Imagine There Was No Stigma to Mental Illness | Dr. Jeffrey Lieberman | TEDxCharlottesville

Summary

In this powerful talk, Dr. Lieberman addresses the pervasive stigma surrounding mental illness, highlighting its impact on society and the importance of understanding and treating mental disorders. She emphasizes the effectiveness of modern treatments and the need for early intervention, community-based care, and public awareness to combat the stigma and improve mental health outcomes.

Takeaways

• 🧠 Mental illnesses are common, affecting 20% of the world's population at some point in their lifetime.
• 🤔 There's a significant lack of understanding and awareness about mental illnesses, leading to reluctance and shame in admitting to them.
• 🏷 Stigma is a major barrier to mental health treatment, similar to historical stigmas associated with other diseases.
• 👨‍⚕️ The medical profession, particularly psychiatry, faces unique challenges and stigma, with an active anti-psychiatry movement.
• 💡 Mental illnesses affect cognitive, perceptual, and emotional functions, and are as real and treatable as physical illnesses.
• 🧬 The brain's complexity makes understanding mental illnesses challenging, but progress is being made.
• 💊 Effective treatments exist for many mental illnesses, improving and even transforming the lives of those affected.
• 🌐 Stigma can be reduced through increased awareness, advocacy, and the dissemination of knowledge about mental health conditions.
• 🛑 Early identification and intervention are crucial for better outcomes in mental health treatment.
• 🏥 Comprehensive community-based care is essential for those with advanced stages of mental illnesses, providing support and preventing further harm.
• 💰 Proactive mental healthcare can reduce overall healthcare costs and alleviate the burden on families and society.

Q & A

What is the estimated percentage of the world's population that suffers from mental disorders at some point in their lifetime according to the World Health Organization?

The World Health Organization estimates that 20% of the world's population suffers from mental disorders at some point in their lifetime.

What are some of the conditions that are commonly thought of as mental illnesses?

Conditions commonly thought of as mental illnesses include depression, schizophrenia, bipolar disorder, anxiety disorders, autism, learning disabilities, ADHD, and addictions to alcohol and drugs.

How does the speaker describe the impact of mental illnesses on the brain?

The speaker describes that mental illnesses affect the same areas of the brain and disturb mental functions of cognition, perception, and emotion regulation by varying degrees.

What are the 'three inconvenient truths' about mental illness that the speaker mentions?

The 'three inconvenient truths' mentioned by the speaker are the lack of understanding and awareness of what mental illness is, the reluctance or shame to admit it, and the high level of stigmatization associated with mental illness.

What does the speaker suggest is the effect of stigma on individuals with mental illness?

The speaker suggests that stigma affects individuals with mental illness by causing them to feel dishonored or disgraced, similar to historical examples of stigmatization, and it prevents them from seeking help or admitting their condition.

What thought experiment does the speaker propose to illustrate the insidious nature of stigma?

The thought experiment proposed by the speaker involves imagining a scenario where one has to cancel attending a boss's birthday party due to illness, and considering which illnesses one would prefer to admit to having in order to cancel.

What is the speaker's profession, and how does stigma affect it?

The speaker is a psychiatrist, and they mention that the profession is denigrated and distrusted, with an anti-psychiatry movement claiming there is no such thing as mental illness and advocating for the elimination of psychiatry.

How does the speaker compare the brain to the heart in terms of complexity and function?

The speaker compares the brain to the heart by stating that the brain is infinitely more complicated, composed of over 100 billion neurons making trillions of connections, and is responsible for basic functions as well as personality and consciousness, unlike the heart, which is a simpler pump.

What historical example does the speaker provide to illustrate the transformation of stigma associated with a disease?

The speaker provides the historical example of AIDS, which was initially stigmatized but underwent a transformation in perception and treatment due to advocacy, awareness, and scientific advancements.

What are the two strategies the speaker suggests for addressing mental illness in a public health initiative?

