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Mental Health in America

Aired November 07, 2013 - 15:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

BROOKE BALDWIN, CNN ANCHOR: Another week, more violence in America and for some reason, the conversation always turns to guns. But today, we're tackling the topic that is most common in these incidents, mental health. I'm Brooke Baldwin. A CNN special report starts right now. Inside a broken mind, what causes someone on the edge to snap?

Plus, after Newtown, she wrote a blog post entitled "I am Adam Lanza's mother." You'll hear from her live.

And is the country overprescribed and misdiagnosed? The answer will surprise you.

Thank you so much for being with me. I'm Brooke Baldwin.

And over the next hour, we will talk about a topic that seems to be taboo in this country, mental health. Did you that nearly 50 percent of Americans, 50 percent, will suffer from some kind of mental illness in their lifetime?

Why is there such a stigma? Is the conversation simply too tough to hear? You are about to hear from doctors. You will hear from celebrities. You will hear from families who are impacted each and every day by this.

Tweet me your questions at @BrookeBCNN. We will get to them answered here in the next hour.

But, first, Don Lemon reports on the new cases of violence leaving us asking, could they have been stopped?

(BEGIN VIDEOTAPE)

DON LEMON, CNN CORRESPONDENT (voice-over): Monday night, police and SWAT teams swarm a mall in New Jersey. Hundreds of frightened people hide while a gunman is on the loose, a scene all too familiar in this country. Just change the details and location, and it could be last week at Los Angeles Airport or last July in Aurora, Colorado, or two years ago in Arizona, gunmen either threatening to or executing a rampage.

In New Jersey, the shooting ended with 20-year-old Richard Shoop killing himself with his own un. At LAX, Paul Ciancia was shot in the face by authorities, but not before shooting and killing one TSA agent, wounding three other people. Then there's Aaron Alexis. On September 16, he succeeded in committing mass murder, gunning down 12 people at the Washington Navy Yard before he also was shot and killed.

DR. MICHAEL STONE, COLUMBIA UNIVERSITY: There is a common thread in those particular ones, it so happens, because I think they were examples of what is called flippantly suicide by cop.

LEMON: Dr. Michael Stone, a professor of clinical psychiatry at Columbia University, has been studying mass killings for 30 years.

STONE: Aaron Alexis in the Washington Navy Yard in Washington, pretty much expected, I would imagine, to be killed when he killed all those people.

LEMON: Leading up to the shooting, Alexis was hearing voices, but experts say people suffering from extreme mental illness are more often a danger to themselves.

DORIS FULLER, TREATMENT ADVOCACY CENTER: The most likely victim of violence associated with mental illness is the person themselves. People with schizophrenia and bipolar commit suicide at a rate three or four times the general population.

LEMON: In fact, according to a 2012 investigation done by "Mother Jones," only 12 percent of mass murders since 1980 were committed by people with severe mental illness.

STONE: People that use the word mental illness for anyone that has some significant problems or disgruntled workers or are a bit paranoid or have personality disorders or are loners and don't function very well in society, that to me is a little bit unfair and too loose a definition.

LEMON: It's a definition, however, fitting of many who have committed these acts, almost all of whom are men.

STONE: Well, mass murder is a guy thing. In my study, 97 percent to 98 percent are men. It's a guy thing. We're wired with testosterone and et cetera to be the defenders of the group.

LEMON: But with each new shooting, we ask the question, why?

FULLER: Certainly, what we have seen is a growing number of mass homicides. And in mass homicides, mental illness is over-represented as a factor. I believe we have had 12 so far this year. So we have an increase in mass killings. We have a decrease in hospital beds for people who are most at risk to commit those killings.

LEMON: While no one can give a definitive answer.

FULLER: We can't predict who is going to be violent. There is a vast amount of public ignorance about what might be red flags. How often do you see a story where there's one of these tragedies and people come out of the woodwork? There are YouTube videos, and it's obvious this person was struggling, and nobody stepped in.

LEMON: And just as crucial, experts say, curtailing their access to weapons. ALAN LIPMAN, CENTER FOR STUDY OF VIOLENCE: The problem with mass shootings is people who have suffered from a psychotic or depressive mental illness and have not been spotted and have laid their hands too easily at the peak of their symptoms on weapons.

