Talking mental illness and “compassionate reporting” with 2012 National Magazine Award finalist and 5280 senior editor Natasha Gardner.

By Candace Mittel

In anticipation of the publication of my long-form piece, Aunt and the Brain, next week in The Riveter, I had the opportunity to discuss the endeavor of writing on mental illness with a likeminded journalist, Natasha Gardener, whose story, “Riders on the Storm,” in 5280 touches on many of the same ideas and questions as mine. We conversed about the challenges of “compassionate reporting,” which both of us have been tackling. It was encouraging to chat with someone who is also devoted to facts but not afraid of feelings. As writers who are personally affected by the subject, we believe that these are pressing stories that need to be told. Mental illness may be a sensitive topic, but as Natasha told me, “it’s what we owe to each other.”

Candace Mittel: I was very happy to read your article. It’s nice to read something about mental illness from someone who is on the same page!

Natasha Gardner: Likewise. Especially now, when there’s been so many articles that are focused on the violence of mental illness—to be like “Okay, wait, let’s back up and have a conversation that doesn’t involve talking about guns!”

CM: Totally.

NG: How long did you work on that piece?

CM: It was a yearlong project. I didn’t know how it was going to look, but I started around last January—for school. It was a longform assignment for my creative nonfiction class in my last quarter in college, and then it turned into this!

NG: Does your aunt know that it’s coming out?

CM: She doesn’t. I don’t know if I will tell her. I’ve thought about it a lot. My dad has read it; my mom has read it. We’ll see what happens.

NG: It’s a tough decision. But I think that, under the guise of being private, we’ve actually removed this conversation from public. Which means that there’s not enough discussion. So the help that your article will do for people like your aunt is so much greater than keeping it silent. At least that’s what I tell myself!

CM: What kind of responses have you received since your article has been published?

NG: We got such a powerful response from people. Colorado has had its first two recall elections in the last two months, and we were facing a third, and it’s all related to legislatures who voted for gun control measures in the last session. So the conversation about guns is really heated in Colorado right now, and I fully expected that when the story came out that the conversation would veer in that direction. But I’ve been so pleased to see that is not what has happened at all. I think people are just immersed in how big the topic is. I’m excited to see that the conversations are happening and continuing. And, as I’m sure you know, that’s pretty much all I can ask for as a writer.

CM: For sure! That’s what it’s all about. Those conversations are what humanize mental illness. I loved when you wrote, “Why couldn’t other people just see Michael as another person struggling through life,” because that’s what I wanted my piece to do, to sort of re-humanize mental illness, which I rarely see in news articles.

NG: I think that for both of us, in the stories we are writing, because they are longform, we have that chance to do compassionate reporting. I’m absolutely dedicated to facts, but I don’t have to go in there and pretend that I am not interested in what people are feeling, or that the topic isn’t personal to me, or that I don’t think that this is a topic that has been reported incorrectly by a lot of people. So this gives us some freedom to really explore the issue, and I think readers can pick up on that. Because we’re not just telling the facts. This sort of compassionate reporting we’re doing is so often missing in the dialogue.

CM: I like that term, “compassionate reporting.” I don’t know if you coined it.

NG: Let’s say I did! But someone has probably said it a million times…

CM: But seriously, without this compassionate reporting, I wonder who is going take down these mental illness stereotypes. Because what reporter will feel compelled to debunk the stigmas about mental illness? You need that compassion to break the stereotypes.

NG: Yes. One of the things I struggled with in my reporting was that, to me, it was so obviously a civil rights issue, but convincing other people that it was a civil rights issue was the hardest part. Another hard part was getting anyone to talk on the record. I’ve done a lot of really sensitive topics, and I’ve never had the same difficulty of getting people to speak about this.  But I think that the more family members who talk about it—it’s like “I have schizophrenic aunt” or “I have a bipolar brother, and it’s no big deal, I mean our lives are different, but so are yours! No one is perfect!”

CM: I completely agree. It’s all a civil rights issue. It’s ridiculous that people with mental illness have to lie at work and say, “I have strep throat again, and that’s why I keep going to the doctor.”

NG: Yes, and it’s so upsetting to me. I don’t want to live in a society where people don’t feel comfortable saying, “I have a mental illness, and I am not ashamed.” But we’ve got a long way to go before that happens.

CM: A long way to go indeed. It reminds me of when cancer and AIDS were stigmatized this way. I reread Illness as Metaphor and AIDS and Its Metaphors by Susan Sontag, and I couldn’t help but make the comparison to mental illness today. I mean, people were ashamed of having cancer; it was thought that they must have done something wrong, and there were so many myths surrounding these diseases that really affected the patients. You had to keep your illness a secret. It’s unthinkable to us today, and I can only hope that this is how we will look back on mental illness, and we will say our society really got it wrong. These are clearly diseases. Brain diseases!

CM: What’s also sad to me is that creative, loving, supportive care teams don’t really exist for mental health in the United States. To get a team together is…

NG: Impossible?

CM: Yes, impossible! Did you find that in your research as well?

NG: It seems like everything needs to be line itemized, and that takes away the personal-ness of each individual’s care. You know, one thing I was obsessed with in my research was long-term care options. No one seems to be interested in long-term integrative healthcare for someone’s mind. But that’s not unique to mental illness in our country! I mean, you try to get your neurologist to talk to your general practitioner, and him to your OBGYN. So, the individual patient becomes the person who has to connect those dots, but when you’re dealing with someone with mental illness, to expect them to be able to do that, it sets everyone up for failure. Whether it’s the doctor, the psychiatrist, the therapist, the vocational trainer—I don’t know, but somebody has to step up and bring it together, to bring that healthcare together for the person dealing with it. And I think most often that ends up being a family member.