The two strategies suggested by the speaker are early identification and intervention through screening mechanisms in various settings, and providing community-based comprehensive care for those at more advanced stages of the illness, including medical management, rehabilitative services, and residential facilities.

How does the speaker describe the potential impact of removing stigma and implementing the suggested strategies on individuals and society?

The speaker describes the potential impact as significant, with individuals receiving timely treatment, reducing suffering and harm, and society benefiting from reduced healthcare costs, relieved emotional and financial burdens on families, and a decrease in social problems such as mass violent incidents.

Outlines

00:00

🤔 The Stigma of Mental Illness

The speaker begins by addressing the audience with a personal question about mental illness, highlighting its prevalence and the common misconceptions surrounding it. The paragraph discusses the variety of mental health conditions, emphasizing their impact on cognitive and emotional functions. The World Health Organization's statistics on mental disorders are cited to underscore the scale of the issue. The paragraph also touches on the stigma associated with mental illness, likening it to historical symbols of disgrace, and introduces a thought experiment to illustrate the societal reluctance to admit to mental health struggles. The speaker, a psychiatrist, shares personal experiences of stigma within the medical field and the anti-psychiatry movement, advocating for a shift in perception to view mental health through a medical lens.

05:02

🧠 The Complexity of the Brain and Mental Health

This paragraph delves into the intricacies of the brain, drawing a comparison between its complexity and that of the heart. The speaker explains how mental illnesses affect the brain's neural circuits, which are responsible for both basic bodily functions and higher cognitive processes. The paragraph also discusses the historical stigma associated with various diseases, using AIDS as a case study to demonstrate how advocacy and scientific progress can transform public perception and treatment of an illness. The speaker argues for the importance of understanding mental health conditions and the transformative power of effective treatments, sharing a personal story of a patient named Sarah who overcame panic disorder and agoraphobia through therapy and medication.

10:02

🛑 The Challenges and Ironies of Modern Mental Health Care

The speaker discusses the irony that despite the availability of treatments for mental illnesses, the main barriers to care are lack of awareness, access to care, and stigma. The paragraph outlines two strategies for improving mental health care: early identification and intervention through screening in various settings, and community-based comprehensive care for those with advanced stages of illness. The speaker emphasizes the importance of timely treatment to prevent the worsening of conditions and the associated risks, including self-harm and addiction. The paragraph also highlights the potential societal benefits of proactive mental health care, including reduced healthcare costs and diminished social issues such as mass violence.

15:03

🏥 The Economic and Social Impact of Mental Health Care

This paragraph explores the economic rationale for investing in proactive mental health care, arguing that it can lead to overall cost savings and alleviate the emotional and financial burden on families. The speaker also addresses the social problems that can be mitigated through better mental health care, such as mass violent incidents often linked to untreated mental illness. A personal account of a tragic case involving a young man with bipolar disorder is shared to illustrate the urgency and importance of accessible mental health care. The paragraph concludes with a call to action for individuals and society to recognize mental illness as a treatable medical condition and to overcome the stigma associated with it.

20:04

💌 A Message of Hope and Compassion

The final paragraph shares a heartfelt email from a former patient named Laurie, who had been severely mentally ill but eventually recovered with treatment and support. The email serves as a testament to the transformative power of mental health care and the importance of compassion in the healing process. The speaker reflects on the significance of showing empathy and understanding towards those with mental illnesses, urging the audience to join in the fight against stigma and to promote awareness and access to treatment. The paragraph concludes with a powerful message of hope, emphasizing the potential for recovery and a better life for individuals with mental health conditions.

Keywords

💡Mental Illness

Mental illness refers to a wide range of mental health conditions that affect mood, thinking, and behavior, impairing an individual's ability to function in daily life. In the video, it is the central theme, encompassing conditions like depression, schizophrenia, bipolar disorder, and anxiety disorders. The script emphasizes the prevalence and impact of mental illnesses, noting that one in five people may suffer from a mental disorder at some point in their lives.