LEMON: Don Lemon, CNN, New York.

(END VIDEOTAPE)

BALDWIN: And here we go. We have experts on this topic from coast to coast joining us live right now, Dr. Drew Pinsky from our sister network HLN, psychiatrist and author Dr. Gail Saltz, Dr. Jeffrey Lieberman, chair of psychiatry at Columbia University, and Doris Fuller, executive director of the Treatment Advocacy Center. It's a nonprofit focused on improving policy to help people with severe mental illness.

All of you, huge, huge thanks for being with me over the next hour.

Dr. Drew, let me begin with you.

We just heard in Don's piece somebody saying this is a guy thing. I have covered too many of these. It seems to me it is a young male trend. Why?

DR. DREW PINSKY, HLN HOST: It is a young male thing.

As he said, males are wired with testosterone and aggression. But the other thing is that mental illness does tend to manifest in sort of the 18-to-25-year-old window. I suspect that's what's going on here. We have the perfect storm of male aggression meeting the onset of mental illness that goes undiagnosed or untreated or people around that person are in denial or physicians are unable to do their job, say, of treating that person or requiring them to get help or there's limited access to insurance or limited access to hospital beds.

All these things are coming together now in sort of a perfect storm.

BALDWIN: Gail, what do you think? Young men, why?

DR. GAIL SALTZ, ASSOCIATE PROFESSOR OF PSYCHIATRY, THE NEW YORK PRESBYTERIAN HOSPITAL AT WEILL-CORNELL SCHOOL OF MEDICINE: Young men, well, the truth is actually that most of these young men aren't seriously mentally ill.

One factor, however, is substance use and abuse. That greatly increases the odds of somebody committing a violent act. And men are more likely, actually, to struggle than women with substance use and abuse. And I think that also men have less access to emotional support when something is going wrong.

They're not expected to be struggling and talk about it, culturally speaking, in the same way that, say, girls of that age are sort of permitted to. I think that they often become isolated and then they become angry, and it's sort of this angry disenfranchised and often slightly paranoid person. Particularly if you add substance use and abuse on top of that, then you really increase the risk.

BALDWIN: Dr. Lieberman, I'm watching you shake your head. Why?

DR. JEFFREY LIEBERMAN, PSYCHIATRIST IN CHIEF, NEW YORK PRESBYTERIAN HOSPITAL: Yes.

Brooke, first, I think the thing to note is as Doris Fuller said, with mass killings of this sort, although the mentally ill as a group do not account for a substantial proportion of violence in the general population, number of crimes, they do -- they are over-represented in terms of these senseless mass killings.

And they do tend to be predominantly younger males. Now, the one thing that they have in common and one of the things that probably makes males more prone than females to do this is because none of the people is in treatment. They either have gone untreated, they have fallen between the cracks, been neglected, as Doris mentioned, or if they have been in treatment, they were in inadequately or they dropped out.

The reason it's males is because males are more resistance to the idea of being subordinated by what they view as authority to take something which is an assault on their sort of manhood and integrity. But the reality is, is that most of these crimes, if not all of them, are preventable if adequate treatment had been provided.

BALDWIN: Let me -- I want to come back to you, Dr. Lieberman, with this, because there is definitely ignorance. I don't want to just say this is -- people with mental illness, this absolutely leads to violence, because it does not, but in talking to people who have loved ones, husbands, wives, children, it's a slow descent.

And when you're so close to someone, you oftentimes don't even see the signs to know to ask for help.

LIEBERMAN: Well, I think people do see the signs, except they don't know quite how to interpret them and how to understand what they mean.

And even if they do think, oh, there must be something wrong with the person, we should try to get them help, they're not sure where to go and what to do. If you think someone is having problems with their mood, with their mental functions, with their behavior, and if -- particularly if they're exacerbating it by substance abuse, you think, who do I go to? My primary care doctor, my priest, a psychologist, a social worker, a therapist, or a psychiatrist?

And then do my benefits cover this? And so how do I get access? There's really a labyrinth to try to navigate to get to care, instead of having it be immediately available to them.

