with the things I hold most dear are capable of acting like that.  What I know or what I believe gives me no monopoly on what I can become.

The second thing is that all of us are sinners (and I know that is about as politically incorrect as I can be).  We are all fallible and have an amazing ability to make bad choices and then justify them in the highest sounding way possible.  We are all capable of using others for our pleasure and purpose and then dispensing with them as little more than trash when they no longer serve our purpose.  People that I agree with about major things have the ability to radically dissapoint.  As do I .  And often I do.

Life is about more than what point I make.  And most certainly I am not the point to be made.  It does not matter how many stars I accumulate, how much money I have,  how well I am known, or how much power I have.  Life is not about making myself the tallest building in the world.  For none of us are buildings no matter how frantically we try to lay the bricks.

We all live by faith I think.  All of us have beliefs about what life is about and how we should spend our time.  Even those who say all faith is illusion and convention live by the faith that what they say is true. 

Life is about caring for other people.  It is more about reaching out to others than pointing fingers at them.  It is less about knowing the right things than it is about being the right kind of person.

It that world it doesnt matter how you are labeled.  There is no need for a Robert Enke to step in front of a train, because he is afraid of what people will think of him.  In that world life is more that Boardwalk and Park Place and racing to get hotels and houses.  In that world we know that in the end it all goes back in the box.   In that world the question is not whether or not you have won or lost, but rather or not you are lost and need someone to lean on.

I have strong beliefs and ideas and I think they are important.  But none of this ideas place me under obligation to hold those who disagree with me in contempt.  Feel free to disagree with me at every turn and that is okay.  And when I forget, as I am sure I will, that life is more than a mirror for my glory please point that out too.  And that will be very much okay.

Take care and remember the words of the old song.  “There aint nobody right if everybody’s wrong….”

Have a great day.

 

 

Second look: On remembering your name

My wife and I do a bible study on Sundays for a group of Alzheimer’s patients at a local nursing home.  When we got ready to leave, Linda asked one older lady what her name was.  She wanted to pray for her.  The lady looked around the room tentatively as if searching for something.  Quietly, hesitantly she replied, “I don’t remember what my name is…”   For a minute time stopped for us.  We didn’t know what to say.  One of the other ladies finally turned to her and said, “Your name is …….” 

 

Hopefully I will always know my name.  Hopefully you will too.  In biblical times though names were descriptions of character.  They were not just what we were called.  They were who we were.

 

In that sense all of us sometimes forget our names.  We sometimes lose the ability to see clearly.  Sometimes life diminishes us so much that we lose contact with who we are.  If you have struggled with bipolar disorder or any other type of emotional illness you have had times when you thought you were nothing more than your disorder.  Overwhelming pain and stress leads us to identify with what seems the source of that pain.  We start to believe we are “nothing but…”

 

The greatest gift we can give each other is to help each other to remember our names.  To truly care for someone means to let them know that they are more than the limits of their experiences.  I know in the worst of my moments it is hard for me to see anything other than those moments.  It is those around me who help me to see what God has given me.  It is in their vision that I stay tied to my own and find gratitude in life.

 

Linda has had brain surgery and memory is a huge issue for her.  She told me when we walked out of the nursing home today that God had shown her how much she had to be thankful for.  It helped to coalesce in her mind how many times in how many ways, that even in the worst of times God had been there for her and stood with her.  She is a grateful person, but now even more than ever, she is grateful for the gift of her memory.

 

You have a name.  That name is a gift from God.  Treasure those around you who help you to remember that gift.

 

By the way, the lady’s name was Hope.

ON the habits of doctors

Doctors see what they are used to seeing.

There was a study several years ago in New Hampshire or Vermont. I have lost the specifics of it. The doctor wanted to see why there were more diseases of one kind in one part of the state and of another disease in another part of the state. He couldnt understand why people would be so different. For example, I think one part of the state had significantly more hysterectomies than another.

His conclusion after a lot of research was that the people werent different. The doctors were.

The most important part of treatment was not the application of medical science to people’s medical needs. Doctors diagnosed what they were used to diagnosing and treated the way they were trained to treat. The conclusion of this study was that what happened to you was more of a function of your doctor than of you.

If you have been in the mental health system you know this. Every person I know with bipolar disorder can tell stories of the diagnostic wars they have survived. Doctors who dont believe in bipolar simply dont see it. Some doctors see it everywhere. Different programs operate under different “fashions.” I have known psychiatrists who see the ugly hand of depression everywhere. I know of another who was especially adept in seeing borderline personality where other people saw none. I know a psychiatrist now who believes that bipolar diagnosis should be expanded to bipolar 7. He believes borderline personality it a variation of bipolar and give you chapter and verse of the “scientific” justification of this.

