The loss of Robin Williams is a harsh reminder to anyone who has lost a relative or friend to suicide. For so many people, such recollections are riddled with a feeling that had one more phone call been made, one more visit paid or extended, an ounce more empathy or sympathy expressed, the outcome could have been different. It's a heavy burden to carry, the pain perhaps second only to the loss incurred.
Rationally speaking, there is likely nothing anyone could have done. Williams had access to the best mental health care, unlike so many millions of sufferers. In the U.S.A., more people die of suicide each year than in road accidents.
I still remember the pain of wondering "if only" with regard to a member of my own family. I believed then that much of life could be controlled; I wasn't yet aware of the extent to which some things lie totally beyond our influence.
This doesn't mean we should throw up our hands when a loved one is deeply depressed. We should, however, be appalled at how difficult it can be for people with mental health issues to access care in America and around the world. It's shameful how emergency-oriented the mental health "system" has become. The average hospital stay for psychiatric inpatients is a woefully inadequate seven days -- and that only when admission is gained, which usually requires the perception of imminent harm to self or others. As Allen Frances, Duke University professor emeritus, wrote only days ago, "This is the worst of times and places for many people with severe mental illnesses."
With so much to learn about the human brain, and despite political progress, we've been stalled by the stigma of mental illness and deceived by yesterday's promises of deinstitutionalization and "mainstreaming" that came to mean nothing more than ostracizing and criminalizing patients. Until we understand that mental illness is not something that happens to other people -- and to other people's families and children -- but rather a capricious visitor who may well have your address, we'll continue to allow millions of people, who could be helped, to suffer and perhaps to die.
As we take in the tragedy of Robin Williams' passing, we should also reject the shambles that is mental health care for most Americans. If there is an "if only" that makes sense, it is a societal one. Not everyone can be saved and certainly not indefinitely, but people who treat or support mental health patients, including families and friends, need to speak loudly about how a society that purports to be civilized, and whose representatives until recently bragged ignorantly of having the best health care in the world, treat a vulnerable and significant population of its citizens.
Robin Williams left us with many precious gifts. Among them, may this be one of the most enduring.
Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.