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LCM Bookstore: Order Tapes and Transcripts Check out The Infinite Mind's broadcast date and time in your area Copyright © 1997-2002
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|  Welcome to State of Mind: America 2002, a special presentation of The Infinite Mind. We begin with the host of The Infinite Mind, Dr. Fred Goodwin, at the National Press Club in Washington, D.C. Dr. Goodwin introduces the program with a few observations and questions. On September 11th the country's emotional well-being was shaken by unprecedented terrorist attacks. Now, nearly six months later, he wonders what our national mental state really is. Where are we heading? Who's coping and who isn't? Just how far has the fallout reached? We've all been coping with greatly increased uncertainty, dealing with everything from anthrax attacks to the problems of a faltering economy. Mental health is suddenly front-page news, with 55,000 New York City police officers told to see therapists, with untold numbers of Americans afraid to fly. Now we've convened some of the nation's top mental health experts to assess where we're headed and where we should be headed. From the Museum of Television & Radio in New York City, The Infinite Mind's John Hockenberry begins with the numbers from a poll commissioned by The Infinite Mind and the American Psychological Association and conducted by Greenberg Quinlan Rossner Research in early February. He discusses the results of the poll with Robert Boorstin, vice president of research at GQR. Hockenberry asks what the goal was, what the poll was trying to find out. What were the surprises? Boorstin replies that the poll was essentially trying to answer Dr. Goodwin's question of how we are doing, using a snapshot of 1500 people from around the nation and another 400 from New York City and DC. It found that about one in four people were not doing as well now as they have been at other times in their lives-they are more depressed and/or anxious. Most of this can be explained by personal trauma or financial woes, but 16 percent of those one in four attribute the problems they're experiencing directly to the events of September 11th. On the other hand, Americans are moving on from the terrorist attacks--since November economic concerns have replaced terrorism as the country's chief worry. Hockenberry asks what Boorstin, himself a noted mental health advocate, was most interested in learning about the one in four people reporting trouble coping. Boorstin replies that the question in his mind was whether these people are getting treatment, whether they're seeking help. The poll found that while about seven percent of all of those surveyed had visited a therapist as a result of September 11th, in the subgroup of 16 percent that figure was about three times greater, but that's only about 20 percent. Overall, the poll shows that a significant amount of people are still affected and saying they are affected by the terrorist attacks. Still, people are resolved and resilient and engaged in soul-searching, trying to pay more attention to what really matters. After the statistics about how people are doing, we put a human face on some of the numbers. John Hockenberry introduces Billy Watkins, from Jackson, Mississippi. He asks how the events of September 11th resonated in that community. Watkins says that growing up, New York sometimes seemed a long, long ways away-not even real. But now, that gap is closed-New York and Jackson seem much closer. People were lining up around the block to give blood in Jackson. It was a lot tougher on people there than they ever thought something that happened in New York could be. Next, from Connecticut, Captain Scott Shields and his rescue dog, Bear. They were one of the first canine rescue teams at the World Trade Center site. Captain Shields hasn't been able to sleep more than three or four hours a night since. He says he thinks that despite the trauma he is a better person from the experience and that New York is a better city. Jill Nees is in the audience from Oklahoma City. She had just moved back there from Los Angeles before the 11th. She is in New York to offer lessons from her experience of the 1995 bombing. John Hockenberry now introduces three experts for the program's first panel discussion. Dr. Dennis Charney of the National Institute of Mental Health is an expert on mood and anxiety disorders. Dr. Carol North of Washington University in St. Louis has studied and continues to study the effects of the Oklahoma City bombing attack. Richard Rockwell is the executive director of the Roper Center for Public Opinion Research at the University of Connecticut. He's tracked dozens of polls looking at the mood of Americans since September 11th. Hockenberry asks Rockwell how The Infinite Mind/APA poll results compare to results from polls conducted just after the attacks. He also asks how it was possible to do such polling. Interviewers surely could not be detached in such a situation. Rockwell replies that for many questioners it was the hardest thing they'd ever done. At Gallup, for example, interviewers found the experience wrenching for them but a great release for those they were questioning. People wanted to talk and were grateful to have someone to listen to them. Dr. Charney emphasizes that people in general are extremely resilient and that most people do bounce back from traumas, even one of this magnitude. What he watches for is a syndrome called acute stress disorder where people have feelings of anxiety and depression, as well as sleeplessness, that last for up to a month. Some of the risk factors for developing these kinds of symptoms include, of course, proximity to Ground Zero, but whether someone has previously experienced a trauma is also important. Post Traumatic Stress Disorder is actually a fairly common disorder and in general the more personal an event-a rape, for example, as opposed