This article first appeared on The Progressive.
It was April 7 when my mother died.
One moment we were out to dinner, laughing and planning the summer, when she suddenly started breathing hard. She’d suffered chronic respiratory problems—COPD—for the last five years. She collapsed. I wrapped my arms around her, as her body convulsed. Paramedics arrived. They intubated her. We rushed to the hospital, following the ambulance.
“Do you think she’ll be OK?” my son Mark asked.
I hesitated. Hope gave way to reality.
“I don’t think so,” I said.
Within five minutes of our arrival, she was dead. I held my son in my arms as we both cried.
My mother, Patricia McKissack, was a celebrated writer of children’s books. A career that began with hope culminated with a mountain of accolades and success beyond her imagination. Our family was proud and touched by the tributes we received by mail, email, and phone calls from people who considered her a mentor and inspiration. She was humble and giving, and shared her time and wealth with her community.
In our talks over the last few years, I knew she didn’t fear death. However, she was terrified about living through an increasingly painful existence, watching herself deteriorate physically and losing her sharpness.
Depression was there. She felt alone. It didn’t make sense. She could pick up the phone and a slew of friends would be at her side. A host of people and institutions all over the country wanted her to come visit.
She was lonely for her husband—her best friend and writing partner—who died in 2013 just a few months shy of their fiftieth anniversary. Losing physical independence only exacerbated her distress.
A writer’s worst nightmare is not being able to write. Losing the love of her life, the muse who pushed her to reach beyond dreaming, had the effect of water dousing a fire. We knew embers burned, but we couldn’t figure out how to help fan the flame.
For years, we’d suggested she seek counseling, and even though she agreed, she was reluctant to do so.
The second time I cried about my mother was six days later. A woman stood in the doorway and asked if she could see my mother. I assumed she was a visiting nurse, and we had forgotten to cancel appointments. The woman’s color quickly drained from her face when I gave her the news.
“I’m a counselor,” she said. “We had an appointment to meet.”
I cried because I saw my mother’s strength in a moment beyond her corporeal life. She knew she had a problem, and she wanted to sort through it.
She just didn’t get the chance.
I don’t know if my mother’s life would’ve been extended if she had sought a therapist earlier. I do know that her struggle with depression after my father died had deprived her of her drive.
As her child, and as a fellow writer, I could only provide an ear, some encouragement, and my unquestioning love. We all—sons and daughters-in-laws—did this over the phone and, privately, in her home. It was good, but not good enough because behavioral modification is what she needed and what a professional could provide..
My mother was fortunate in that she had the financial means and familial support to seek help. This isn’t generally the case.
According to the American Psychological Association, older Americans underutilize mental health services for a variety of reasons, including:
- Inadequate insurance coverage
- A shortage of trained geriatric mental health providers
- Lack of coordination among primary care, mental health and aging service providers
- Stigma surrounding mental health and its treatment; denial of problems; and access barriers such as transportation.
Mental health continues to be an overlooked problem in the health care debate. It involves not just older Americans, but children impacted by trauma, soldiers and first responders under stress, as well as behavioral intervention for addiction and lifestyle change.
There is a stigma attached to getting mental health care, with the potential for social shame, career humiliation. In my mother’s case, like many, accepting that she had a problem was tied to feeling she had lost self-control.
Yet my mother needed that care. And the fact that she saw that she needed it, even if it came too late, touched me. The fact that she could care for herself was an extension of her capacity to care for me, and for the other people she loved. We need more of that in this mean and scary time.
Medicaid is on the chopping block, which could severely curtail support for the public mental health system.
The Republicans’ “skinny” budget also gouges $356 million from the National Institute of Mental Health, and over $400 million from the Substance Abuse and Mental Health Services Administration.
“The President’s Budget request is the single biggest threat to Medicaid and mental health care in decades,” said Mary Giliberti, CEO of National Alliance on Mental Illness. “Mental health care is an issue with strong bipartisan support, so we’re shocked that the President’s Budget would ravage Medicaid, the cornerstone of our public mental health system. This will devastate mental health services, especially for children and adults with the most severe mental illnesses.”
Over the last few years, but particularly since the election, I’ve grown tired of a particular kind of moral flexibility that ties Christianity, our national foundational principles, and rational egoism, a noxious theory that elevates self-interest over everything.
It disgusted her to see the desires of the privileged overwhelm the needs of the powerless. Her humane vision influenced me, and a whole lot of our nation’s children. May they carry it forward into a brighter day.
Fred McKissack is a former editor at The Progressive, and a communications fellow at the Center for Community Change. He lives in Fort Wayne, Indiana.