I have learned the hard way about doctors fashions. 8 years ago my wife had a brain operation. She had serious problems with seizures and was told that was her only hope. Seizure control has gotten better, although the “cure” we hoped for never came close to happening. What she did get though was a whole host of disabilities she never had before the surgery. They took out her amygdala and hippocampus. Her short term memory was destroyed. Her brain frequently “shuts down” and she cant process. At times she cant read with any comprehension. She could get lost walking across the street (literally). She gets overwhelmed by a lot of information. And that is just the tip of the iceberg.

I dont know if the surgery was her “last chance.” It might have been. I just dont know. I cant help but wonder though if we had lived somewhere else if it would have been. You see we lived in a university town with a very well known neurologist who was especially well known for the people he saved through brain surgery. They told us it was no big deal and after a few headaches she would be good as new and we believed them. In their eyes, it was no big deal.

The last few days have been especially hard for Linda. Most of the difficulty has been with the “gifts of the surgery.” For me the last few days have been a low bubbling rage. I will always wonder how those doctors could be so oblivious of their ability to do harm. My wife is the kindest and I think the best person I know. I see her struggle with many of the most ordinary events of life and I simply wonder at her courage. And I still wonder if the destruction of her memory which leaves her at times feeling so robbed, was the accident of a desperate attempt to fight her seizures or a result of a doctor who saw only what he was used to seeing.

I know some doctors I think that bless life. They give hope and relieve suffering. I know therapists and psychiatrists I feel that way about. But they have never forgotten that they are human beings. And because of that they never forget their potential to do harm and try hard to never simply be content with what they are used to seeing. Medicine you see, should be a function of the people treated, and not the habits of those who do the treating.

On jailing the mentally ill

One result of lack of mental health services invariably is that the jails will become for many the only mental health system they know. And it is a terrible system that doesnt work for anybody. The article below talks about one idea in Knoxville, Tennessee. What is your community doing with this issue? Please share, I would like to know. It is one of the major issues affecting many with mental health issues.

From the “Knoxville News Sentinel”
For far too many people their mental health system is the jail. And once they get in the system they find it hard to get out. Jails are going broke trying to deal with those with mental health issues. As mental health spending is cut down more and more the reality of jail for those with mental health issues will only go up. The article printed below is the response to the issue of Knoxville, Tennessee. I would be very interested in knowing how your community is dealing with this issue if at all.

Knox County’s Criminal Justice Committee is grappling with the best way to deal with the mentally ill who wind up in jail, and their solution so far would cost $1.7 million in yearly operating costs – a plan that committee members hope is addressed in next year’s budget.

Knox County District Attorney General Randy Nichols, who serves on the committee, says mentally ill inmates do not belong in jail, but because they don’t get the services or medicine they need, they often wind up in jail over and over.

“It’s a revolving door,” Nichols said. “The problem, of course, is money.”

Sheriff Jimmy “J.J.” Jones estimates 18 percent to 26 percent of those housed in jail suffer from persistent, serious mental illness.

“It is extremely costly and it’s wholly ineffective,” Nichols said. “We keep you there until you sober up, then let you go and you’re back in three to four weeks. It makes no difference in the lives of these people and we’re going broke at the same time.”

It costs $75-$80 a day to house an inmate, but the psychotropic medications double the cost for a mentally ill inmate, Jones said. The county spends $400,000 a year on the medications.

The concept being discussed has three parts:

n First is a proposed Safety Center, with 15-20 beds, where mental-health professionals would allow those arrested to voluntarily stay for up to three days and be assessed, get medicines and begin treatment.

The purpose of the center is to keep people out of the jail. The Safety Center is the facility that committee members hope may be addressed in next year’s budget and would cost $1.7 million a year to run. That does not include costs to build or lease space for the center.

n The second facility would be the currently operating Crisis Stabilization Unit, a place for a voluntary stay of up to three days for people who are diverted from the jail or come from emergency rooms or a mobile crisis team, or who come in on their own.

The unit would pair people in “psychiatric distress” with their current mental-health provider or find them a provider. Such a facility now is operating on Ball Camp Pike, along with a Medically Monitored Detox Unit for people who have substance-abuse issues.

n Finally, people who are chronically homeless would have the opportunity to be referred for permanent supportive housing where a case manager would oversee their treatment and services.