to a tornado or hurricane-the more severe are the symptoms. Dr. North interviewed 182 people in Oklahoma City who were in the direct path of the bomb blast there, the equivalent of being at Ground Zero. She found that a full 34 percent of people interviewed fit the criteria for PTSD but emphasizes that that means the majority did not develop a psychiatric disorder. She explains how different populations have different mental health needs and that it's important to be alert to those differing needs. Dr. Charney emphasizes that some people may feel that their distress isn't okay, and that this may in fact worsen their problems-not least because they may be reluctant to seek treatment. Both Charney and North say that their research shows people with pre-existing psychiatic disorders are more vulnerable when exposed to sudden major traumas. John Hockenberry and Richard Rockwell discuss the seeming generation gap when it comes to how people are doing in the wake of 9-11. Audience member Barbara Edwards Delsman is concerned about how the people she works with in her job, many of whom already had PTSD and/or worked in the service industry, are finding themselves very hard-pressed by the attacks and the resulting economic downturn. Hockenberry wonders whether the focus on September 11th isn't actually siphoning off support services from some of those who are most needy. Dr. Charney agrees this is a problem. Audience member Alan O'Leary describes his experience getting out of the World Trade Center when it was attacked. He is now much closer to his family, who live in Ireland and England, and his wife has been an invaluable help. Getting back to work was very helpful for him in relieving stress and anxiety. Dr. Goodwin now who introduces some members of the audience in Washington, D.C. Jan Tcazyck from Cape Cod ,Massachusetts says that in the high school where she works she has seen young people who were already in struggling in one way or another doing worse after September 11th. Olga Linney is a teenager (she's 16 and a junior in high school) from Virginia who says it can be helpful to talk to adults who are not your parents about problems you may be having. It can be easier and less embarrassing than talking to one's parents. Jim Kidney, also from Virginia, is a parent whose 12-year-old son Daniel hanged himself after he had begun counseling and treatment for depression. After the fact Mr. Kidney and his wife were able to get the psychologist's notes and educate themselves about depression. He thinks that it is important to be able to evaluate the effectiveness of counseling. Reflecting on this disturbing story, Dr. Goodwin reminds us that when it comes to children and mental health the stakes couldn't be higher. He asks whether we are short-changing our children. One out of 10 American children and adolescents struggle with mental illness and most of those are not being treated. Dr. Goodwin introduces the guests for the program's second panel discussion, Dr. Marilyn Benoit, president of the American Academy of Child and Adolescent Psychiatry, Marian Wright Edelman, founder and president of the Children's Defense Fund, and Dr. Rosemarie Truglio, Vice President of Research and Education for Sesame Street. They are joined by former First Lady and child and mental health advocate Rosalynn Carter via telephone from Colorado. Mrs. Carter has called the situation with respect to children and mental health a "national crisis." Dr. Goodwin asks why. She explains that there is a need for primary care providers, law enforcement personnel, teachers, etc. to be educated about the symptoms of mental illness so that children do not slip through the cracks. Mrs. Carter says that we know what we need to do for children but we don't do it. Dr. Benoit says that she looks at children's functioning in school and the social realm to assess how they are doing. The content of children's artwork and changes in their eating and sleeping. are other important signs of problems. Dr. Benoit says that she is seeing some signs of regression in some children trying to cope with the aftermath of the terrorist attacks. She concurs that this is a national crisis-in the years between 1980 and 1996 there was a one hundred percent increase in the suicide rate of children between the ages of 10 and 14. Dr. Goodwin returns to the audience and speaks with Susan Bently of Wyoming. She points out that her entire state has only one pediatric psychiatrist and that children may have to wait as long as a month to receive psychological counseling and psychiatric treatment. Families with insurance have caps on what their insurance will pay for; sometimes people have to drive two to eight hours to get to treatment. There's a real lack of support. Panelist Marian Wright Edelman reminds us that here in the richest nation on earth we have nine million uninsured children. We need to make sure that this situation changes and that there is parity for mental health needs-that they are put on a par with children's (and adults') physical needs. There are millions of children witnessing and experiencing violence all around this country, all the time. We need to address the hidden but urgent needs of our children. Dr. Benoit reminds the audience that just as the first group of panelists mentioned, we need to be alert to those whose personal histories place them at higher risk for developing psychiatric disorders after 9-11. She mentions as one example immigrants from repressive countries where they experienced trauma before they came to the United States. Rosalynn Carter says she is concerned that children with mental illnesses are not being diagnosed early enough. Early screening is extremely important. Rosemarie Truglio explains how Sesame Street sought to respond to the events of September 11th in a way appropriate for its very young viewers. What are the coping strategies children can learn about expressing their emotions? How can adults help