‘Nobody prepares you’ to deal with mental illness


Ways for people with mental illnesses to navigate professional environments was the focus of a panel of experts at the University Senate plenary on Mental Health and Academia. 

The plenary, which took place on Oct. 8, featured remarks from Kay Redfield Jamison, a professor of psychiatry at the Johns Hopkins University School of Medicine and author of the bestselling book, “An Unquiet Mind: A Memoir of Moods and Madness,” which chronicled her experiences as a psychiatrist with bipolar disorder. 

Other attendees included Sansea Jacobson, an associate professor of psychiatry at the School of Medicine; Chancellor Patrick Gallagher, Provost Ann Cudd and more. Linda Tashbook, a Pitt international law librarian and head of the Senate’s mental health task force, moderated the discussion. 

The University Senate has made addressing mental health in academia a priority this year. The plenary was originally planned for the spring 2020 semester, but the pandemic forced it to be postponed. A Zoom session was held in the spring, but the discussion with Jamison was rescheduled.

During the discussion, experts asked Jamison for advice for faculty, staff and students navigating academia while coping with mental illness and struggling with disclosing mental illness to their employers. 

In her opening comments, Jamison said mental health is even more important because of the pandemic. 

“It’s always been important and always underserved, underfunded, unappreciated for the amount of devastation and death and illness that it causes,” Jamison said.

What’s especially difficult about mental illness, Jamison said, is that “nobody prepares you” for it. “It’s just so devastating not to know the ground rules,” she said. “You don’t get lessons when you’re 10 years old about what to do when you go mad.”

Tashbook asked Jamison to describe the ideal work environment for faculty and staff struggling with mental illness that would allow them to perform to the best of their abilities.

Jamison said she wasn’t entirely sure what an ideal work environment would look like, but she said she would start by examining how open people are and can be about their mental illnesses. 

She added that there’s an assumption that it’s a good idea for people to be open with their struggles, but she’s not convinced.

“I think sometimes it is, sometimes it isn’t,” Jamison said. “It kind of falls along the lines of people asking whether they should be honest applying to medical school or residency programs. 

“I mean, you’d like to think the world was full of really understanding people. But when you’ve got 200 people applying for one spot, it’s very easy to choose someone else, which is easier. It’s easier legally. It’s easier psychologically. It’s easier stress on the system,” Jamison said.

There are things that faculty and staff can do, but there needs to be a discussion about how decisions in schools and departments are made and what the consequences are for being open, “because the consequences aren’t obvious. There is a certain amount of cruelty and misunderstanding,” she added.

Jamison said she wasn’t trying to be nihilistic and that there are solutions to these problems. However, she’s “struck by the fact people don’t get together nearly as much as they could in terms of people who are in leadership positions and trying to work on these things with people who actually have these illnesses.”

For example, she suggested giving people more access to light, which can help people cope with mood disorders, and making it easier for people to have meaningful access to treatment. 

Jacobson then asked Jamison for her advice for employees who are thinking of self-disclosing their illnesses and seeking help for their struggles.

Jamison said that when she speaks to students who tell her of their experiences, she always makes sure to tell them upfront that this can be very difficult. It’s important to acknowledge that, she said.

“It’s hard. Just start from there,” Jamison said. She added that disclosure may have different consequences for different departments. It’s important for people to be careful who they choose to disclose to.

“If you’re thinking about disclosing, you really need to talk to a lot of people that you know and whose judgment you trust,” Jamison said.

Darr later asked Jamison about her thoughts on the intersectionality of identity and disclosure for clinicians and faculty of color. 

She recalled how David Satcher, former surgeon general of the United States and the first Black man to hold that position, was the first surgeon general to publish programs and reports on mental illness. 

He was stunned by how prevalent mental illness was in all groups of people, but particularly people of color who couldn’t or wouldn’t talk about their struggles.

To address this, he reached out to churches because he was concerned they were interpreting mental illness as a matter of “not praying hard enough,” among other beliefs.

Citing Satcher’s efforts in addressing mental health, Jamison said it helps to utilize churches and places of worship to mitigate stigmatization and help spread helpful information on mental health.

John Rozel, an associate professor of psychiatry in the Department of Psychiatry, asked Jamison for her advice on self-care for faculty struggling with issues related to the pandemic and social issues.

Jamison said it helps if people have and create their own “islands” filled with things they love, such as music, literature, friends and family.

“You’ve got to do it yourself. And you can get a huge amount of support from other people,” she said. “There is sometimes a tendency to focus too much on burnout and not enough on, ‘What can I do to make a difference in my own life and pull water through the gills?’ ”

Another person asked Jamison what kept her going through some of her more serious struggles with mental illness. She recalled a “kind of period of utter stupidity” in her life when she stopped taking her medications and went back on them. During this time, she nearly died from a suicide attempt and was comatose for several days.

“It’s not like I just sort of sailed through it. I didn’t,” Jamison said. “And I think that is so hard in the early years to try and deal with these things.”

She used this example to further emphasize the value of effective mental health treatment. Psychotherapy can be extremely valuable for treating people dealing with psychotic illnesses, not just for people with more moderate illnesses, she said.

And with time, things get easier.

“It does get easier. There’s no question,” she said. “And I know this treatment will get easier. But I think you get slightly more philosophical about what’s going on. I think everybody has to kind of work out their own path.”

Donovan Harrell is a writer for the University Times. Reach him at dharrell@pitt.edu or 412-383-9905.


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