Robert Epstein, Sept. 1999 (Inglés)

Author/s: Robert Epstein
Issue: Sept, 1999

PT's exclusive interviews with a former and future first lady

We may be on the verge of a new era in mental health. o says Tipper Gore, wife Vice President and presidential hopeful Al Gore. And she should know. Tipper Gore, who has two degrees in psychology, recently organized and chaired the first-ever White House Conference on Mental Health, attended by President Clinton and Hillary Rodham Clinton, top government officials and mental health professionals from around the country.

As mental health policy adviser to the president, Gore encouraged Surgeon General David Satcher to prepare the Surgeon General's Report on Mental Health, due out this fall. She's been a driving force in the new "parity" movement--striving to provide the same insurance coverage for psychological problems as for physical problems. And she's a leader in the recent effort to destigmatize mental illness--the effort to recognize that depression, schizophrenia, autism and other behavioral disorders should be treated, rather than hidden or scorned.

Rosalynn Carter, wife of former President Jimmy Carter, got involved with the mental health community in 1971, back when many mentally ill were still being warehoused in huge state mental hospitals. Responding to the pleas of constituents and friends, she has worked ever since to improve services in the mental health field and to educate the public about the plight of the mentally ill.

In her recent book, Helping Someone with Mental Illness, written with Susan K. Golant, Carter explains the urgency of the problems facing the mentally ill in this country: Every year "more than 50 million people, or 22% of our nation's population over age 18, will suffer a mental disorder," she writes.

The book moves us with stories about battles won by celebrities like Mike Wallace, as well as everyday people like auto parts worker Stuart Perry, and offers the serious reader lists of further reading, organizations, Web sites, an extensive glossary and more.

Editor-in-Chief Robert Epstein interviewed both of these courageous leaders as their countrywide campaign for improved mental health care gathers new momentum.

Tipper Gore on Depression, Humor and Mental Health

Gore: It's an honor for me to do this interview. PSYCHOLOGY TODAY has been a big part of my life for a long time.

Epstein: But I hear we somehow messed up your subscription.

Gore: I subscribed all through college when I was getting my B.A. in psychology and then working on a graduate degree. It was only when my husband was at Fort Walker that the magazine didn't catch up with me.

Epstein: Well, I think we can correct that. In the meantime, I have a dollar bet with our publisher that you will be the next first lady of the United States, and I think that will probably be the best thing that's ever happened for the mental health of Americans. Your recent disclosures about your own successful battle against depression have probably already helped a lot of people.

Gore: I said that I had clinical depression, that I recognized it and went to a social worker. I got diagnosed and then successfully treated. I hope that will encourage people to seek treatment if they think they are suffering from depression.

Epstein: As first lady of the United States, what would be your agenda?

Gore: Al and I have been involved in trying to educate people about mental health issues for many years. I will continue to do that. Mental health should be integrated into the health care system, into the way we think about health care as we go into the 21st century. We've got to become more compassionate and more supportive of people who have mental health problems, both in the way that we offer access to treatment and the way we train our professionals. It's also important that we push for parity in insurance coverage so that mental health services will be covered under health care policies.

Epstein: If you have a physical problem, like a broken leg, your insurance will cover treatment as long as you need it. But with depression or bipolar disorder, that's not the case. When your sessions are up, the insurance cuts off, even if you haven't improved.

Gore: It's discrimination based on diagnosis and it's terrible. It has no place in our society, particularly one founded on equality. But we're making great headway on this issue, both at the state and federal levels. I'm hoping that the conference on mental health that we held recently at the White House will help to reduce this kind of discrimination.

Epstein: How do you stay on an even keel? You must experience more stress than the average American.

Gore: Stress is relative, so I wouldn't say that I'm necessarily different from anyone else. But I do think it's important to have a strategy for dealing with stress, no matter who you are or where you find yourself in life. Al runs regularly and does a workout routine six days a week. I run, I rollerblade, I bike ride. It's important for me to be outdoors as much as possible.

Epstein: You do all these things surrounded by Secret Service agents?