💡Cognition

Cognition is the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses. The script mentions that mental illnesses can disturb cognitive functions, which are critical for activities such as learning, memory, perception, and decision-making. The impairment of cognition is a significant aspect of mental disorders.

💡Perception

Perception is the process of interpreting and organizing sensory information to give meaning to the environment. The video script discusses how mental illnesses can affect perception, leading to distortions in how individuals understand and interact with the world around them, which is a key aspect of the experience of mental disorders.

💡Emotion Regulation

Emotion regulation is the ability to manage and control one's emotions. In the context of the video, it is highlighted that mental illnesses can disrupt emotion regulation, leading to intense emotional responses that can be challenging to manage. This disruption is a common feature of many mental health conditions.

💡Stigma

Stigma refers to the negative attitudes, stereotypes, and discrimination associated with certain conditions or groups. The script discusses the stigma surrounding mental illness, which can prevent individuals from seeking help and contribute to feelings of shame and isolation. The concept of stigma is deeply intertwined with the video's message about the need for increased understanding and acceptance.

💡Depression

Depression is a common mental disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities. In the script, depression is mentioned as one of the mental illnesses that affect a significant portion of the population, highlighting its impact on daily functioning and the importance of treatment.

💡Schizophrenia

Schizophrenia is a chronic mental disorder affecting less than 1% of the population, characterized by delusions, hallucinations, disorganized speech and behavior, and impaired cognitive ability. The video script uses schizophrenia as an example of a severe mental illness that affects brain function and can significantly disrupt an individual's life.

💡Bipolar Disorder

Bipolar disorder, also known as manic-depressive illness, is a mental disorder characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). The script mentions bipolar disorder as one of the conditions that affect cognition, perception, and emotion regulation, illustrating the complexity of mental illnesses.

💡Anxiety Disorders

Anxiety disorders are a group of mental health conditions characterized by excessive and persistent worry, fear, or apprehension. The video script discusses anxiety disorders as part of the spectrum of mental illnesses that can impact an individual's ability to function and emphasizes the importance of recognizing and treating these conditions.

💡Addiction

Addiction is a complex condition where an individual has a compulsive engagement in rewarding stimuli, despite adverse consequences. The script refers to addictions to alcohol and drugs as mental illnesses that affect the brain and behavior, and it highlights the need for understanding and treatment to overcome the associated stigma.

💡Treatment

Treatment in the context of the video refers to the medical and psychological interventions used to help individuals with mental illnesses manage or overcome their symptoms. The script emphasizes the effectiveness of treatments like medication and therapy, and the transformative impact they can have on people's lives, such as the story of Sarah who overcame panic disorder.

💡Awareness

Awareness in the video script refers to the recognition and understanding of mental illnesses by society. It is highlighted as a crucial factor in reducing stigma and ensuring that individuals with mental health conditions receive the support and treatment they need. The speaker calls for increased awareness to facilitate early identification and intervention.

💡Advocacy

Advocacy is the act of publicly supporting or recommending a particular cause or policy. In the script, advocacy is presented as a necessary action to influence government and media perceptions of mental illnesses, ensuring that effective treatments are made available and that the stigma associated with mental health is reduced.

💡Compassion

Compassion is the feeling of sympathy and concern for others' sufferings, often leading to a desire to alleviate that suffering. The video script concludes with a story that underscores the importance of compassion in the treatment of mental illness, suggesting that it is as vital as medical knowledge and clinical skills in helping individuals recover.

Highlights

Mental illness affects a vast portion of the global population, with 20% of people experiencing a mental disorder at some point in their lives.

Stigma surrounding mental illness is pervasive, often leading individuals to hide their conditions rather than seek help.

Mental illness should be treated like any other medical condition, yet stigma creates barriers to treatment and understanding.

The brain is a complex organ, with over 100 billion neurons and 30 trillion connections, making mental illness particularly challenging to understand and treat.

