Quiet Tragedies 

A roundtable discussion of mental illness

The major mental illnesses - schizophrenia, severe depression and bipolar disorder - used to be considered emotional disturbances, attributed to things like bad mothering or stress. But we now know that these conditions are biochemical illnesses affecting millions of people. With that knowledge have come better treatment methods, from more effective drugs to more comprehensive community-care programs. Still, thousands of people with mental illness are homeless, existing outside the mental-health system. Countless others represent the "quiet tragedies," as National Alliance for the Mentally Ill board member Carla Jacobs puts it, living isolated lives with little hope in their family homes, or in board-and-care facilities.

We called together some of the county's most impassioned voices to discuss the situation in Los Angeles. Roundtable participants included: Christopher Amenson of Pacific Clinics Institute; Peter Chen, chief of Community Care Programs for the Los Angeles County Department of Mental Health; Susan Dempsay, founder and until recently director of Step Up On Second, a drop-in center for people with mental illness; Carla Jacobs, member of the board of directors of the National Alliance for the Mentally Ill; and Mark Ragins, psychiatrist at the Village Integrated Services Agency.

Related Stories

  • Yunnan Cuisine 10

    Despite the obvious wealth of Chinese food in the San Gabriel Valley, it’s always worth it to take a moment to appreciate what is truly an incredible landmark in the world’s culinary sphere. There is, maybe, one other area outside of China that serves Chinese food as wonderfully diverse and...
  • China's Hip-Hop Godfather

    Not long ago, I found myself in Western China, and met some dancers who talked with great reverence about a man named Stanly. They made him sound like a legendary figure; the "godfather" of Chinese hip-hop, some called him. "You don't go to Shanghai without seeing Stanly," said Pracat, a breakdancer...
  • Shen Yun Celebrates Chinese Dance. But It Also Has a Political Edge

    You've probably seen the billboards. Perhaps you've been handed flyers by volunteers on Hollywood Boulevard. Or you're a small business owner in San Gabriel Valley who has been asked to display a poster. These images showing beautiful, leaping women in classical Chinese dress are advertising this year's rendition of Shen...
  • Old House, New Money 7

    Built in Pasadena in 1915, the stately Tudor mansion had been the setting for debutante teas, and even hosted a bridal garden party for Herbert Hoover's granddaughter. In its heyday, it was owned by newspaper scion (and staunch anti-Communist) Philip Chandler, who welcomed to his home the founder of the...
  • L.A.'s Culture War Over America's Last True Skid Row 36

    "Yo!" A black man in a filthy, yellow, collared shirt lies sprawled out in the middle of the Sixth Street sidewalk, out cold. No more than four inches from his face is a Business Improvement District officer, who shouts again: "Yo!" "Is he breathing?" asks a woman passing by, worried...

WEEKLY: I suppose any discussion of mental illness and its impact on society needs to begin with a discussion of what severe mental illness is.

CHRISTOPHER AMENSON: We don't properly differentiate between mental-health problems and mental illness. Mental illnesses, things like schizophrenia and bipolar disorder, are neurobiological illnesses. With physical problems we make the distinction better. Most severe physical illnesses are not called the same thing as the day-to-day experiences. Severe headaches are not called headache syndrome, but rather a brain tumor. But very severe biological depression has the same name we give to a mild case of the blues. So people get confused and think that the true mental illnesses are similar to everyday mental-health problems. But they're not, just as a sore leg is not the same as a broken leg.

MARK RAGINS: I only partially agree, actually. I work in a place where a lot of people have become seriously disabled or are homeless, and although I do see a number of people with biochemical disorders, with many of the people I meet it's less clear what's going on, less clear that it's a brain disorder. I meet the person who was that weird-looking kid in third grade who used to go in his pants and hit the girls. He has now grown up to be a homeless person. Society is saying, "You're a medical specialist, and that's not a medical disorder. He's got some sort of personality or social problem, so don't deal with him." Or if I meet someone whose mother was murdered by his father when he was 3 and he ran away and was homeless and using drugs by 9, I can argue that his problem really isn't a mental illness, that it's a mental-health issue and so he shouldn't be in the public system. But he's still homeless, still suffering. I think a lot of the people that we should be helping do not actually have biochemical disorders, or have other issues on top of their biochemical disorders.

CARLA JACOBS: Mental-health issues are social problems, but severe and persistent mental illness, such as schizophrenia or bipolar disorder, is a physical brain disease. And we have to accept that and start from that point before we can prevent the profound chronicity that occurs from spending your life in the streets eating out of dumpsters, being in jail, being scorned by society. And so while I understand exactly what Mark is saying, that there are all sorts of people that can be helped by mental-health treatments, severe and persistent mental illness starts as a neurobiological condition.

SUSAN DEMPSAY: I think so much of what we are discussing stems from the stigma attached to mental illness. In my retirement, I have started to volunteer at UCLA's Neuropsychiatric Institute, because I want to get involved at the time of the first break, at the time an 18- or 19-year-old is in the hospital for the first time suffering from delusions and hallucinations. The family is usually very confused about what's happening, and they've maybe put off hospitalizing the person for longer than they should have, because they didn't want to admit there was a problem. It's a time at which a lot of professionals hesitate to talk about a diagnosis, because they don't want to stigmatize the person. I think we have to get to the point where we say openly and early, "I think we're dealing with schizophrenia here." Only when we're honest and forthright and talk about symptoms and talk about treatment and medications - which can make an incredible difference - will the individual and the family get the kind of early help they need. Statistics show that only 50 percent of the people who should be in treatment for schizophrenia are in treatment. It's stigmatization, I think, that's behind that.

Related Content

Now Trending

Los Angeles Concert Tickets


  • Comic-Con's "Celebrity" Autograph Area
    A sometimes overlooked (but still incredibly unique) aspect of San Diego Comic-Con are the celebs available to sign autographs, as well as the autograph seekers themselves. If you've ever wanted to meet the Soup Nazi from Seinfeld or the guy who played Michelangelo in the original Teenage Mutant Ninja Turtles, chances are, as you wander the Autograph Area, you'll be able to connect with someone you didn't even realize you were waiting your whole life to meet! All photos by Rob Inderrieden.
  • Real Madrid Soccer Practice at UCLA
    Fans came out to greet world champion soccer team Real Madrid as they practice at UCLA. This is the first time that soccer star Cristiano Ronaldo has practiced with the team this year. All photos by Jeff Cowan.
  • Here's What Happens When President Obama Comes to L.A.
    President Obama came to town again to rake in some funds and clog some traffic. The only view of his visit you probably saw were the brake lights of the car ahead of you in the traffic jam he caused, but here's what was really going on. All photos by Ted Soqui.