Gore: Well, no. I try to get some in back of me or some in front of me instead of being surrounded by them. [laughs] I think humor, too, is a stress reliever, as is doing things we enjoy

Epstein: There are now 64,000 Americans over age 100, and a recent study suggests that what many of them have in common is a sense of humor and good stress-management skills.

Gore: Is that why they lived so long? [laughs] Well, that would simplify our medical bills, wouldn't it? I know a number of people in their 80s who are very active, and I think we have neglected to look at the mental health needs of our aging population. People often say that depression is just a normal part of the aging process, but it isn't. Elderly people respond well to the right treatment.

Epstein: Any last words for our readers?

Gore: I want people to understand that the science is there and that the treatment is there. I also want to encourage people to go into this field. There's going to be a greater demand for guidance counselors in schools, for trained mental health professionals and for medical doctors who can recognize mental health issues. We have got to do a better job. And we can. Our science demands it.

Rosalynn Carter on Celebrity Advocates and Destigmatizing Mental Illness

Epstein: I bring you regards from Stuart Perry. He's on a one-man march from state to state to try to destigmatize mental illness.

Carter: Stu Perry had recovered from severe depression a few years ago. I invited him to talk at our local state university. He'd never made a speech before. He was so nervous. But he was great. We laughed and we cried as he told his story.... Then he got a grant from the National Institute of Mental Health to speak around the country. He's had a great experience.

Epstein: Tell me about your new book, Helping Someone with Mental Illness.

Carter: I've been interested in mental health for a very long time, and I've seen many changes. When I first became involved, nobody even talked about it. All of that has changed in just the last decade or so. We've learned so much about the brain and about mental illness. It can be diagnosed, it can be treated, and the overwhelming majority of people can lead productive lives. I don't think most people know that, so I wrote the book to try to help overcome the myths and misconceptions about mental illness.

Epstein: With all that research, how did you make it so readable?

Carter: I write like I'm telling my mother what I'm doing. And she's 93 years old, so it has to be very simple. But I didn't want to leave out all the information I had gleaned from the research, so I put the notes and other material in the back for people who want more details about the issues.

Epstein: How did you get involved in such an unpopular cause?

Carter: When Jimmy was campaigning, I had so many people ask me what my husband would do for a mentally ill family member or an emotionally disturbed child that I became really interested in the issue. When I mentioned that I might work on mental health, mental health advocates in Atlanta descended on me, saying, "We need your help, we need you." And the more I learned about the issue, the more I realized how much help was needed for people suffering from mental illness.

Epstein: You note in your book that Jimmy Carter had launched the Mental Health Systems Act to improve mental health care but that the act was basically undone when Reagan came into office.

Carter: It was one of the greatest disappointments of my life when the Mental Health Act was not implemented. We had many meetings and many conferences at the White House on mental health when Jimmy was president, and it was very difficult to get the press to come. Someone from the White House press corps told me that mental health was not a very sexy issue. But this is an especially exciting time right now. The movement has just exploded.

Epstein: I understand you direct a program on mental health at the Carter Center in Atlanta.

Carter: We work on anti-stigma initiatives, trying to educate the public about the true facts of mental illness, and we have an annual symposium, which is attended by leaders from over 60 mental health organizations. One of the programs I'm really excited about is a fellowship program for journalists. They do research on a mental health issue for a year and then report back to us. The program has led to some fine reporting about mental health and mental illness. One of our journalists has won several awards for his work on mental illness in prisons. Prisons are now the major mental health institutions in the country

Epstein: Which means, unfortunately, that we're not labeling people properly and that we're not providing appropriate treatments.

Carter: One of this year's reporters is doing a study of Abraham Lincoln, who suffered from severe depression much of his life. I think that will help overcome stigma, because if Abraham Lincoln suffered from severe depression and was still a good president, then anyone should be able to admit to having a problem with depression.

Epstein: Your book also mentions a number of other notable people who have struggled with depression--Patty Duke, Rod Steiger, William Styron, Rodney Dangerfield, Margot Kidder and others. Why the focus on celebrities?

Carter: Because when celebrities or people who are really admired by the public admit to a mental illness, that helps eliminate stigma, and it's stigma that has held back our progress.

COPYRIGHT 1999 Sussex Publishers, Inc.

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