Mental illnesses like depression, anxiety, and schizophrenia disturb cognitive, perceptual, and emotional functions of the brain.

Historical examples of stigma, such as with AIDS in the 1980s, demonstrate how advocacy and awareness can lead to breakthroughs in treatment and reduce stigma.

Early intervention and community-based comprehensive care are key strategies in reducing the impact of mental illness and preventing severe outcomes.

There is a significant gap in awareness and access to mental health care, which prevents many from receiving the treatment they need.

Proactive mental health care can reduce overall healthcare costs while improving the quality of life for individuals with mental illness.

Personal stories, such as that of Sarah, illustrate how effective treatment can transform lives, enabling individuals to regain normalcy and purpose.

Despite the availability of effective treatments, conditions like borderline personality disorder remain challenging, highlighting the need for continued research and support.

The case of Gus Deeds, a young man with bipolar disorder who died after his father struggled to get him treatment, underscores the tragic consequences of inadequate mental health care.

Mass violence incidents are often linked to untreated mental illness, emphasizing the need for early identification and intervention.

Laurie's story of recovery from borderline personality disorder shows the importance of compassion and persistence in mental health care.

The speaker calls for a collective effort to raise awareness, eliminate stigma, and ensure that mental health care is accessible to all.

Transcripts

Translator: AJ Jungbluth Reviewer: Rhonda Jacobs

I know we're only just meeting for the first time,

but I'd like to ask you a question,

and it's a rather personal question.

How many of you suffer from, or know someone who suffers from,

a mental illness?

Well, think about it.

Your family, your friends, your classmates in school, your colleagues at work.

I'll bet that virtually everybody knows someone with a mental illness.

Now, maybe I should explain what I mean by mental illness.

Commonly thought of conditions like depression, schizophrenia,

bipolar, and anxiety disorders, and also intellectual disturbances like autism

and learning disabilities and ADHD,

and addictions to alcohol and drugs.

All of these conditions affect the same areas of the brain

and disturb, by varying degrees,

the mental functions of cognition, perception, and emotion regulation.

So we're not talking about the worried well here or problems in daily living.

The World Health Organization

has estimated

that 20% of the world's population suffers from mental disorder

at some point in their lifetime.

That's one in five people, over 70 million Americans.

A billion people worldwide.

So if you do the math,

everyone should know someone who suffers from a mental disorder,

and the fact that many of us may think we don't

reflects three inconvenient truths:

that we lack an understanding and awareness of what mental illness is,

that we're reluctant or ashamed to admit it,

and that mental illness is highly stigmatized.

Now, stigma literally means "dishonor" or "disgrace."

It's the mark of Cain in the Bible.

It's the "A" on the dress of Hester Prynne in "The Scarlet Letter,"

and it's the yellow stars that were emblazoned on the clothing of Jews

in Nazi Germany.

So why should mental illness be similarly stigmatized?

Well, to show you how insidious stigma can be,

let's do a little thought exercise.

Imagine that you were invited to celebrate your boss's 50th birthday party,

and you were picked to give the toast.

But on the day of the event,

you got sick, and you had to cancel.

When you called to cancel, would you prefer to say

that you couldn't come because you had a kidney stone

or that you were depressed and suicidal?

Or would you rather say you threw out your back

or were having a panic attack?

Or would you rather explain that you were having a migraine headache

or you were strung out on prescription pain medication?

If you would prefer the former to the latter in each case,

you, my friends, are affected by stigma.

Now, I experience stigma every day as a psychiatrist.

The profession to which I have dedicated my life

is the most denigrated and distrusted of all medical specialties.

There's no anti-cardiology movement that's trying to stamp out cardiology,

(Laughter)

and there's no anti-oncology movement that's trying to ban cancer treatment.

But there's a virulent anti-psychiatry movement

that claims there's no such thing as mental illness

and wants to eliminate psychiatry.

Now, if we thought of mental illness like we do heart disease,

then symptoms like depression would be like chest pain.

