(This is an excerpt of a larger piece submitted to the Journal of Psychology & Psychotherapy for scholarly review and publication it remains intact minus some of the demographic and epidemology factors that are not important to this blog)
Abstract:
Recent events in the United States have spurned national debates on mental health and crime. Much of the discussion is comprised of gun controls and vague references to treatment. The discussions do not address specifics about the people who are committing these crimes and what makes for meaningful treatment. The more we can learn from the people out in our communities who have mental illnesses, the more we can reduce the costs to our communities. Most of these crimes are perpetrated by a small portion of the estimated 5% 7 of the adult population with severe mental illnesses.
The discussions rarely focus on what it means to have a mental illness. Mental illness does not preclude a successful and fulfilling life. This article uses the example of mental illness in some of the people that we expect to be the most highly functioning, our Presidents. One specific example is reviewed. This past President was at times suicidal and would have to be considered at times to have a severe mental illness. While he was significantly impacted by depression, he became one of the most respected leaders in history.
Keywords:
Mental Health, Presidents, Crime, Treatment, Social Stigma, National Debate
Introduction:
With the rash of recent school shootings and other major traumatic events that have been perpetuated by those with mental illness, we may be forgetting that mental illness is no respecter of persons. It affects those from all walks of life. It has become easy to react to these people with doubt and mistrust. What would you think if the President announced that he too had a mental illness? Would you call for his immediate resignation? If you knew that a candidate had such an illness, would you vote for him?
According to the Substance Abuse and Mental Health Administration or SAMHSA; mental disorders are common in the United States and internationally. An estimated 26.2% of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year 1. This demographic is not limited to the poor, under educated, and disaffected. Mental illness can be seen in people from all walks of life. Doctors, judges, artists, neurosurgeons and CEOs all are as likely as anyone else to be impacted at least sometime in their lives.
Body & Discussion
Surely our Presidents are free from this worrisome problem, right? According to an article by Dr. Jonathan Davidson, professor of psychiatry and several of his colleagues at Duke University 2, these mental illnesses have affected Presidents since the formation of our great nation. This study used diagnostic criteria from the DSM-IV and found that 48% of the Presidents from 1776 to 1974 had a diagnosable mental illness. The most prevalent diagnosis was depression. Of the 18 Presidents with mental illness, 24% of them suffered from depression. Surely when we look at these men we would find that those with mental illness are worthy of the least regard. But then, perhaps not.
For a moment, let us consider one particular past President. This man was born into a poor family from the South. He was like many poor rural people of his time, he had limited access to formal education. If we look back into his history we discover that he had only about a year and a half of dedicated instruction. His principal teachers were clergymen and as a result he learned to read by reciting the Bible 3. He would stand for hours reading it aloud and committed much of it to memory. This had a significant impact on the young man. It habituated him to read all of his written works out loud. This method worked so well for him that he may have been one of the most profound of the Presidential speakers and writers. While he was never a well regarded poet there are two poems that are notable. Both of these poems have some literary credibility but their content was an indication of a somewhat morose and insidious suffering that impacted his entire life.
One of his poems, Suicide Soliloquy, was published in the Sangamo Journal on August 25, 1838 4:
Here, where the lonely hooting owl
Sends forth his midnight moans,
Fierce wolves shall o’er my carcase growl,
Or buzzards pick my bones.
No fellow-man shall learn my fate,
Or where my ashes lie;
Unless by beasts drawn round their bait,
Or by the ravens’ cry.
Yes! I’ve resolved the deed to do,
And this the place to do it:
This heart I’ll rush a dagger through,
Though I in hell should rue it!
Hell! What is hell to one like me
Who pleasures never knew;
By friends consigned to misery,
By hope deserted too?
To ease me of this power to think,
That through my bosom raves,
I’ll headlong leap from hell’s high brink,
And wallow in its waves.
Though devils yell, and burning chains
May waken long regret;
Their frightful screams, and piercing pains,
Will help me to forget.
Yes! I’m prepared, through endless night,
To take that fiery berth!
Think not with tales of hell to fright
Me, who am damn’d on earth!
Sweet steel! come forth from your sheath,
And glist’ning, speak your powers;
Rip up the organs of my breath,
And draw my blood in showers!
I strike! It quivers in that heart
Which drives me to this end;
I draw and kiss the bloody dart,
My last—my only friend!
This moment of despair was not an isolated event. He was a tall and lanky man. This suffering President could not be considered to be handsome. He was at times a loner. He recognized and commented to friends that he was probably a less than eligible bachelor. In his life he had few romantic entanglements. After one relationship was severed, at least temporarily, his friends were forced to search his rooms to make sure that there was nothing that could be used to hurt himself 5. If this were the case today he would likely have been detained and checked into a locked down hospital ward.
