Spotting the signs of mental illness can save lives

Mother of suicide victim creates group to spread awareness

Nancy Churnin / The Dallas Morning News /

Published Mar 14, 2013 at 05:00AM

DALLAS — Grant Halliburton was handsome, artistic, bright, popular and loved.

He also suffered from bipolar disorder and depression. When he was 19, he jumped off a 10-story building to his death.

His mother, Vanita Halliburton, has gone over this tragedy again and again. If she knew now what she knew then, she believes the outcome might have been different than it was that awful day in November 2005. She created the Grant Halliburton Foundation in Dallas in the hope that the outcome will be different for others. The group teaches the signs of mental illness and puts people in touch with available resources.

It’s a crucial mission because, while experts agree that early intervention saves lives, most people wait years before getting help. The delay can be tragic.

“We were a typical family,” Halliburton said softly on the phone. “We were parents with reasonable intelligence and reasonable means to do whatever it might take to get our son well. And if we didn’t get this right, then what about the people who don’t have a clue or don’t pay attention to the signs or brush them off?”

The statistics, as Halliburton says, are shocking.

One in 5 Americans 18 or older has experienced a diagnosable mental illness or behavioral or emotional disorder in the course of a year, according to a 2010 national survey released by the Substance Abuse and Mental Health Services Administration.

The survey, of about 67,500 people 12 and older, shows that 5 percent of adults suffer from mental illness so severe that it limits major life activities.

About 8.7 million people have had serious thoughts of suicide. The survey shows 2.5 million planning suicide and 1.1 million actually attempting it.

According to the National Alliance on Mental Illness, suicide is the eighth-leading cause of death overall in the U.S. and the third-leading cause of death for people between the ages of 15 and 24.

The good news is that mental illness can be managed successfully with medication and therapy, experts agree. The bad news is that only about 4 in 10 people experiencing mental illness receive services, according to the SAMHSA report.

The average time between when symptoms appear and treatment begins is nine years. Among the roadblocks to getting help are guilt over the idea that you or the person with the illness is at fault, confusion about what to do and resistance on the part of the loved one to acknowledge his illness, says Dr. Lloyd Sederer.

Erasing the stigma

Sederer, a psychiatrist and medical director of the New York state office of mental health, wrote “The Family Guide to Mental Health Care” (W.W. Norton & Co., $25.95), a practical guide due out in April, which clarifies that mental illness is a physiological disorder that is no one’s fault.

“There are certain areas of the brain that look different in people afflicted with mental illness than in those individuals who are not,” Sederer said. “We have to set aside confusion, sadness, anger and despair and get on with what needs to be done.”

Sederer says once family members spot the signs, they should be direct when talking to a loved one they think might be suffering. “Describe to the person you love what you see going on. Be specific. Tell the person, ‘I have not lost confidence in you. I love you and believe in you. I know this is not who you are, this is not the person I’ve known for so long. My love for you insists we find help. I will be here to support you.’”

Dr. Preston Wiles, a psychiatrist and medical director of the University of Texas Southwestern/Children’s Medical Autism Center, was, like Halliburton, a panelist on the symposium, “Erasing the Stigma: Mental Illness and the Search for Solutions,” sponsored by The Dallas Morning News, KERA and Mayor Mike Rawlings in February. He believes eliminating the stigma could make a difference in people getting the help they need.

He’d like to see pediatricians, teachers, school counselors and young people learn and report the signs as a lifesaving measure similar to the way we’re taught to stop the bleeding when we see a wound, do chest compressions for people in cardiac arrest and use the Heimlich maneuver to relieve choking.

With 50 percent of those with mental illness manifesting signs of their disease before the age of 14, and 75 percent before the age of 24, according to the National Institute of Mental Health, “we actually have a wonderful opportunity to catch things when we can do the most good,” Wiles said.

All too often, people may see signs but are afraid to press forward with questions, particularly in the case of depression, he says.

“There’s almost this myth if you talk to someone about whether he or she is suicidal, that will increase the risk, which is totally not true. Most of the time, people are relieved when you ask them. It’s a secret they’ve been keeping that they’re scared of. When they talk about it, you can help create a plan for them to feel better and to address the problem.”

A 24-hour suicide hot line and local mental health organizations can be a good place to start if you suspect a problem, experts say. Early resources can include trusted clergy, a family doctor, a pediatrician or a school counselor. If further help is recommended, ask for a referral to a therapist or psychotherapist, social worker, psychologist or psychiatrist. Many mental illnesses, including all psychotic conditions, require a psychiatrist or psychopharmacologist to prescribe medications. A psychiatric-mental health nurse practitioner can prescribe medication under the supervision of or in collaboration with a psychiatrist. Psychiatrists are physicians who can both prescribe medication and perform psychotherapy; some will just prescribe medication in coordination with therapy by other mental health professionals.