BALDWIN: Doris, let me go to you. We heard from Gail. I want to hear from you, Doris, because I want to stay on this, the signs,because a lot of people are watching and I'm sure a lot of people know folks who have maybe seen what they think could be signs, but they're not quite sure. What should people be looking for? FULLER: Well, you know, first of all, we have got to remember mental illness is a disease. It's a treatable disease. It's something we can all learn about.

In these young men that we're talking about -- and these cases all involve men at that key age -- usually, the onset of symptoms, prodromal symptoms, the early signs, took place a long time before. It's sort of a spectrum. And the early symptoms are hard for parents to figure out, because, is this mental illness or is it just a squirrelly seventh grader?

BALDWIN: Acting out.

FULLER: Yes, it can be confusing.

But when we get to most of these cases where there is a terrible tragedy or a tragedy that's terrible but doesn't make headlines, oftentimes, the families will say, I sought treatment for years and nobody would help. They wouldn't -- the medical providers, especially when we get to adults, you hit 18, the parent is out of the loop. They go to the medical provider, the medical provider won't talk to them. They go to the school, the school won't talk to them.

They start looking for help. They start saying, I'm seeing these things, and they get an answer that depending on what state they live in, oh, well, he hasn't hurt anyone yet. We can't help you. This is a big problem.

BALDWIN: I'm glad you bring up the point. We're going to talk actually live. Everyone, stand by. We're going to talk live with a woman, this is a mother whose blog post sparked a national conversation following the tragedy in Newtown. This blog post was entitled "I Am Adam Lanza's Mother," and she says she loves her son, but admits she is terrified of him. Liza Long joins me on the impact mental illness has on families next. You're watching a CNN special report.

(COMMERCIAL BREAK)

BALDWIN: Welcome back.

You're watching a special CNN special report on mental health. I just want to read a quote from a woman you're about to meet.

This is what she writes: "I live with a son who is mentally ill. I love my son, but he terrifies me."

Liza Long wrote that in a blog about her 13-year-old son shortly after last December's deadly elementary school shooting in Newtown, Connecticut. And this mother describes a particularly disturbing and harrowing ride to school with her own child. And then she tells us why she's sharing her own story.

She says: "I am Adam Lanza's mother. I am Dylan Klebold and Eric Harris' mother. I am James Holmes's mother. I am Jared Loughner's mother. I am Seung-Hui Cho's mother." She goes on: "And these boys and their mothers need help. In the wake of another horrific national tragedy, it is easy to talk about guns, but it's time to talk about mental illness."

And that's what we're doing today.

Liza Long joins me from Boise, Idaho. And Dr. Drew joins us as well.

So, Liza, so nice to have you on. What an incredible piece, so open you were in this. What is it like to have a child where, you know, day to day, you write, he terrifies you?

LIZA LONG, MOTHER OF MENTALLY ILL TEENAGER: Well, it's pretty much what I wrote, to be honest. You feel like you have no good options as a parent.

I think any parent whose's had a child with a disability of any kind knows the frustrations and the hopes and dreams that you have for your child. And when you can't find answers anywhere, when you're actively seeking help for your child, and everywhere you turn, you can't get solutions, it's a really frightening thing.

BALDWIN: You have other children as well. You talk about that, and an incident with a knife in this particular piece. How is your son doing since you wrote this?

LONG: You know, honestly, Brooke, it's been kind of an amazing journey for us.

In the wake of the blog post, several health care professionals reached out to me. During the ensuing months, my son did have another crisis. He was back in the hospital for a while, and during that hospitalization, he was diagnosed with juvenile bipolar disorder.

BALDWIN: Wow.

LONG: And just having that diagnosis finally has opened so many doors for him. I'm really happy to say that when I wrote the blog post, I was frustrated and helpless. But now that we have a diagnosis, therapies that work, medications that work, it's like a night-and-day difference in my life.

And I do want to offer that message of hope as we talk about being able to intervene in young people's lives and children's lives. This is the difference that we can make for families, for communities, and our societies, getting these children help.

BALDWIN: I love the hope in your voice and the optimism.