Yet he was an entirely remarkable man. Although he had a limited education he was a business owner, the holder of a patent, an appellate level attorney and eventually became one of the most admired people in history. Doris Kearns Goodwin 6, a noted presidential historian, gave a TED Talk about learning from past Presidents. The TED Talks are a series of speeches that are available on ted.com. Their motto is, “Ideas worth spreading. This speech is certainly one of these ideas. During her speech she said:
I was so thrilled to find an interview with the great Russian writer, Leo Tolstoy, in a New York newspaper in the early 1900s. And in it, Tolstoy told of a trip that he'd recently made to a very remote area of the Caucasus, where there were only wild barbarians, who had never left this part of Russia. Knowing that Tolstoy was in their midst, they asked him to tell stories of the great men of history. So he said, "I told them about Napoleon and Alexander the Great and Frederick the Great and Julius Caesar, and they loved it. But before I finished, the chief of the barbarians stood up and said, 'But wait, you haven't told us about the greatest ruler of them all. We want to hear about that man who spoke with a voice of thunder, who laughed like the sunrise, who came from that place called America, which is so far from here, that if a young man should travel there, he would be an old man when he arrived. Tell us of that man. Tell us of Abraham Lincoln.'" He was stunned. He told them everything he could about Lincoln. And then in the interview he said, "What made Lincoln so great? Not as great a general as Napoleon, not as great a statesman as Frederick the Great." But his greatness consisted, and historians would roundly agree, in the integrity of his character and the moral fiber of his being.
Yes, the man who was thus afflicted; who freed the slaves, who won the civil war, and who held a worn and weary nation together was Abraham Lincoln. Lincoln’s greatness as a human being and as President came from his practical understanding of one of Plato’s profound utterances. Plato said, “Be kind, for everyone you meet is fighting a hard battle”.
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| The Front of the SAMHSA building at 1 Choke Cherry Road in Rockville, Maryland. (Photo credit: Wikipedia) |
We have begun a national dialog on violence and mental illness. We must consider those with mental illness in a broad manner. Not all people with mental illness are dangerous or incompetent. Not all who commit violent acts have a mental illness. For all of those with mental illness there is hope. There is a reasonable potential for wellness and achievement. People who have mental illnesses are not a threat on that basis alone. Further, statistics show that severe mental illness affects approximately 5% 7 of the adult population. Although these people can have significant challenges, most are not dangerous. During this time of national discourse please consider people like Abraham Lincoln. Please also consider the 1 out of 4 people who have some form of mental illness. Try to see in them possibility and not disability. I encourage you to learn more about mental illness. It is not a character deficiency nor a reason to throw out the human behind the disease. After many years of research, SAMHSA tells us that recovery from mental illness is possible.
Part of my work with others occurs when people have been arrested. These crimes span the spectrum of offenses. Mental illness can and does have an impact on why people commit these egregious acts. Most of the time it does not excuse their actions. It should however impact the dispositions of their cases. People with mental illnesses need to get treatment that is appropriate to their needs. Each person has their own path to recovery. For the most part they can go on to lead happy and productive lives and contribute back to their communities. For the small margin that remains we can only hope that the suffering of the community, their families and their own suffering will not spill over into tragedy.
Conclusion
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| English: Picture of the Abraham Lincoln statue in the Lincoln Memorial. Italiano: La statua di Lincoln al Lincoln Memorial. (Photo credit: Wikipedia) |
I believe that if we can look at people like President Lincoln we can develop a balanced approach to evaluating mental illness. It is easy to be influenced into believing that all people who have a mental illness are not able to be responsible with their lives. This is true whether or not they are gun owners. Fear should not dictate our perspective in the debate about mental illness. In Lincoln we have a clear example that for some, mental illness can lead to inspired lives.
It seems that his suffering helped him to understand that all people suffer. It was in this way that he learned so clearly about the human condition and our inherent value as a human beings. It is how he seemed to understand the principles of freedom within the words of the founding fathers: We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness. When we begin to see all people from within this perspective, we will have the greatest impact on reducing both the tragedies and horrors of mental illness in our communities.
References
1.) The Substance Abuse & Mental Health Administration web site, http://www.samhsa.gov/data/NSDUH.aspx
2.) Haley Hoffman, The Chronicle (Duke), 23/02/2006
3.) A. Lincoln A Biography, Ronald C. White Jr., Random House, First chapter - Undistinguished Families
4.) Neal Conan and Joshua Wolf Shenk, author of The Melancholy of Lincoln. National Public Radio Broadcast, Talk of The Nation air date 04/09/2004. From the book, The Melancholy of Lincoln
5.) A. Lincoln A Biography, Ronald C. White Jr., Random House, page 112
6.) Doris Kearns Goodwin, ted.com. Posted October 2008
7.) A discussion of the methodology used to generate SMI and any mental illness estimates can be found in Appendix B. For information on mental illness see chapter 2 in Office of Applied Studies. (2010). Results from the 2009 National Survey on Drug Use and Health: Mental health findings (HHS Publication No. SMA 10-4609, NSDUH Series H-39). Rockville, MD: Substance Abuse and Mental Health Administration. Retrieved from http://store.samhsa.gov/product/Mental-Health-Findings-Results-from-the-2009-National-Survey-on-Drug-Use-and-Health-NSDUH-/SMA10-4609