Halliburton says if there had been less of a stigma, she might have been able to find friends to talk to about her son’s condition. She said she was quick to get him help as soon as his first symptom, self-cutting, occurred at age 14, but there was too much she didn’t know.

Recognizing red flags

At that time, she wasn’t aware of the National Alliance on Mental Illness, which provides free support groups across the country for family members as well as those who have mental illness.

She put Grant in a mental health facility when he left his freshman year of college early, asking for help, but she didn’t know when he emerged from the hospital that, instead of being stronger, he was actually at his most vulnerable. She remembers talking to him on the phone the day he died, two weeks after his release.

“I asked him how he was doing, and he said, ‘Great,’ and I thought, ‘He sounds like his old self; he sounds good.’ That should have been the first red flag. He felt confident because he had a plan, a solution to his pain. He was cleaning his room, and I went, ‘Wow, that’s great.’ He had taken posters off his walls and given away all his things, including his iPod. And that should have been another red flag. He was putting his affairs in order, tidying up things for his death.”

She says she’s since learned that eight out of 10 times when people take their own life, they give warnings. She has those warnings printed on the brochures that the Grant Halliburton Foundation gives to schools, medical professionals, government officials and anyone who asks.

“My son exhibited every one of the signs on the list in the weeks before his death, but we didn’t know what was going on right before our eyes.”

Her decision to start the foundation came soon after his death, in January 2006. It was born out of a cascade of grief and shock, she says.

“I kept wanting to know more about what had happened to our wonderful, bright young boy. As time went on, I realized this has got to be about the living. When you’ve had this kind of loss, you know any one teenager you can help, anything you can do to save a life is wonderful. We’re here to make a difference.”

Where to find help

These organizations and websites offer advice on what to do if you or a family member needs help.

Grant Halliburton Foundation, http://granthalliburton.org: Offers programs that teach how to recognize the signs of distress or suicidal crisis in youths and find help. 972-744-9790

American Foundation for Suicide Prevention, http://afsp.org: Offers information and support on understanding and preventing suicide through research, education and advocacy and reaches out to those with mental disorders and those impacted by suicide. 888-333-2377

National Alliance on Mental Illness, http://nami.org: Offers access to services, treatment, research and mental health support. 800-950-6264

http://depression-screening.org: This online test from Mental Health America, a national organization promoting mental health, can help you see if you are suffering from depression 800-969-6642

Half of Us, http://halfofus.com: Offers an online resource for college youths with information and resources on mental health issues on college campuses and in college communities.

Depression and Bipolar Support Alliance, http://dbsalliance.org: Offers hope, help, support and education for people with mood disorders. 800-826-3632

National Institute of Mental Health, http://nimh.nih.gov: Offers understanding and treatment of mental illnesses through current research. 866-615-6464

24-hour hot lines for those with thoughts of suicide or self-harm:

800-273-TALK (8255): The National Suicide Prevention Lifeline. http://suicidepreventionlifeline.org

1-866-488-7386: The Trevor Project’s confidential crisis and suicide prevention helpline for lesbian, gay, bisexual, transgender and questioning youth. http://thetrevorproject.org

Common forms of mental illness

Depression

Loss of interest in food and pleasure, slow movements and the feeling of being a burden. This most prevalent of all nonpsychotic disorders affects about 7 percent of adults each year, is the leading cause of disability globally, and can be fatal, leading to suicide.

Bipolar disorder

A psychotic disorder, commonly arriving in a person’s early 20s and continuing through adult life, it is characterized by acute mania — an overwhelming state of excitement, agitation and irritation — rapidly cycling to episodes of depression.

Schizophrenia

A psychotic disorder usually beginning in late adolescence or early adulthood, manifested by withdrawal, preoccupation with things that others don’t understand, odd choices in clothing, impaired sleep and paranoia as he or she responds to threats or sounds that only he or she can discern.

Source: The Family Guide to Mental Health Care

Signs of mental illness

• Significant changes in behavior, mood and thinking that have lasted for at least two weeks; for example: increased or diminished appetite and sleeping; changes in hygiene and self-care, activity, behavior, socializing and mood; sped-up or slowed-down thinking; and increased smoking and alcohol and/or drug use.

• Changes that have occurred without an evident cause such as a physical illness or traumatic life event.

Source: The Family Guide to Mental Health Care

Suicide warning signs

• Sense of hopelessness about the future

• Drastic changes in behavior or personality

• Uncharacteristic impulsiveness, recklessness or risk-taking

• Expressions of rage, uncontrolled anger, aggressive behavior

• Preoccupation with death, dying or suicide through writing, artwork or talking

• Giving away possessions

• Loss of interest in personal appearance

• Increased use of alcohol or drugs

• Withdrawal from friends, family and society

• Extreme anxiety or agitation; inability to sleep or sleeping all the time

• A recent severe stressor, such as real or anticipated loss of a relationship, unplanned pregnancy, victim of bullying or family conflict

• A previous suicide attempt or exposure to another’s suicidal behavior

Source: Grant Halliburton Foundation