Or anxiety would be like shortness of breath.

Or psychosis would be like an arrhythmia.

In the former case, symptoms emanate from the brain.

In the latter case, they emanate from the heart.

But the brain is infinitely more complicated than the heart,

or any other organ in the human body, for that matter.

The heart is basically a pump composed of four chambers,

a dozen blood vessels,

and comprised of two billion muscle cells.

The brain, on the other hand, is a three-pound corrugated mass of tissue

composed of over 100 billion neurons,

which make over 30 trillion connections

and form an intricate array of a myriad number of neural circuits,

which simultaneously orchestrate functions as basic and vital as breathing,

temperature regulation, hunger, coordinate movement.

But also form what your personality is and who you are as a person.

The brain gives rise to consciousness and creativity,

and it also houses the human spirit.

It's no wonder that it's taken us so long to understand the brain

and appreciate how it relates to behavior and mental illness.

Now, stigma is not unique to mental illness.

We've seen it associated with illnesses throughout human history.

Tuberculosis, leprosy, cancer.

The most dramatic example that I know of is AIDS.

In the late 1970s, I was an intern at St. Vincent's Hospital

in the Greenwich Village section of New York City

when the first cases of AIDS began to appear.

I remember seeing patients come into the emergency room

with terrible infections,

and we couldn't figure out what was wrong with them,

and we had no treatments, and they invariably died.

Now, this by itself would have been enough to stigmatize this illness,

but the fact that it was occurring predominantly in discriminated groups,

including homosexuals and intravenous drug users,

made its victims virtual pariahs.

But then an amazing thing happened.

The AIDS Advocacy Group and community aggressively spoke out.

They expanded awareness,

and they pressured the government to fund research.

And within five years, 1984,

two scientists isolated the human immunodeficiency virus,

the cause of AIDS.

By 1987, AZT was introduced,

the first treatment for AIDS.

And now AIDS is like diabetes.

It's a chronic illness but you could live a pretty normal life with treatment.

Contrast the outcome of Rock Hudson, who was diagnosed with AIDS in 1984,

and he was dead within a year,

to Magic Johnson, who was diagnosed with AIDS in 1991,

and he's still alive living a normal life, I saw him on TV the other day,

with treatment.

That is the power of science leading to knowledge and awareness

and effective treatments.

Treatments don't just eliminate the symptoms of the illness.

They also eliminate the prejudice and the stigma.

Now we're still learning the causes of mental illnesses,

but we already have effective treatments

which have helped millions of people around the world.

In many cases, these eliminate the symptoms of the person's illness,

but in some cases, they actually transform their lives.

Earlier in my career, I treated a young mother named Sarah,

and she suffered from panic disorder,

which had kept her housebound for 10 years

because she was afraid to go out, a condition called agoraphobia.

To start I had to make house calls and visit her at home,

and when she opened the door to her home at our first meeting,

I saw before me this woman in a long, black, shapeless tunic

with dark glasses and long dark hair.

She looked like Morticia from the Addams Family.

I began with exposure therapy and then gradually introduced medication.

And within a couple of months,

she was able to come to see me in the clinic,

but she insisted on sitting next to an open door

with her bike perched just outside

so she could dash at a moment's notice.

But within a year, she changed her attire.

She was fashionably dressed, cut her hair.

She was going out with her husband, socializing with friends,

and picking her kids up at school.

When we ended treatment, she came to our last session,

and she came up to me and thanked me, and she said,

"I feel like I've been let out of prison, like I've been given my life back."

Now,

not all disorders have good treatments.

Witness Alzheimer's disease and autism,

and not all patients respond as well as Sarah does.

A particularly difficult condition that psychiatrists treat

is called borderline personality disorder.

This affects young people and produces extreme mood volatility,

self-mutilating behavior, and stormy relationships with people.

The noxious nature of the behavior drives away family and friends,

and even psychiatrists are reluctant to treat patients.

