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Millions of Americans suffering just like Robin Williams

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Comedian Robin Williams was found early this morning of an apparent suicide. He was 63 years old. He struggled with addiction and depression for most of his life and recently checked into rehab as part of his constant battle.

But if the statistics are correct, he was one of 9.2 million people in the United States who suffer from what’s known as “dual diagnosis” of substance abuse and mental health problems.

Perhaps comedians are more at risk for suicide, I can’t say. If you haven’t seen it, the very heartfelt message from late night host Craig Ferguson on the subject of addiction above is very moving. Ferguson was 15 years sober when he gave this monologue.

No one can know how Robin Williams felt at the time he made his decision to take his own life. But I can tell you what I’ve heard from literally thousands of other alcoholics and drug addicts I’ve met in 14 years of sobriety who have been in a similar place, struggling with a disease they just can’t seem to beat.

The next time you see a homeless person with mental health or substance abuse issues on the street, stand there and watch them for a little while. More importantly, watch the people who walk past them. See how embarrassed they are that this person is there at all, and in such a degraded condition. See the contempt they have that they’re being asked for something, or their anger at even being bothered. Or watch them stop out of pity and give the homeless person their spare change, hoping it will just make the whole thing go away.

The way that homeless person looks on the outside is no doubt very different from how Robin Williams looked on the outside, but on the inside anyone struggling with mental illness and addiction usually feels the same way no matter their station in life.

There are 10 times as many mentally ill people in jails as there are in hospitals in the United States, and it doesn’t save taxpayers one bit of money. Roughly half the people in federal prison are there on drug related charges. That should tell you something about what kind of signals we’re sending to people with mental health and substance abuse issues. We don’t see addiction and mental illness as just that, illnesses. We see people who suffer from them as weak, as criminals, as people of low character and we treat them accordingly, as people we are deeply ashamed of and who need to be locked away for the greater good.

Depression and substance abuse are inexorably intertwined for reasons too lengthy to go into here, but it’s fair to say that what happened to Robin Williams is not an isolated incident. Many famous people who have struggled with depression and addiction will tell you the same story no matter what their outsides looked like, on the inside they felt like that homeless person. Completely trapped, utterly degraded and ashamed, unable to “pull themselves up by their bootstraps” the way that society expects them to.

We can’t just help people in isolated pockets and think that individual treatment alone will solve the problem. If it would, rich people would be fine and Robin Williams would still be alive. Treatment certainly does help some but it won’t take away the shame and the stigma surrounding addiction and depression. We might as well start telling people with breast cancer or Parkinson’s disease to pull themselves together and get a job and everything will be fine and then locking them up when it isn’t.

Depression is estimated to have direct and indirect workplace costs to the economy of $34 billion per year. Which is probably a gross underestimate, because the National Institute on Drug Abuse estimates that the cost of drug abuse is $559 billion per year. And things are only getting worse. A 2012 study concluded that the number of people in the U.S. who experience depression at some point is increasing by 20% each year.

Any sane society would acknowledge that these are not just serious problems but in fact public health crises and make it a top priority to deal with them.

Robin Williams may have been rich and had access to all the treatment in the world, but nobody can escape feelings of shame, weakness and guilt that depressed and addicted people feel in a society that just wants them to “buck up” and “treats them” by putting them in jail if they don’t.

Stopping our horrific policy of trying to torture people into mental health and sobriety is only part of the problem, however. Beyond that there is a dramatic need to change the way we think about people with mental illness and substance abuse issues, how we identify them and get them help. The cost to our GDP is already far in excess of anything it would cost to do so, and the cost in human misery, not only to those who suffer but to those who love them and try to get them help is incalculable.

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