validate those emotions? Dr. Goodwin asks if children are more responsive to stories than to a direct approach. Dr. Truglio describes positive feedback the show has received in the form of calls and letters saying children have learned practical, important skills-like how to deal with a fire emergency-from watching the program. As a closing comment Mrs. Edelman emphasizes that children come in families and communities and that we can best care for children by reaching them through their families and communities. Next, Dr. Goodwin introduces a special commentary by the Reverend William Sloane Coffin written for this State of Mind: America 2002 broadcast. The Reverend Sloane Coffin has been active in peace, human rights, and social justice movements for the past 40 years. His commentary is read by actor David Strathairn, a highly acclaimed performer known for bringing out the psychological complexity of his characters in dozens of films and on the stage. State of Mind: America 2002 now returns to New York and the Museum of Television & Radio where John Hockenberry introduces the Metropolitan Opera's Jessye Norman. She sings Duke Ellington's "Come Sunday," written in 1943 as part of the Black, Brown, and Beige suite. Miss Norman is accompanied by violinist Patmore Lewisof the Metropolitan Opera Orchestra. After a break for intermission, State of Mind: America 2002 returns to John Hockenberry in New York. He reviews again the results of The Infinite Mind/American Psychological Association survey which found a percentage of those surveyed equivalent to about nine and a half million Americans who said they were feeling more anxious and/or depressed than they had at other times in their lives directly because of September 11th. These are people who may be new to questions of mental health and new to feeling like they might need help. After outlining the second hour's programming, we return to Dr. Fred Goodwin in Washington who introduces a video interview with U.S. Surgeon General Dr. David Satcher by noted journalist Robert Krulwich. Dr. Goodwin points out that the Office of the Surgeon General has issued five reports on mental health. All five were the initiatives of Surgeon General Dr. David Satcher, who sat down with noted tv and radio reporter Robert Krulwich during his final weeks in office. Dr. Satcher explains that though there is certainly much healing in the nation five months after 9-11, some people are not healing. Of those who experience PTSD, for example, 50 percent will recover within six months, while 50 percent will not. Mr. Krulwich and the Surgeon General discuss that while things are, obviously, different for those people with a personal connection to the events of September 11th, some people could in fact be traumatized by repeated exposure to the images of disaster that were repeatedly shown on television. Different people come to these experiences with different histories and those who may have already suffered some damage may be more susceptible. Dr. Satcher said that he was in Oklahoma City three weeks after the terrorist attacks and that some of his colleagues reported symptoms like sleeplessness in patients who had made good recoveries from the 1995 bombing there. The Surgeon General explains that his office's report predicts that some 10 percent of those directly affected by the events of the 11th will develop PTSD. But he cautions that the prediction is not as precise as he's like it to be, mainly because data on mental disorders is so sketchy. And why is that? Because we've created an environment in which people feel that their character is lacking or that they are weak if they're suffering from a mental disorder. But mental disorders are common. Things go wrong with the brain as with other organs. Our experience with rescue workers shows that people feel more comfortable seeking help for a pulled muscle than they do asking for help for mental problems. Robert Krulwich's last question to the Surgeon General concerns a point of personal history. In his youth in Alabama Dr. Satcher experienced some of the more traumatic aspects of racism-for example, grew up 60 miles from Birmingham, where four young girls were killed in a church bombing in 1963. He also personally experienced violence when protesting segregation. Krulwich asks whether he learned anything from those experiences that he found applicable to dealing with the aftermath of September 11th. Dr. Satcher replies that one of the most useful lessons he learned was the importance of taking action, of not just dealing with things internally. Returning to John Hockenberry in New York we hear from a few more audience members. Ken Thompson is from Oklahoma City. His mother was killed in the bombing there. She was the last person to be identified. Mr. Thompson credits the way he was raised and his sense of humor, his ability to laugh in a horrific time, for helping him get through the aftermath of his loss. Audience member Tom Ryan is a New York City firefighter. He talks about the tight-knit firefighter culture helping men pull through. But there are also those who feel far more comfortable now in the firehouse than with their families. He himself feels pride in the incredible performance of many men he trained, but as a survivor he feels much sadness regarding those he's lost. John Hockenberry asks Mr. Ryan if he remembers the first time he laughed after September 11th and what it was about. He does, and he mentions how firefighters often use humor to help them through the terrible situations they experience on the job. Then Hockenberry introduces the program's third set of panelists, Dr. David Spiegel of Stanford University's Psychosocial Treatment Laboratory and Emmy award-winning comedian Al Franken. Dr. Spiegel explains that humor is a way of seeing the same situation from two points of view and so can be a useful defense. Humor is a way for people to deal with horrible things but give themselves a sense of