One such patient that I treated was named Laurie.

She was in her early 20s, a waif-like girl with short hair,

large glasses, a very fragile demeanor

that could explode into volcanic rage

and propel her into aggressive or suicidal behavior.

I worked really hard trying to help Laurie control her mood volatility,

stop her from these self-destructive acts.

But the treatments I used, the medications I tried,

had limited effects,

and when she dropped out of treatment,

I felt I really hadn't done very much,

and I worried about what would happen for her.

So, we don't have treatments for every disorder.

And not all patients respond well.

But make no mistake,

there is indisputably a world of difference

between modern mental health care today

and what existed for all human history

prior to the latter part of the 20th century.

So I find it particularly ironic

that while people suffered from mental disorders

throughout human history

because of the fact we had no knowledge and limited or no effective treatments,

in the 21st century, when we do have treatments,

the biggest barriers are lack of awareness,

lack of access to care,

and stigma.

So, if there were no stigma,

we could launch a public health initiative

against mental illness, like we've done before successfully

such as with infectious diseases,

with heart disease,

with environmental toxins like asbestos,

lead, and smoking,

and we would begin with two simple strategies.

The first involves early identification and intervention.

And this involves having screening mechanisms in place

in primary care settings like family medical clinics,

pediatrics offices,

obstetrical and gynecologic clinics and offices,

and also in schools and in universities,

and also in the work place.

And individuals who were screened for being at risk for,

or having symptoms of, a mental disorder, would be referred promptly to a clinic

that specialized in providing the array of treatments

that would be helpful to their condition.

The goal of this is to get people engaged early,

before the illness has effects on their brain, disrupts their lives,

and risks them doing something that'd be harmful to themselves or others.

The second strategy would be an approach

of providing community-based comprehensive care

for people who were already at more advanced stages of the illness

and had suffered some disability.

This would include medical management, rehabilitative services,

and also residential facilities

to support people who can't care for themselves

and prevent them from falling through the cracks

and ending up on the streets homeless, or in prisons,

or sequestered in state mental hospitals.

So we have the means to do this,

and this would provide extraordinary changes

in people's lives in many, many ways.

People who are depressed,

who studies have shown suffer from symptoms of depression

for up to seven years before they get diagnosed and receive treatment,

would not have to endure this.

And also at the same time while they're waiting to be diagnosed and treated,

risk the possibility of hurting themselves through suicide attempts

or becoming addicted to something

through misguided attempts at self-medication.

People who experience trauma from violent crime or accidents or natural disasters

would be treated promptly, before they develop symptoms,

as they're treated for their physical injuries,

instead of waiting for their symptoms of PTSD to emerge

and then having them having to seek treatment.

And for people like the first responders and military personnel,

who go into harm's way routinely as part of their job,

there would be preventative and decompression treatments

routinely administered,

rather than waiting to see who develops symptoms

and has to overcome the embarrassment of speaking up and seeking help.

People who are abusing substances

would be encouraged and supported, rather than blamed and shamed,

to seek detox, rehab, and maintenance treatment

before intractable addictions developed.

And one in four women expecting babies

would not have to risk experiencing a pre- or post-partum mental condition,

but would routinely be treated as part of their pre- and post-natal care

and so that they wouldn't have to potentially endure symptoms,

potentially harm themselves, or even, God forbid, infanticide.

And children who have learning disabilities or attentional problems

would be identified early in their educational course.

And they would not just have remedial education,

they would have cognitive training, emotional support

so they didn't become so frustrated at their failure in school

that they resorted to anti-social behavior and potentially ended up in prison.

Now, you might be thinking to yourself, "Okay, that sounds good.

How much is this going to cost? Can we afford to do all this?"

Well, the reality is that health economists have found

that providing this kind of proactive mental healthcare

would actually reduce the cost of delivering healthcare

and result in enormous savings.

In addition, the families of people with mental illness

would be relieved of tremendous emotional stress

and also financial burden.

