[Editor’s Note: Dana Dillon is Associate Professor of Theology and Public and Community Service Studies at Providence College. She is also President of the Board of Directors of National Alliance on Mental Illness of Rhode Island. She also serves as a teacher in NAMI’s Family to Family program and as a facilitator of a NAMI Family Support Group. May is National Mental Health Awareness Month, and she spoke about the issue with Charles Camosy.]
Camosy: May is National Mental Health Awareness Month. Can you say a bit about why this is a special month for you personally?
Dillon: Just about everyone I know who is a mental health advocate, especially if they live with a mental illness or has a loved one who does, loves May and the Mental Health Awareness events that come with it. We are, of course, very aware of mental health all the time. But each May, you see more news stories and features and conversations about mental health happening. It is energizing and stigma-reducing.
My connection to mental health advocacy is very personal. My father, who passed away in 2002, was diagnosed with schizophrenia before I was born. I didn’t know anything about that until I was a teenager, and I really didn’t understand what it meant until much later. When I was 23, my brother Paul — then 19 — had his first psychotic break and was hospitalized. Although he was treated for schizophrenia at first, about a decade into his illness he was diagnosed with schizoaffective disorder (bipolar type) and his treatment was adjusted accordingly.
He has done much better since. My mother had been involved in NAMI in my hometown [Corpus Christi, Texas] and always spoke very highly of the organization as a resource and as a community of support. After both of my parents passed away, I found myself in a position where I needed to wire someone some money in Texas to put my brother on a bus to me in North Carolina.
In the almost 48 hours it took for my brother to reach me, I googled NAMI and found a local number. A man named David talked to me for about an hour with recommendations for lining up medical care, housing, and more for my brother. When Paul and I moved to Rhode Island in 2006, NAMI Rhode Island was one of the first calls I made.
I have always been so grateful for the ways that NAMI members—usually just volunteers themselves with their own personal experiences and a little training—helped me get my brother and me the resources we needed in those hard times. Once I got myself settled here in Rhode Island I became a volunteer myself so that I could help others in the same way.
How does your work with NAMI connect with Catholic theology?
This is a great question, but a real challenge to answer. Both of these roles are really pervasive for me; each touch everything about me in a way, making it hard to name these connections. I think there are certain insights that come from Catholic social thought that I have gotten to live out through my relationship with my brother and also in the community of NAMI.
I think about the dignity of the human person, and the sense of how inviolable that dignity is. When someone is in the throes of a psychotic episode or a manic episode (or other sorts of issues as well, but those are the two that I have seen where this is so clear to me), you see a person who is unable to think or act rationally.
It can be really terrifying. I’m grateful for the ways the Catholic tradition has trained me to know the person’s dignity transcends what I see in that moment. NAMI says that, too. One of the principles of NAMI support groups is aiming to see the person, not the illness.
I also think a lot about the common good with regards to mental health. Those of us with loved ones with mental illnesses know that we need a better mental health care system. We can’t make it much better for any of us unless we all work together to make it better for all of us. Turn that around, and it sounds like St. John Paul II talking about solidarity as “not a feeling of vague compassion [but] a firm and persevering determination to commit oneself to the common good; that is to say to the good of all and of each individual, because we are all really responsible for all.”
I say this often when I talk to people with a very particular interest, who are asking how they can reduce the stigma around mental illness for people of color, or for student athletes, or some other specialized group: the only way to reduce the stigma for any of us is to reduce the stigma for all of us, and anything we do to reduce the stigma for any of us will help to reduce it for all of us.
One other thing that I will mention here. So much of my work in NAMI has been with family members of those with a major mental illness. These are people who are teachers, lawyers, accountants, chefs, professors, and so many other professions who have a son, daughter, spouse, sibling, parent, or other loved one with a mental illness. You would not know by looking at them that they are going through something so challenging. And many of them keep the secret of what their loved one is going through to themselves. This has taught me that there are many “invisible” burdens that people carry.
Suicide rates are rising, particularly among those aged 15-24. What might the Church offer to help address this problem? It seems that too many erroneously believe that the Church teaches all suicides are mortal sins.
For me, it is crucial that the Church keep proclaiming a couple of messages that may seem contradictory.
First, I think it’s important for the Church to continue to teach that suicide is objectively evil and that, when undertaken knowingly and willingly, is a mortal sin. Second, the Church must teach as clearly as it can that the best research says that about 90 percent of those who die by suicide have a mental health issue.
Those mental health issues cloud the intellect and the will and thereby reduce the freedom of the person in the act and his or her culpability for the act. Thus, those who die by suicide should be presumed to have died as the result of a (mental) illness, rather than a freely chosen (and sinful) act.
Why not just start proclaiming that suicide is never a sin? Well, one thing is that it can be freely chosen, and it is important to name that possibility as objectively evil.
But there is another crucial piece of this. A couple of years ago, I was at a funeral for a young man who had died by suicide. I sat with other NAMI folks, mostly family members like me, as the priest preached hope in the resurrection and proclaimed very clearly that this young man had died as a result of his illness and not through any moral failure of his own. That seemed exactly right to me.
But after the funeral, I talked with several friends I know through NAMI who were living with mental illnesses, including one who said to me very clearly: “I live with suicidal ideation every day, and I feel like it’s my job to fight that, and to never give up. I feel like that priest’s message was basically that I don’t need to fight that battle. I can just give up and God and everyone will be fine with that.”
I tried to say to them: if you are able to fight the suicidal ideation and continue to choose life, you must do that, and it would be sinful not to. And if there comes a time when you cannot, know that it is your illness, and it is not a sin.
This is an incredibly hard line to walk: We effectively presume a lack of full agency on the part of those who die by suicide, but we also have to do everything we can to support the agency of those who struggle with suicidal ideation and help them choose life each day.
Especially as the culture becomes more secular, it seems that we struggle to give a full account of the moral status of those mentally ill human beings who lack what some might call “full agency.” Is that your sense as well? And if so, how do you think we ought to respond?
Agency and mental illness is an incredibly difficult topic. Unlike, say, an intellectual disability that tends to maintain any diminishment of agency at a pretty consistent level, mental illness is much more complicated.
A person can seem completely free, but can (say, in the midst of a manic episode) give away or spend money in ways s/he would not ordinarily do. I think the compromise of agency is so complicated. I struggle with this personally with my brother, who sometimes can’t seem to do anything but sleep.
These are usually greyer, colder days (and, I may be imagining it, but it seems like there are chores he was supposed to be doing. But on a warm, sunny day, if I offer to take him to a favorite restaurant of his, he’s up, in the shower, and ready to go.
It can feel manipulative. It can feel like he wants to claim more or less agency when it is convenient for him. But I believe there are much more complicated dynamics at work. But the ebb and flow of agency in those with mental illness is something that I do think moral theologians need to give more thought to.