Almost invariably, those who are the most devoted to the cause of improved mental health care eagerly share personal stories on the subject.
“Somebody I knew in college had a nervous breakdown,” says Mary Ellen Nudd, 68, who has performed a number of roles for Mental Health America of Texas, a statewide advocacy group, since 1973. “What the heck was that? That led to wanting to know more about mental health and mental illnesses.”
For her part, Lynn Lasky Clark, 48, now president and CEO of the group, discovered the lack of resources when her brother was diagnosed with paranoid schizophrenia in his early 20s.
“I’ve grown up with it,” Clark says. “Mental Illness and substance abuse on both sides of the family. Suicides in the family.”
Clifford Beers, the man who, in 1909, founded the national group that evolved into Mental Health America, had been confined to a Connecticut state asylum.
“When he was released, Beers went on to become a successful businessman,” Clark says. “But he wanted to do something about it. That’s why our highest national award, named for Beers, goes to somebody with mental illness. That’s always our focus — the people who are actually affected.”
Melting down the shackles
To personalize the story further, when this reporter opened a 1985 pamphlet on the 5oth anniversary of the Texas group, which lobbies for mental health legislation, I found a 1934 list of the charter directors for what was then called the Texas Society for Mental Hygiene.
Among the Austin delegates: “Mrs. Val M. Keating, Texas Relief Commission.” She was my maternal grandmother. And yes, like so many families, we have dealt with our share of mental illness.
Margaret C. Berry’s 1985 history records the incrementally better ways that Texans have dealt with mental illness in their midst.
Considered a vast improvement in what was still a frontier region, the State Lunatic Asylum opened in Austin in 1860. In 1917, a State Epileptic Colony was added, and then a State Colony for the Feeble-Minded.
Progress advanced during the governorships of Pat Neff and Miriam “Ma” Ferguson, so at least the names of the institutions were changed to “state hospitals” and “state schools.” As late as 1931, a separate “psychopathic” hospital was opened in Galveston for “Early-State and Hopeful Cases.”
Still, at the time, patients could be chained and shackled like dangerous prisoners.
A small group of reform activists, led by Violet Greenhill, a child welfare specialist, met at the State Capitol on May 12, 1934. This group became the Texas Society for Mental Hygiene on Nov. 19 of that year. Incorporated in 1935, it was able to squeeze $500,000 — a lot of money at the time — out of the legislature for mental hospitals.
Several bellwether achievements along the way: The monumental addition of the Hogg Foundation for Mental Health’s partnership with the University of Texas in the 1940s, the National Mental Health Act of 1946 and the Community Mental Health Act of 1963.
Several prominent names show up again and again in these stories, among them Helen Farabee, first wife of the late State Sen. Ray Farabee; Gov. Ann Richards; the Rev. James Allen, rector of St. David’s Episcopal Church; and famed philanthropists Mary Elizabeth Holdsworth Butt (of the H.E.B. family), namesake for an award from the Texas group; and Ima Hogg, whose brother’s estate made the Hogg Foundation possible.
How about this nugget? In 1956, the Austin American-Statesman received the national Mental Health Bell Award for outstanding newspaper coverage of the fight against mental illness.
The Mental Health Bell, a sort of Liberty Bell cast in 1953 from the melted-down chains and shackles that restrained the mentally ill, remains a symbol of the movement.
Making policies personal
Mary Ellen Nudd grew up in Illinois and graduated from schools there and in Texas. She joined the Peace Corps and, in 1973, served as an intern with what is now called Mental Health America of Texas. Retired, Nudd serves as a consultant on education programs and suicide prevention. She is amused by the group’s periodic name shifts.
“It’s like changing tires,” she says with a laugh. “You have to do this.”
Compared to attitudes prevalent during her early days in the field, there is now more public knowledge that mental disorders are illnesses and should be scientifically diagnosed and treated.
“Sadly, one big reason is that mental health and suicide in our military has made governments more aware,” Nudd says. “The military is now addressing this head-on.”
She also saw the push, after President John F. Kennedy’s advocacy in the early 1960s, to move more patients to community centers. Critics have long made a link between that movement and increases in homelessness and in the treatment — or lack thereof — of the mentally ill in the criminal justice system.
“We gradually moved people out of state hospitals,” she recalls. “Because back then you had to be hospitalized to receive services. You either keep people locked up and safe. Or, when possible, you serve them in the community, giving them tools, including medication. That’s always a balancing act between doctors and the justice system.”
Lynn Lasky Clark grew up in Houston and studied at UT and the University of Houston. A specialist in policy matters, she has also worked for the National Alliance on Mental Illness, whose efforts overlap somewhat with those of her current outfit.
“It’s really kind of all in the family,” Clark says. “We all work together, but do different things.”
Her staff of 14 to 15 operates with a budget of $2.5 million. Clark also has seen a sharp rise in bipartisan attention to mental health issues.
“Some of that is the education by advocacy groups,” she says. “Working with families, legislators hear from their constituents. There is so much to know if you are a legislator; you don’t understand it until you hear the personal stories and connections. Also the tragedies that we see all too often.”
Among the advances are improved and expanded Parents As Teachers programs, suicide prevention and grassroots help for families. Federal funding has recently become available to states for home visitation programs in needy areas. Teachers, law enforcement and medical personnel are working more closely together than before.
And, Clark points out, there is such a great cost to not taking care of the problems.
“We know that they can recover,” she says of the ill. “It’s a matter of providing the treatments and enough services for people to be successful. They are able to go to work, pay taxes, buy houses.”
And for all the policy talk, it all goes back to those personal stories.
“I learned early in life the challenges of finding not only a diagnosis but also treatment and housing, all the things that someone with a disorder would need,” Clark says. “I knew policies would have to change. I’m very blessed to work in this field to help people like my brother.”