distance from those things. It's important for people to be able to use their contacts with others to help those others, and this can give meaning to an otherwise terrible situation. He has seen this in work he's done with women suffering from breast cancer. Al Franken talks about how he went down to Ground Zero about a week after September 11th with the Creative Coalition. He spoke to some firefighters who told him their stories about what happened to them on that day. These stories are terrible in the details but they also involve using humor as a response to stress. John Hockenberry asks Dr. Spiegel if there is a profile of a resilient individual. He identifies three important qualities of such people. One, they're open to their own emotions; they know what they are feeling and don't feel compelled to pretend that everything is fine if it's not. Two, they do things with other people. Being with people, as others have mentioned throughout the program, is healing and helps us transcend our own sense of vulnerability. Three is being flexible regarding the meaning of things, being able to reframe and reprioritize when necessary. Now, Al Franken's Saturday Night Live character Stuart Smalley makes an appearance. Audience member Ken Thompson stands up again and they discuss the first moment after the Oklahoma City bombing when he laughed. Believe it or not, it involves him and his brother sorting through his mother's effects and finding a pair of bright red panties, after which they both laughed for 15 minutes. Dr. Spiegel discusses how shame cuts people off from others and prevents them from seeking out the resources that are all around them. Al Franken is asked if he wants the last word, to which he replies, simply, "no." For the concluding panel discussion, we move back to Washington and Dr. Goodwin. He introduces audience member Pat Scoones from Florida, who tells the tragic story of how her son died by suicide after seeking help for his depression and encountering roadblocks at every turn due to staffing shortages and the bureaucracy of managed care. Dr. Goodwin comments that this story is a reminder that all practicioners need to recognize that mental illnesses can be as deadly as any other disease. Audience member Diane Engster, from Mount. Vernon, Virginia, speaks about how her congregation has a very active ministry to people with mental illnesses and includes them in their circle of caring and that this is very important. She comments that clergy are in a position to take the lead in combating the stigma around mental illness. Dr. Goodwin introduces the two members of State of Mind: America 2002's final panel, founder and honorary chair of the National Mental Health Awareness Campaign Tipper Gore and psychiatrist and author Dr. Peter Kramer. Their discussion begins with the issue of stigma, the stigma surrounding mental illness and those who experience it. Mrs. Gore explains how and why she chose to go public regarding her own depression a few years ago. She says that speaking to groups of children around the country she was shocked to find how many had considered or knew someone who was considering suicide. She then realized she could have a greater impact on people's lives if she went completely public about her own experiences. She talks about how we need to come together to eradicate stigma and improve access to treatment. Dr. Kramer talks about how our understanding of mental illness has changed in recent years. There is a much firmer grasp of the fact that mental illness has a biological basis, which isn't to say that the contributors to mental illness don't include various stressors like the traumatic events discussed earlier in the program. Those get translated into biology. Mental health treatment has been good at interrupting and muting what he calls "acute flare-ups" of mental illness, whether it be anxiety or depression or worse illnesses. There is a challenge in dealing with chronic mental illnesses that are taking place across the life cycle. Prevention is a wonderful area of promise in psychiatry. Dr. Goodwin and the panelists discuss the gap between what we can do, in terms of treatment for mental illness, and what we actually are doing. Mrs. Gore speaks about the gap in getting research results to care providers. There's a need for culturally sensitive mental health centers that people feel comfortable going to. Dr. Kramer says the gap between what can be done and what is done for people with inadequate or no health insurance is shameful. Audience member Yvette Sangster from Connecticut points out that treating people with mental illnesses as people is the most important thing. People with mental illnesses need more than pills and doctors; they need employment, friends, people who understand that they can and do recover. Dr. Kramer concurs that broadly-based social interventions are very important, along with medical intervention, in treating mental illness. Audience member Delfy Pena-Roach from New Mexico talks about how her husband, who had a dual diagnosis of manic depression and substance abuse, died fourteen years ago. The problems they had were in getting treatment for both halves of this diagnosis-they were being shunted from one provider to another and people were not looking at the full picture. Mrs. Gore concurs that we need an integrated, holistic mental health system similar to what is starting to emerge in other areas of medicine. Dr. Goodwin talks about federal programs forcing states to combine mental health and substance abuse services to positive effect. Mrs. Gore points out that there is a lot of activity on the state level, with some 31 states having passed parity legislation. For the last segment in State of Mind: America 2002, we return to John Hockenberry in New York. He speaks with singer/songwriter Judy Collins, who discusses the healing power of music, and of the arts in general. She then sings "America the Beautiful," a cappella. | ||