Dr. Drew, though, many parents don't feel Liza's same hope. You know, she found hope because of this diagnosis. What options do parents have when they have a child like she does?

PINSKY: There are -- well, it's not so much there are options. It's getting to proper care, as Liza's story highlights. I'm wondering what happened with Liza that initially she was having such frustrated trouble. As you see, once she's hospitalized, she's in good hands, the care is available. There are treatments for these things.

The problems that I keep running into is parents don't want to acknowledge or accept that there is mental illness, don't want there to be medications and want the problems above the neck treated somehow different than the problems below the neck. It's a medical problem with a medical solution.

And if we can get insurances to help them gain access and enough hospital beds where there's actually sufficient medical care available, which is really the problem, those two things, but I'm wondering what Liza's frustrations were.

BALDWIN: Go ahead, Liza. What were they?

LONG: Well, I have to say, Dr. Drew, you have hit the nail right on the head. It's really -- it comes down to stigma. And I have learned there are two kinds of stigma.

There's the self-stigma that we feel as parents because as a society, what we have seen is that we like to blame parents for their children's mental illness. We would never blame the parent of a child with cancer for that child's cancer. We would certainly never blame the child for having cancer, but that's what we do to parents and their families with mental illness.

When I wrote that blog post, I blogged anonymously. That was really a coming-out experience for me nationwide, I never expected that, but to my own community. Very few of my friends, my co-workers, the people in my life knew the struggles that my family had faced for years. And so you're exactly right.

I believe that until we can talk about this issue, until we can stop the stigma that attaches to diseases from here...

(CROSSTALK)

BALDWIN: How? We're sitting here and we're talking about it.

(CROSSTALK)

PINSKY: Like this.

BALDWIN: We're sitting here and we're talking about it, and this is just the beginning, but the stigma is very real, it is discriminatory. We, as a society, are ignorant. We're uneducated.

(CROSSTALK)

PINSKY: There's another piece.

BALDWIN: What is that? PINSKY: And Liza -- there's another piece, and Liza is going to deal with this when her child becomes an adult. When he doesn't want to take his medication, when he doesn't want to follow up with a doctor, he's not obliged to. And parents have absolutely no right unless they get a conservatorship to have any influence there.

Listen, if you look at those mass killers, Brooke, most of them were seeing a psychiatrist and bailed out of care or the psychiatrist couldn't do the care they needed to do because the rights of the individual take precedence over the individual's well-being and the well-being of the community.

Who are we to say that this guy needs to take his medication? Can you imagine when he's 18 and he decides he wants to do it his way, how frustrating and painful that's going to be.

BALDWIN: Liza Long, stay in touch with us. Stay in touch with us, please.

LONG: I will. Thank you.

BALDWIN: We would love to follow you, your son. We wish you well. We love the hope.

Dr. Drew, we're coming back to you because this conversation is not over.

And speaking of this entire stigma dilemma that is very real, I'm talking with an actor -- you know him as Joey Pants, Joe Pantoliano, and he says we need to stop the stigma that surrounds mental illness. It's something that impacts him very personally. Do not miss this conversation. Stay with me.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

JENNIFER LAWRENCE, ACTRESS: What meds are you on?

BRADLEY COOPER, ACTOR: Me? None. I used to be on lithium and Seroquel and Abilify, but I don't take them anymore. They make me foggy and they also make be bloated.

LAWRENCE: Yes. I was on Xanax and Effexor, but I agree, I wasn't as sharp, so I stopped.

COOPER: You ever take Klonopin?

LAWRENCE: Klonopin, yes.

COOPER: Right?

LAWRENCE: Jesus.

COOPER: Like, what? What day is it?

(LAUGHTER)

COOPER: How about trazodone?

LAWRENCE: Trazodone?

COOPER: It flattens you out. You're done. It takes the life right out of your eyes.

LAWRENCE: I bet it does.

(END VIDEO CLIP)

BALDWIN: That is "Silver Linings Playbook." It's a film that brought mental illness into the national spotlight.

My next guest says the only way to overcome the issue of mental illness is to remove the stigma that surrounds it.