Nichols said the committee would like to see the Safety Center located in the downtown area to be close to law enforcement and staffed by Helen Ross McNabb Center mental-health professionals.

“The police are not trained to deal with mentally-ill people,” Nichols said.

While the committee’s main task is to reduce jail overcrowding, dealing with mentally-ill inmates is a large part of that.

“That’s a segment of the population we need to work with,” said Commissioner Brad Anders, a committee member and Knoxville Police Department sergeant. “They’re mentally ill instead of criminals. The mentally ill are going through a revolving door, and they’re going in and out of jail without treatment. If we can do this facility (Safety Center), we can see them less in jail and more as productive members of society.”

Commissioner and committee member Richard Briggs said, “The jailers at the detention facility are not trained to take care of those kind of people and we’re responsible for their medication. That’s expensive. And once they’re arrested they lose TennCare and the county is responsible for their medical care.”

In the long run, committee members believe facilities like the Safety Center would save the county money.

“That’s an economic decision and there’s a humanitarian decision,” Briggs said. “Why put people who are mentally sick in jail when there’s not a threat to public safety? These people need help. They don’t need to be detained and arrested.”

Briggs said the committee is looking for a site – either as a purchase or a lease. He said the committee is discussing requesting the issuance of bonds.

Jones noted that once someone is charged and convicted, he or she loses TennCare coverage, the state’s insurance program for the poor.

“If they don’t have insurance, nobody wants to treat them,” Jones said. “Those 18 to 26 percent, we’re not talking about the criminally insane. We’re talking about shoplifting, indecent exposure, public drunkenness.”

Currently, Jones said mentally-ill inmates are released with a month’s worth of medicine.

“They take the medicine three to four days or they lose it or someone steals it,” Jones said. “When they’re not on their medicine, they do the same thing again and they’re right back in jail.”

Andy Black, CEO of Helen Ross McNabb Center, agreed that diversion from jail – or a mental-health hospital – is the aim behind the planning.

“The goal of the Safety Center is to divert people from high levels of care, whether it be the criminal justice system or mental health hospitals,” Black said. “When law enforcement picks up someone who is having a psychiatric issue, they would be brought to the Safety Center rather than to jail.”

Rebecca Ferrar may be reached at 865-342-6357.

© 2009, Knoxville News Sentinel Co.
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More on Robert Enke

I came across this tribute to Robert Enke. It seemed worth sharing.

He died because he was afraid of people finding out he was dealing with mental health issues. He doesnt have to be afraid any more. Such a rotten, rotten shame.

Second look: On something really, really sad

This post is a followup to the previous post about the death of Robert Enke.  It was originally posted a couple of months ago, but perhaps gives a wider context to his tragic story.

 

Yesterday I put a post on my other blog (“16 Minutes” – http://everysixteenminutessomeonedies.blogspot.com) about some statistics about suicide from the World Health Organization.  Suprisingly it got a lot of comments- many of which I did not expect.  But what really stuck with me was one person who described it as “very sad statistics.”  She got it right.

In this country 1 person dies every 16 minutes from their own hand.  Their is an attempt every minute.  And that is just what we know.  How about the untold times that a family tries to handle it on their own, because they dont trust the system or are afraid of getting someone in trouble.  Where I live more people die from suicide than car wrecks, homicide, and AIDS combined. 

If you have a mental illness the statistics go through the roof.  The first support group we had there were about 27 people there.  When we started to talk there were probably 65-70 suicide attempts in the room.  I think I know about 25-30 people who are basically one bad thing away from attempting.  I  know many people for whom suicide is a daily thought.  A daily thought. 

The statistics I saw say that if you have bipolar that 1 in 5 will die from suicide.  It is why many people call it a terminal disease.  If you have bipolar and schizophrenia the figures go even higher.  1 in 3 die.

If you are a teenager it is the third leading cause of death.  The statistics are overwhelming in virtually every way you look at them.  It touches virtually every area of life from the young to the old to the militiary to men to women.   Everywhere.  It is a public health emergency of major proportions.  And it is the greatest indictment of the mental health system I know.

For whatever reason many, many people simply do not get anything close to effective help.  The reasons are many and everyone can argue for what they think are the most important: overreliance on medication for people who need people more than anything, not enough services, too many roadblocks to getting the services needed, stigma of mental illness, lack of public awareness, lack of funding…. the list is endless.  But there is a bottom line.  People are dying that dont have to.

