Here She Is Boys

The University of Colorado, Denver has been conspicuously silent about their former graduate student turned gunman. There’s nothing particularly surprising about that. Universities are loath to discuss their students or alumni unless doing so will bring glory to the institution. Universities are also part of the elite group of organizations known as suffering from acute “litigation paranoia.” But onlookers accept the silence as being a vague yet misguided attempt at protecting someone’s privacy.

If what we were discussing was a physical disease or impairment, patient privacy would be a valid and even laudable motivation. As a society we’ve determined that patient privacy, even when a diagnoses could involve potential contagion, is necessary. We’ve also determined that when a disease poses an imminent public threat the afflicted will be quarantined (and thereby outed.)  In other words; public good trumps the individual. On the most basic level we apply this same principal to mental health as well. If a person states (unequivocally) that he/she is going to hurt him/herself or others, they are held (usually for a very short period) until they can be examined and either sent on their way or hospitalized.

This flaccid approach to protecting individuals and the public stems from the deinstitutionalized of mental healthcare several decades ago. The “expression of specific harm” is employed to prevent people being hospitalized against their will. One only need sit with the preceding sentence a bit to see the absurdity of this approach. People struggling with mental health issues rarely are clear and conscientious enough to seek hospitalization on their own. We leave it to the ill to state clearly their intentions to do harm before highly trained professionals are allowed to intervene. That’s a problem.

Adding to that little issue is the fact that we are freaked out by mental health issues. Yes, we’ve been Oprahfied enough to (sometimes) toss around the right terms. But we are glaringly uncomfortable dealing with real life mental health. If we see someone, day in and day out, who we consider odd, what do we do? Maybe we mention it to a friend, but beyond them who would we actually tell? And what is exactly do we say? Is the guy who only comes out at night and keeps his door covered in aluminum foil a danger to anyone? Are his odd behaviors actually highly honed coping skills for his illness? Maybe he sees a psychiatrist every day and is adequately medicated. Maybe he’s just eccentric (versus ill.) More often than not, we say nothing and just hope to avoid someone who makes us uncomfortable.

There is somewhere where aluminum foil should send an observer directly to the phone, and that’s at a university. Most students (graduate and undergraduate) are under 30 years of age; a primetime for the onset of very serious mental illnesses. Students are often sent away to school already presenting symptoms and perhaps fully medicated. The beauty of a controlled environment (like a university) is that elaborate and accessible systems are in place. A professor who observes disturbing behavior knows exactly how to report it immediately. No doubt, they sometimes do. But too often we err too heavily on the side of our own discomfort (which we shroud in “patient privacy” rhetoric.) It’s very unsettling to be the person who may upend someone’s life. However it’s far worse to be the one who stayed silent.

When we stop seeing mental health issues as being somehow shameful we will be a safer and more humane society. When newsreaders no longer intone (in sotto voce;) “He even spent time in a mental hospital” we will be further ahead. When a political candidate gains sympathy points for a spouse with a physical illness and looses popularity for one with a mental illness, we will be further ahead. When we stop using the word “rehab” (invoking images of large sunglasses and hangovers) as a euphemism for mental health facility, we will be further ahead. And when celebrities stop claiming to be suffering from “exhaustion” (as if it’s the 1900s) versus having depression, we will be much further ahead. There is no shame in illness of any kind. The only shame is silence.