The tragic news of the crash of the Germanwings jetliner in the French Alps on March 24 caused immediate shock, sadness, and an outpouring of sympathy and concern for the families of those who perished. Initially, questions focused on pilot error, mechanical failure and the fear that perhaps the crash was an act of terrorism. Few would have considered the possibility that the crash resulted from a deliberate action by the 27-year-old co-pilot of the plane, Andreas Lubitz.
Now that that possibility has become the reality, the focus of the investigation has shifted to whether Andreas Lubitz had a diagnosed mental illness and whether, if he did, proper steps were taken to ensure that his condition was communicated to his employer. Reports indicate that Mr. Lubitz had been treated for depression, and possibly suicidal ideation, in 2009. One piece of evidence recovered from his apartment suggests that he had been deemed “unfit” for duty by a medical professional on or around the day of the crash.
Coverage of the story has shifted to how best to screen pilots and others who might place the public at risk. And while these discussions are understandable and the desire to protect the public from violent acts absolutely appropriate, efforts to improve screening for mental health disorders are unlikely to prevent similar acts from occurring in the future.
Sadly, we have been here many times before. The circumstances are different, but the shock and sadness is the same. Several events over the last few years in the United States — and similar tragedies in other parts of the world — remind us of the potentially devastating consequences that can occur when someone who is mentally ill or emotionally unstable turns a gun, or a plane, on innocent victims who happen to be in the wrong place at the wrong time.
But as disturbing and senseless as these acts are, we must remember that the vast majority of those who suffer from mental illness are far more likely to be the victims of aggression than the perpetrators of it. Moreover, efforts to develop new and improved screening tools will have only limited success in identifying individuals who “might” engage in violence. Our science is just not capable of this level of certainty. Rather, our goal should be to address the cultural barriers that prevent those who are suffering — and those who recognize the signs of suffering — from speaking up and seeking care.
As long as those who struggle with mental health disorders and mental illness feel ashamed of the conditions that affect them, as long as we are reluctant to discuss our own mental health and the mental well-being of those in our families and communities, as long as we fail to recognize that our mental health (like our physical health) is a critical aspect of each and every one of us, we will keep those who experience mental health concerns from self-identifying or asking for help. And we will prevent those who recognize emotional distress in their loved ones from voicing concern or stepping up to help those who are unable to help themselves.
One in five Americans has a diagnosable mental health condition and one-half of all lifetime cases of mental illness begin by age 14. While we may not all have a disorder, we all have mental health, and we all experience emotional pain and suffering at some point in our lives. Perhaps more important, we have all been touched by the consequences of unaddressed mental health concerns, either in ourselves or in our families. Everyone has a story whether of personal struggle or of a family member who died by suicide, had a significant substance abuse problem, experienced untreated postpartum depression, was otherwise depressed and lost a marriage, was schizophrenic and became homeless… “One in five” means it is nearly impossible to find a family that has not been touched by a mental health condition.
Yet we often fail to acknowledge and address the emotional distress we experience in ourselves. We regularly ignore the mental suffering we see in those we know. We place a premium on our physical fitness and yet we do little to maintain our mental well-being. Although we seem to accept that we have little control over the development of most diseases that affect us, we refuse to accept that we have little control over our genetic predisposition or the life circumstances that contribute to the development of mental health conditions in so many of us. As a result, we continue to judge ourselves and others who experience mental health concerns as “weak,” “damaged,” or “broken.”
It seems odd that in this data-driven era, we seem to be unmotivated by the overwhelming cost of mental disorders in the United States and around the world. In 2006, $57.5 billion was spent on mental health care in this country. The global cost of mental illness was $2.5 trillion in 2010 with a cost of $6 trillion projected by 2030. These are costs that could be significantly reduced if we viewed mental health and mental illness as equal in importance to physical health — if we focused on education, prevention, and early intervention.
But if the unnecessary expense doesn’t motivate us, the unnecessary suffering and loss of life should. In the United States, more people die by suicide than are killed in car accidents. In addition, for youth between the ages of 10 and 24, suicide is now the third leading cause of death. And the Department of Veterans Affairs reports that 22 veterans commit suicide each day.
So how do we become a culture that accepts mental well-being as an important and valued focus for all citizens? How do we learn to share and encourage conversations about mental health and mental illness just as we share discussions about our overall physical health, our level of physical fitness, our injuries, and our illnesses among friends, coworkers, and family members? It won’t be easy. Change is especially difficult when fear and ignorance are at the core of resistance. Sadly, there is plenty of both connected to our beliefs about mental health and mental illness.
But there is reason for hope. Over a hundred organizations — traditional nonprofits, professional associations, corporations, communities, academic institutions, government agencies — have joined the Campaign to Change Direction, a collective impact effort focused on changing the culture of mental health, mental illness, and wellness in America. The largest PR firm in the world, Edelman, has stepped up to become the campaign’s pro bono communications partner. And the First Lady of the United States, Michelle Obama, added her voice to the movement at the national launch of the campaign on March 4 in Washington, D.C.
The campaign’s first objective is to teach all Americans five signs that may mean that someone we know is suffering emotionally and may need our help. Just as we have all learned the signs that indicate that someone may be having a heart attack, we can learn the signs that indicate that someone is in emotional trouble. And if we recognize these signs, what do we do? We show compassion, we reach out, we inspire hope, and we offer to help.
Teaching all Americans to recognize (and respond to) five signs of emotional suffering cannot, by itself, change the culture of mental health. But it is a huge step forward, and it is something that everyone can do. By creating a common language that we can all use to discuss what we see in ourselves and others, we can move conversations about mental health into the open, where they belong, around dinner tables, in classrooms, and at community centers. To learn more, visit www.changedirection.org.
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If you — or someone you know — need help, please call 1-800-273-8255 for the National Suicide Prevention Lifeline. If you are outside of the U.S., please visit the International Association for Suicide Prevention for a database of international resources.