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Mental health in the USA—a time to mourn (


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Author: To read Abigail Mundy's article, please click here.

“I just feel like kids have it harder nowadays,” a 15-year-old boy in Rhode Island, USA, tells his father, shortly before taking his own life. Earlier in Ken Burns' new two-part documentary series, Hiding in Plain Sight, grainy footage from the 1950's shows a boy joyfully throwing a paper airplane. Mid-flight the paper transforms into aluminium and the plane hits the World Trade Center, the scene cutting cleanly to footage from Sept 11, 2001.

The documentary pieces together extended interviews with over 20 young people, varied in age (from as young as 11 years old) and background. Some have spent years in foster care, others have grown up in affluent neighbourhoods. There is an Indigenous young woman, a transgender teen. Their voices join into a chorus of the most excruciating harmony, different in so many ways but united in the anguish they describe. Some recount not caring if they wake up in the morning. Some speak of deep isolation, “How do you admit to friends that you want to kill yourself?” One girl defines her depression, “Something pulling you down and holding you in that dark spot.” Another recounts her delusions. Playing in a field as a small child, she heard the voices of her friends calling, turned around, and found no one there. As an adolescent, she started seeing three shadowy figures, for years telling no one. A young man experiences bipolar disorder, “There's a war going on in my brain.” Some stories involve overdoses, some self-harm and suicide attempts, others incarceration.
Mental health workers and advocates appear somewhat parenthetically, offering context and a few statistics. Psychiatrists discuss the value and risk of diagnosis, the benefits and side-effects of medication, and a health-care system ill-equipped to handle mental illness. They recount how emergency room staff are minimally trained to deal with mental health crises, and labyrinthine health insurance policies make receiving treatment difficult or virtually impossible. The spotlight remains on the young people who have experienced the inside of diagnostic labels (ie, Diagnostic and Statistical Manual of Mental Disorders codes) and beyond. From the beginning and throughout, in the background, the question of why young people experience mental illness—and at such high rates in the USA—lingers. Psychiatrists point to the interplay of nature and nurture, genetics and environment. But after so many dark experiences told in the first person, these explanations, though not hollow, feel incomplete. The urge to grasp for an answer remains.

The second episode in the two-part series is entitled Resilience, following The Storm. Focusing on the notion of hitting rock bottom and the possibility of rising to recovery, almost jarringly, most of the stories recounted in the first episode take a turn. Some of the individuals who felt like they were underwater start to speak of birdsong and blue skies. The legitimate need for advocacy pushes the documentary toward actionable hope and warmer endings—albeit not perfectly sunny. As one boy says, “I guess I'm not sad, but I still am.” But after the depths of the first episode, the silence of those somewhere off screen and outside the frame, at their rock bottom, resounds. How many will find their way out? While the second episode acknowledges this, it leaves little time to mourn. The pain of The Storm is soothed too soon in its sequel, hope offered too quickly.

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