Profiles in Mental Health Courage

“the authors hope the lived experiences here will boost our understanding of ‘how much courage it takes to endure the daily struggles for continued or improved mental health.’”

This book might help eliminate well-meaning but naïve comments about people struggling with mental illness, such as, “Oh, they seemed to be doing so well the other day at the [insert event/destination/activity].”

But the authors of Profiles in Mental Health Courage aspire to more than raising awareness about the visage of poor mental health. Kennedy and Fried profile 12 individuals and their families who have battled mental illness and its close cousin, addiction, in order to “transform the way people see and talk about mental health.”

The stories will probably come as little surprise (indeed, could be triggering) to those already on the front lines, including the families and friends of people struggling with conditions. But those who’ve won the mental health lottery and get most of their information about mental illness and addiction from shocker headlines stand to learn a lot. Even psychiatrists, cruising along with their 15-minute “med checks,” might benefit from pausing to contemplate the excruciating details of the conditions they treat.  

The prologue offers the latest statistics. In 2022, the number of people in the U.S. 18 and over who had at least one mental health disorder was 84 million. That’s one in four. As the stories show, each individual has a family and friends who experience chronic stress as they navigate their loved one’s symptoms, the care system, the costs, and the fear.

To chip away at social stigma, the authors use real names, an exercise in courage for those profiled (some did pull out at the last minute). Names include Philomena Kebec, an attorney for The Bad River Band of Lake Superior Chippewa Indians; NFL player Solomon Thomas, whose family founded Defensive Line for suicide prevention after his older sister died by her own hand; and Gabrielle Anwar, who danced the tango with Al Pacino in Scent of a Woman.

The stories carry us through chaos, crushed dreams and often irreversible loss. The destruction might ooze across decades. The book aims “to show, in great factual and emotional depth, just how challenging these illnesses are.”  

It delivers.

For some people, symptom onset occurred in their teens; for others, after they’d launched careers, adult stresses mounting. Some perilously delayed seeking help. Naia Butler-Craig, an aerospace engineer in the Georgia Tech PhD program, had suffered since adolescence but only sought care after her science hero took her own life at age 28. “I came to the realization that I can’t be an astronaut if I’m dead,” she said.

The life of Justin Maffett, high flying lawyer in New York, took many destructive turns before he was diagnosed with bipolar disorder. In one manic-psychotic episode, he tried to get into the White House to discuss an imagined matter and then went to his boss’s house and keyed his car. The law firm fired him and pressed charges.

From the stories, it’s hard to see a predictable disease progression for mental illness or addiction, but the authors aren’t at fault. Uncertainty is one of the hallmarks of these conditions, setting them apart from many physical diseases. The stories reveal the oft-ignored protracted state of limbo—a true hell’s border—that parents, spouses and friends find themselves in as they try to save (and maintain hope for) their loved ones.

Kennedy mentions his own struggles with bipolar disorder and addiction, covered in his previous book, A Common Struggle. A former congressman from Rhode Island and the son of Senator Edward “Ted” Kennedy, he sponsored the Mental Health Parity and Addiction Equity Act of 2008, to end discrimination against mental health care. His Alignment for Progress website proposes a National Strategy for Mental Health and Substance Use Disorders. The authors resist policy talk here, however, to keep the focus on people.

Dubious quality of care is part of these stories. Kennedy’s own cousin, Harry McMurrey, was lost to suicide in his senior year of college, and his psychiatrist oddly reflected he hadn’t seen suicide on his “radar.” Disjointed access to care is another theme. Ashley Dunlop found care in Tennessee for her auditory hallucinations which started as a teenager and for addiction, but when she moved to Kentucky she faced an entirely different mental health system and lost continuity of care.

The authors point out that from state to state, there is little treatment consistency or information available to patients. One gets the sense of millions of people with mental illness and substance use disorder wandering the great expanse of America with no coordinated care, living “in the face of statistics and systems that are stacked against you and your wellness.”

At the very least, the authors hope the lived experiences here will boost our understanding of “how much courage it takes to endure the daily struggles for continued or improved mental health.”