We would also have the benefit

from the fact that many of the glaring social problems that roil our society

would be reduced or eliminated,

and I'm speaking here particularly about the mass violent incidents

that have increasingly occurred.

Too many of these incidents have been perpetrated by young males, largely,

who are mentally ill

and manifest their symptoms long before they committed their crime.

They acted strangely.

They were in emotional distress.

They were socially isolated.

But nobody reached out to them for help.

Instead, they were shunned, ridiculed, or feared.

In some cases, families, friends

do reach out to try and get their family members or friends help.

Take the case of Gus Deeds, 24-year-old man with bipolar disorder.

His father,

Virginia State Senator Creigh Deeds,

desperately sought to have his son,

who was in the throes of a psychotic episode, hospitalized.

But to no avail.

Subsequently, Gus viciously attacked his father and then killed himself.

So Senator Deeds is now left with scars on his face

and pain in his heart,

instead of his son.

So how can we stop the suffering, the violence, the stigma?

We have to begin by recognizing mental illness for what it is,

a medical condition that can be treated, like we do physical illness.

If you look around you and you saw somebody next to you

who was grimacing in pain or passing out or choking,

you would rush up to them or you would ask them,

"Is there something wrong, or can I help you?"

But we don't do this when we see somebody who's emotionally distressed

or acting strangely,

or too often intoxicated.

But that's what we need to do.

We need to be involved, show our concern, don't be afraid to ask,

make it your business.

What's the worst that can happen?

They say to you indignantly, "Mind your own business"?

Or "I'm fine, thank you"?

But the best that can happen is you may be able to get somebody help

and alleviate unnecessary suffering

and potentially harm to themselves or others.

Now, that will work for those around us, that are close to us,

or that we're with, but to have an effect on the whole population,

we need to influence the government and the media,

either individually or through advocacy groups.

We have to make them understand

that mental illnesses are real medical conditions

and that we have effective treatments

and these must be made available to people.

I've been trying to do this by speaking out publicly,

including to audiences like you,

and writing articles for the lay public and the media.

When Robin Williams died, I wrote an article about suicide,

and I received an email in response that was titled,

"Message from a patient from very long ago,"

and I'd like to share this with you.

Dear Dr. Lieberman,

Last night I read your article about the suicide of Robin Williams

and recognized your name.

You probably don't remember me, but between the ages of 15 and 30,

I was severely mentally ill

with borderline personality disorder and depression.

I made many suicide attempts and was frequently hospitalized.

One of those times I took a large overdose

and awoke in the intensive care unit of St. Vincent's Hospital.

You were assigned to be my doctor,

and I clearly remember how very much you helped me.

You probably didn't see it that way, as I know I gave you a really hard time

with my acting out and self-destructive behavior.

However, eventually, with a lot of treatment,

I was able to get myself together.

I got married, enrolled in nursing school, and graduated as valedictorian.

For the past 22 years I've worked in psychiatric hospitals.

When I look back at just how mentally ill I was early in my life,

I would never have thought it could turn out so well,

how very fortunate I feel to have a pretty happy life.

And so I just had to let you know.

What I remember most from when I was your patient

is that you genuinely seemed to care about me

and didn't judge me.

But I suppose the best doctors are always the ones with the most heart.

Signed, Laurie.

So this was the same Laurie that I treated and feared for so long ago.

I was thrilled to know that she had recovered

and to think that maybe I played some small part in this.

But what really struck me most about her email

was the fact that

it wasn't my medical knowledge or my clinical skills

that she keenly remembered.

It was the fact that I showed compassion for her,

and compassion is something that we all can show to people,

including those with mental illness.

So while science and medicine

continues to pursue the causes and the cures of mental illness,

I ask that you join me

to find the heart and muster the will

to reach out to all people,

particularly people who may show signs of mental illness,

to raise awareness of the public,

of the government, and of the media to end the stigma of mental illness.

Thank you for listening.

(Applause)