His face, you will know, but his mind had a darkness even he didn't understand for years. He is Joe Pantoliano. He started in "The Sopranos" and "Goonies" and "Memento." His list of film and television credits, really, it goes on and on and on.

But Pantoliano is not only an actor. He's an advocate for those who suffer from mental illness. He himself received treatment. It's a condition he actually calls brain dis-ease. It's one of his ways to move toward his mission to move end the shame and the negativity around mental illness.

Let me play you this clip. This is a PSA from Pantoliano's campaign called No Kidding, Me Too.

(BEGIN VIDEO CLIP)

HARRISON FORD, ACTOR: There's no stigma or discrimination against the heart, liver, the kidney, or a gallbladder. It doesn't even a have a job.

UNIDENTIFIED MALE: Yesterday, depression was kept in the dark.

JOE PANTOLIANO, ACTOR: And bipolar disorder was your best friend's mother's problem.

UNIDENTIFIED MALE: But the tide is turning.

PANTOLIANO: We're stopping the stigma.

UNIDENTIFIED MALE: We're coming out.

FORD: Our goal is to make the discussion about mental dis-ease cool and trendy.

UNIDENTIFIED MALE: No kidding?

UNIDENTIFIED MALE: Me too.

UNIDENTIFIED MALE: No kidding?

UNIDENTIFIED MALE: Me too.

UNIDENTIFIED FEMALE: No kidding?

UNIDENTIFIED MALE: Me too.

FORD: It's time we give the all-American brain some peace of mind.

(END VIDEO CLIP)

BALDWIN: Joining me now live from New York is Joe Pantoliano.

Nice to see you, sir. Welcome.

PANTOLIANO: Thank you.

BALDWIN: Looking at your credits, you're this crazy successful actor, yet, you, Joe, struggled with what you eventually realized was clinical depression or as you call brain dis-ease. Can you describe that aha moment for me?

PANTOLIANO: Well, I was on the brink of disaster.

I achieved everything that I ever wanted in life through my acting. And, somehow, there was a feeling inside of emptiness and despair that I thought that my success and all of the things that I had accumulated would make that go away. And so when it didn't go away, I was lost and confused.

And I couldn't understand why. Through the education and reeducating myself, I came to understand how I was embracing this familiar misery. Mental disease is -- you know, it's genetic, but also it's a byproduct of your environment.

And I believe we are all sick. I think these mental health organizations that are fighting stigma are in fact creating stigma...

BALDWIN: How?

PANTOLIANO: ... in that they say, please help our poor, unfortunate relatives. Please help my son. Please help my sister.

It implies that, well, I don't have the disease, but everyone else does. And it's a fact that everyone has this disease.

(CROSSTALK)

BALDWIN: Joe, how do we flip the script? How do we change that?

PANTOLIANO: Well, let me tell you.

You create a curriculum starting in kindergarten that teach children an emotional hygiene, like you would do with hygiene, physical hygiene. A kid gets hair lice and it's cool. Why isn't he freaked out, anxious, feel like he's an outcast? Because, socially, it's been accepted.

Mental dis-ease and the discussion of emotional intimacy, talking about how you feel so that there's no shame -- what all of these boys have in common is that they were isolated, outcasts, and alone. And instead of embracing these kids by giving them the help, if they knew what I know, is that you're not alone and that you can get better, that help is available, that the treatment is available.

BALDWIN: Let me jump in.

PANTOLIANO: That's the only way that we're going to be able to kind of conquer this.

BALDWIN: When you talk about, you know, starting this as early as kindergarten, talk to the moms and dads out there who have little kids right now. How should a conversation like that go?

PANTOLIANO: Oh, please, I can't tell you how that conversation goes. I'm just saying that...

(CROSSTALK)

BALDWIN: If you're saying it should happen that early, I'm just asking.

PANTOLIANO: Yes, because -- because the parents and the grandparents teach the kids that mental illness is a bad thing.

It's -- you know, it's bigoted against. It's -- the way that I think it -- it -- what we're talking about is emotional intimacy, to make these kids know that it's cool to be out there, that that's why I have all of these actors, including, if you look at our Web site and see all of the creative minds that have come together to say it's cool to be out there.