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By: Paul Gionfiddo, president and CEO, Mental Health America

We don’t usually use this blog to review books. A Mother’s Reckoning
was for me — as it will be for many people — a difficult book to read. It speaks to an incredibly raw and relevant
topic.

A Mother’s Reckoning was written by Sue Klebold. Sue’s son Dylan died by suicide in 1999, and she writes of
her pain in his passing.

But Sue’s pain is different and more intense than most. This is because before he died by suicide, Dylan and his
friend Eric Harris massacred twelve students and one teacher at Columbine High School, injured twenty-four others, and
changed our world.

It may be hard to believe that many parents will relate to her story.

Like Sue in the days leading up to the horrible tragedy, even when faced with clear indications that a child is
beginning to struggle, they have no understanding of how to process that information, no language to use to describe
it, and no place to turn for support, and no idea what to do next.

Sue makes no excuses, but she acknowledges that she did not know the warning signs or clues that pointed to Dylan's
depression. Even if she had, she would not have seen them in Dylan. Up until the day he died, she believed her son was
typical, she knew him well, and her relationship with him was open and honest.

Dylan successfully hid his depression from her. He also hid much of his life from her. He hid his plans for the
massacre and the toxicity of his relationship with Eric.

The consequences of Dylan’s secrecy were tragic for an entire nation.

But every day, there are smaller tragedies that parents face when their children are not mentally healthy. These
tragedies are captured not in the headlines, but in the young people who are homeless in our streets, those who
languish in our jails, or those whose deaths are noticed only in the slight and steady uptick in the nation’s suicide
rate. And then there are those who survive violence like that at Columbine or Newtown — children and adults
who for years to come may face a multitude of physical and mental health challenges. Long after the headlines fade and
the reporters go home, they still need our help.

In our MHA screening program, one-third of screeners
are between the ages of 11 and 17 - because perhaps they don't have access to depression, anxiety, and other screening
tools elsewhere. Like all age groups, two-thirds screen as positive for the condition for which they screen.
Two-thirds of those tell us they have never been diagnosed or treated for the problem or condition. And a third say
they plan to do nothing after getting their results.

The truth is that most depression will not result in death, and most bad relationships will do no lasting harm. But
Dylan’s depression did progress to Stage 4, and the harm that resulted takes one’s breath away.

So how can we prevent this?

I’m not saying we could have prevented the tragedy at Columbine. But we can and should identify mental health
concerns early. We should intervene aggressively to mitigate and address them. And we should never forget how many
lives were taken and ruined in Columbine and elsewhere because as a matter of public policy we do not do these
things.

There are people who believe that today’s status quo is acceptable. They are afraid that if we change it, it will
certainly make things worse. I think they are wrong about this. Yes, some people will point to the unspeakable harm
caused by Dylan and argue that this is why we need to reform our mental health system. They will see only the
connection between his mental illness and the violence he perpetrated.

But if we really listen to the message of A Mother’s Reckoning, I think we’ll come to a different
conclusion.

B4Stage4 means more…

Acting Before Stage 4 means more than acting after a crisis has occurred, more than trying to pick up the pieces of
broken lives, more than wishing we could go back and change one tragic day.

Acting Before Stage 4 means bringing mental health concerns into the light of day, treating not just “serious” mental
illnesses but treating all mental illnesses seriously, and making health and recovery our daily goals.

This is the essence of MHA's B4Stage4 program and philosophy – a program Sue Klebold supports.

If we listen to her voice and try to learn from what she has experienced, our pathways to mental health may be
clearer. We will hopefully be less quick to judge, but quicker to act – in response to depression, to the suicidal
thinking that can accompany it, and to the rage we sometimes don’t see in young people when we are distracted by the
many other challenges in our lives.

We will understand that we are all part of the bigger story, and that we must all do what we can to help all of our
children, including those who need our help the most.

Mary Ellen Nudd (not verified)

Tue, 02/16/2016 - 11:40

If you, or a person you know, is in crisis you can call the national suicide prevention Lifeline, 800-273-8255.

Medical Physic… (not verified)

Tue, 02/16/2016 - 11:53

It is incompetent. it is seen as incompetent by the people who need it to be competent.They have no respect for the way practioners approach people. How do youth come to that attitude? It is from a general attitude of everyone. They know insurance companies don't respect it. They know politicians don't respect it. They discern that parents don't respect it. When sickened by Depression, people are confronted by practioners, by and large, act as if they have some rarified skill no one else can comprehend. It sends a stigma signal like a bomb.

The entire attitude about how to come alongside mentally ill people and especially Depressed people is off. To take a stab at what to change? Try this: No one should be allowed to get a license in Mental Health until they pass an intense customer service training.

Beyond that, restudy the nature of Depression, know what it like from their aspect. It is not what most practitioners think it is. If after the public knows such a change has been wrought, the Mental Health profession has to EARN respect.

Todd L., LCSW (not verified)

Wed, 03/02/2016 - 15:22

I have always thought that the best defense is a good offense. This means that the sooner you can implement any kind of evidenced-based intervention the better. Also it is a good idea to establish protective factors as a safety net fall-back! Thanks for the post!