CM: For sure. It’s almost always no one, or a family member. The psychiatrist isn’t going to step up and say, “I want to talk to the therapist!”

NG: No one wants to take responsibility for this poor person just trying to get care, and make this all come together!

CM: Even if there is a family-member advocate, sometimes the professionals aren’t willing to talk to each other, because it’s not their field or specialty, Mental health facilities won’t treat the eating disorder and the eating disorder rehabilitation center won’t take in someone with schizophrenia. So what are you supposed to do?

NG: Right, there’s no solution if there’s concurrent disorders. So the mental health facilities can treat the mental illness, but they won’t touch the addiction. So then that person who is in a hospital, and already doesn’t want to be there, is supposed to independently go to an addiction resource? No, it’s not going to happen! Why can’t they treat more than one thing at once? I don’t get that.

CM: I don’t get it either. So what’s next?

NG: So the next step would be the connecting of the dots. These two things occur together! But baby steps.

CM: But I feel like we’ve been taking backwards steps for the past 50 years. It’s disheartening.

NG: That was one of the shocking things for me too. Anyone I talked to who had been involved in this for more than 10 years would rave about how we were in the ‘70s. What!? How have we made such a great step backwards? Essentially, my generation has never known those healthcare resources.

CM: So what would you say is the next step forward? A next baby step?

NG: In life, in general, prevention is better than dealing with the problems as they exist. So, let’s deal with the small things before they become big things. I think that any time we can put money into preventative services, that’s going to go a long way. And I rather see that money there than in correctional institutions. [And] awareness and dealing with the stigmas—everyone from employers to educators. I mean, what would it look like if every high school teacher was equipped to see the early signs of depression, or changes in a child? To be able to really look at it and not brush it off as “Oh, that’s part of being a teenager.” I don’t have statistics to back this up, but it seems like everyone I talked to said that the longer the mental illness went untreated, the harder it was to get to full recovery. So getting involved early: What does that look like?

CM: For sure. Almost everyone I talked to said, looking back, we should have seen the signs years ago. They were there, they just didn’t know or recognize them at the time. So what would it mean to be able to recognize the signs?

NG: Right. One of the most terrifying things I learned was hearing people saying again and again that it took them 10 years to get diagnosed with schizophrenia or other severe mental illnesses. I mean, can you imagine a person walking around with a broken leg for 10 years? And the doctors are just saying, “Oh, we don’t really know, maybe it’s broken or maybe it isn’t.” If that happens with cancer—“Oh, my doctor missed it the first time around, and now, 10 years later, the cancer is all over my body”—that’s not acceptable! So things we can do for early prevention are key.

CM: Pediatricians should be able to see the early signs of mental illness.

NG: Exactly. But it’s only recently that general practitioners ask mental health questions. We’re getting there.

CM: Awareness and prevention are where to start so that people aren’t petrified to come forth and say that their son or daughter might be exhibiting some of these signs and symptoms. And that they aren’t ashamed, and they aren’t going to try to deal with it on their own. Using the broken leg example: If your daughter has been limping you’re not going to say, “Oh, I got this. Maybe her broken leg will heal.”

NG: That’s part of the education. I think we all know when to go to the emergency room, to let a medical doctor deal with a physical ailment, but I don’t think people know when to say, “Okay, it’s time to send this over to a therapist. It’s time to get someone else involved, someone who understands the brain better than I.”  If we could get people to do that, that would also go a long way.

CM: Definitely.

NG: Another thing I think about is, what if we had another option besides jail? And besides institutions? That’s another terrifying thing to me. The criminal justice institutions—I’m not saying that they’re bad places, I know people who work there, and they’re really trying hard. But there seems like there has to be something in between. Why the extremes? Why do the extremes have to be the go-to options? And the extremes, to me, seem to be homelessness and jails, prisons and institutions. Why did those extremes become our first choice?

CM: Because no one realized the consequences of defunding mental institutions and care centers, half-way houses, et cetera. Unforeseen consequences. But I also think that the extremes become our first choices because of our society’s conception: great value for and protection of personal autonomy. I’m really concerned with this, and I talk about it in my piece. Where do you draw the line? And who can draw the line? Do you draw it at violence, and then the person ends up in jail? Or do you draw it sooner? Can we draw it sooner for the sake of the person? Talk about prevention! And maybe if the line was drawn sooner, the extremes wouldn’t be the go-to. But then you get into all sorts of personal autonomy issues that I don’t feel comfortable with. But we need productive conversations about these issues rolling.

NG: In Colorado, we’ve been dealing with this all the time. Can we put someone on hold? Is that in their best interest? Oh, but does that infringe upon their rights? It’s hard. There’s no simple solution to any of this. But those conversations need to happen. I mean, I don’t think anything about our legal system or our healthcare system is easy, so why are we shocked?

CM: I’m not shocked!

NG: We have to do it, to have these conversations. It’s what we owe to each other.

CM: I agree. It’s why we wrote what we wrote.

Candace Mittel is a recent graduate of Northwestern University where she studied Mathematics, Jewish Studies and Creative Writing Nonfiction (and no, they are not connected, but she’s open to suggestions). She currently lives in a Starbucks-free city, otherwise known as Jerusalem, and studies at the Pardes Institute of Jewish Studies where she spends her days (and often nights) making 2,000 year-old arguments relevant to her life today. Candace enjoys interviewing Israelis on the street (see her website Jerusalem Medley), listening/singing to the Les Mis soundtrack and eating a superbly ripe avocado or mango.