September is Suicide Awareness Month.  Make it a month that counts.  Do what you can do to contribute to public awareness.  Take part in activities in your neighborhood.  Start activities in your neighborhood.  Do what you can do to effect the bottom line.  People will still die.  But if we can do something that helps to reach one person, to save one life we will have done a good of infinite value.

ON the reality of stigma. The death of Robert Enke

Robert Enke died this past Tuesday. He was a soccer player in Germany.   He stepped out in front of a train and committed suicide.  45,000 people came to his funeral.  His story is reprinted below.

He brings a face to the idea of stigma.  Reportedly he suffered from depression for at least 6 years.  He did not want anyone to know.  He was afraid of his child being taken from him for one thing if anyone found out.  None of his teammates said they even knew.

I have known others who put tremendous energy into hiding their issues from people in their life.  I have known many who were convinced that being found out would be the end of a job…. a relationship….or of something else important in their life.  Stigma is not just what happens when people find out.  It is the fear that drives you to make the most important thing in your life that no one finds out.

It sounds like Enke just ran out of steam.  Untreated the depression was getting worse.  Getting treatment meant exposing himself in a public manner.  He couldnt live with either option.  He chose to die.

Stigma is deadly.  I wonder how many people refuse to get help because of what they think others will say about them.  I wonder how many people put themselves in a pressure cooker of a situation trying to make others think everything is ok when it is not.  I wonder why Robert Enke found himself in a situation where the best solution to him seemed death…. I really wonder.

Next time you hear the word stigma think of Robert Enke.  And think about how many other Robert Enke’s  there are.  And wonder why it is that so many people should be so scared or so ashamed of who they are and the issues they must deal with in their life.

Read the story below please.  And say a prayer for the wife and child of a man who saw no way he could continue to live.

Tens of thousands gather for Enke’s memorial

      

AP – Robert Enke’ s wife Teresa, left, is comforted by an unidentified woman in front of the coffin prior …

• Slideshow:Germany goalkeeper Robert Enke dies at 32

By ZACHARIAS ZACHARAKIS, Associated Press Writer Zacharias Zacharakis, Associated Press Writer – Sun Nov 15, 10:17 am ET

HANNOVER, Germany – More than 45,000 fans gathered Sunday at the Hannover stadium for a memorial service for Germany goalkeeper Robert Enke, whose suicide has shaken the country.

“Robert Enke will never come back to this stadium, the place where he conquered our hearts,” Hannover club president Martin Kind said at the beginning of the ceremony. “But it wasn’t only his success that made Robert Enke so popular, it was the man, his personality.”

The 32-year-old player, who played for Hannover 96 and had a good chance of being Germany’s starting goalkeeper at next year’s World Cup in South Africa, stepped in front of a train near his Hannover home on Tuesday evening. His widow, Teresa, appeared on national television a day later to say her husband had been suffering from depression for six years but did not want it known.

Enke’s coffin was covered with white roses and was placed in the center of the field. German politicians and sports stars were also at the memorial, where many of the fans wore black and the club’s green, white and black scarf.

Before the start of the ceremony, the fans stood and applauded when Teresa Enke walked to the coffin together with a friend. Several members of the German national team also approached the coffin to say goodbye to their teammate.

In a country riveted by soccer, Enke’s death has prompted a debate about whether players receive sufficient psychological support.

Teresa Enke said her husband had kept his depression secret from the public because he had been afraid the couple’s adopted 8-month-old daughter would be taken away from them if his illness was known. The couple’s biological daughter, Lara, died of a heart ailment in 2006 when she was 2.

Enke’s father told weekly magazine Spiegel on Sunday that his son had suffered for a long time.

“I think that his disease did not arise from something inside of him, but was triggered by his life’s circumstances,” said Dirk Enke, a psychotherapist, who said he tried to talk to his son several times but could not get him to talk about his depression.

In a farewell note, Enke apologized to his family and the staff treating him for deliberately misleading them into believing he was better, which was “necessary in order to carry out the suicide plans,” said Valentin Markser, his doctor.

Enke’s struggle with depression was not known to his teammates or coaches.

At the end of the ceremony, as Enke’s coffin was carried out by his Hannover 96 teammates, many crying fans raised their club scarves.

“During the last days, there was only emptiness and sadness,” said Thomas Brauns, 42. “It happened so suddenly. Last Sunday we still saw the game, applauded him … and two days later he throws himself in front of the train.”

Enke was buried later in the day next to his daughter Lara in a private ceremony near Neustadt, outside Hannover.