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ladylore

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We're all to blame for staying mum on mental illness
by ANDRE PICARD, Globe and Mail
June 5, 2008

There is something we need to cry out long and loud: Joshua Lall was mentally ill.

Before the murderous rampage that left two of his children, his wife and a tenant dead, the 34-year-old Calgary man reportedly was hearing voices and feared he was possessed by the devil.

Mr. Lall's family said he had told them he was having a "mental breakdown," and according to an e-mail written by his wife he had been stressed out and unable to sleep for a long period of time - all classic signs of severe untreated mental illness and the psychosis that can grip those with depression, bipolar disorder or schizophrenia.

There are those who do not want to say Mr. Lall was mentally ill for fear of besmirching his memory. Apparently, there is one thing more shameful than being a mass murderer, and that is being crazy.

There are those who fear that openly discussing the role of mental illness in these killings will perpetuate negative stereotypes about those with mental illness.

Yet by tiptoeing around Mr. Lall's apparent sickness, by not daring to speak aloud the words "mentally ill," we are perpetuating the stigma that was likely a driving force in this tragedy.

Mr. Lall was sick. He was exhausted. He was hearing voices. He was probably frightened half to death.

And what did he do? He called his parents. He booked time off work. He hid.

By all accounts, Mr. Lall did not go to his employer and say, "I need help." He didn't reach out to friends. And he apparently did not seek medical help.

If, instead of hearing voices, Mr. Lall had been suffering heart palpitations, laboured breathing or other physical symptoms, do you think he would have hesitated for an instant before going to the emergency room or to a doctor?

If he had broken a leg, would he have booked a few days off work in hopes that it would heal before anybody noticed?

Why are physical wounds treated and mental wounds hidden?

In modern society, and the business world in particular (Mr. Lall toiled in a firm of architects), nobody wants to admit to mental health problems because to do so is a sign of weakness and a surefire career killer.

That's why most mental health problems - two-thirds by some estimates - go undiagnosed and untreated. That's why most people muddle through depression or ignore the strange voices rather than reach out for help. (And make no mistake, hearing voices and other forms of psychosis are a lot more common than most people realize.)

As the media dissected his life, Mr. Lall was portrayed as a loving father, a wonderful employee, a brilliant student and an all-round good guy.

But guess what? So are most people with mental illness. It is the most intelligent and educated who are best able to rationalize their symptoms and who most fear being exposed.

One in five Canadians will experience a bout of severe mental illness during their lifetime. The mentally ill are not only among us, they are us.

Yet we continue to view mental illness very differently from physical illness, as a type of moral failing and an affliction of losers.

There is no evidence that people with mental illness are more violent.

But there is clearly a subset of people with untreated mental illness who are a danger to themselves and others. Most of this violence is turned inward - as evidenced by the 3,500 or so suicides that occur in Canada annually.

But in the rare instances when people with untreated mental illness kill others, they disproportionately commit certain kinds of homicide - the murder of mothers and children tops the list.

Untreated mental illness destroys families in the most horrific ways imaginable.

In his psychotic state, the voices in Mr. Lall's head no doubt told him to kill those he loved most, perhaps because they were possessed by the devil, or to free them from some hallucinatory danger.

But when he was not in a psychotic state, when he could rationally consider what was happening inside his brain, Mr. Lall undoubtedly heard other voices - the judgmental voices that are so commonplace in our society.

Stigma is what keeps most people from seeking the help they need. Stigma is what leads those with mental illness to put on a smile to hide the searing pain inside. Stigma is what leads to isolation and to dangerous spirals downward.

Mr. Lall stabbed to death his wife, Alison, two of their children, five-year-old Kristen and three-year-old Rochelle, and tenant Amber Bowerman. (He spared one-year-old Anna.)

He did so because he was sick and untreated. But Mr. Lall did not act alone.

We are all complicit in those murders. Complicit because we turn away rather than reach out to those suffering from mental illness. Complicit in allowing so many barriers to care to exist. Complicit because we pretend this could never happen to us.

Complicit because we refuse to say aloud that mental illness kills.

Complicit in our silence.
 
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