LIMA — The pain comes, and Charlene Adler begins to cry as she’s reminded of the role she played in her own story.
After eight years of being clean, a cigarette passed around at a party this past week threatened to put her back where she began — before she found the help she needed, before her daughter helped focus her life, before the suicide attempts.
Her eyes redden, and she shifts uncomfortably in her seat sniffling to hold back a history. Thanks to the tears, hormones that relieve stress are sent out to combat cortisol, and those around her pepper her with kind words to help her take the edge off her past.
For those in the room, the moment was brief. For Adler, she had faced the scars of an almost decades-long battle, unseen, and often unheard.
Because mental illness tends to be an invisible problem, it’s not often seen as the root of many individual and societal problems. But for many Ohioans including Adler, it’s a very real phenomenon of a brain suffering from chemical imbalances , which often leads to very real and very destructive behavior.
And the larger societal solutions — at least in today’s current climate — are just starting to gain traction.
Prior to Ohio’s Medicaid expansion in 2013, Allen, Auglaize and Hardin counties could pat themselves on the back when it came to mental health. Those who sought help could find it.
But when mental health care became more accessible, Mental Health & Recovery Services Board of Allen, Auglaize and Hardin Executive Director Tammie Colon said something shifted. Because more and more people could access health care, they recognized that there was an entire population that had forgone mental health solutions because they couldn’t afford it.
“With the increase of Medicaid to lower-income people, there was a demand pool that was greater than what we had ever seen,” Colon said.
The board still isn’t sure exactly how many people need help because of under-reporting of statistics.
Take the example of suicide statistics. The Centers for Disease Control tracks suicides using primarily hospital reports, and it publishes the information for all states and counties up to 2017. But in order to protect individuals who may have committed suicide, the suicide rate for any given area, measured in number of suicides per 100,000 people, isn’t available if a reported incident can be tracked back down to an individual.
In other words, there’s not always a way to track suicides per year or per subgroup unless there’s a large enough population, which makes tracking geographic and demographic trends more difficult. But the numbers do show at least a part of the picture.
Over time, the number of suicides are up across the board, and life expectancy in the nation has started to drop. An extensive study published in the Journal of the American Medical Association at the end of November estimates life expectancy to have stalled at 78.9 years and began dropping post-2014 . Experts point the finger at the opioid epidemic and suicide rates, or what they call “deaths of despair,” as the reasons behind the decrease.
With such trends, mental health officials are watching the number of those struggling through mental illness increase, and officials are recognizing that there needs to be something done — especially among men, young adults and teenagers whose suicide rates are trending higher faster — in order to counteract the need.
“We’re failing to find the people who are hurting, and that’s because of the stigma that exists in the community. We’re trying to find them, but we’re not finding them,” Colon said.
Tucked away in the old YMCA annex under a few meandering hallways, Community Outreach Liaison Maha Zehery gives a tour of Changing Seasons while handing out insights into how the place functions. Most who use the shelter stay in the main room equipped with an Ohio State-themed hangout space, but doors that seem to lead nowhere reveal a much more extensive network of social support.
In one room, showers and laundry are available. In another, clean clothes are set up in a thrift store-like setting. During the tour, one man asks if he could make a purchase when technically the store was “closed” because of an upcoming doctor’s appointment. Zehery paused the tour to ensure someone took care of the need.
In one day, roughly 60 people will come in and out at Changing Seasons, which provides some form of stability for the men. Mental health professionals are also made available for those who drop by, and many use the support systems there as they seek out a place to stay for the afternoon.
Floyd Russell knows their routine well. As one of the caretakers at the Lima Rescue Mission just a few blocks away, he watches many of the same men at the mission find their way to Changing Seasons throughout the day, and he’ll make his way across downtown to help out Changing Seasons staff when asked.
“These are what I call my kind of people,” the 68-year-old Russell said. “They’re broken.”
Russell’s own story involves addiction, and he knows what being “broken” is like. He’s had to cope with the trauma of watching his father stab his mother and other family tragedies when he was a child, and alcohol became his coping mechanism to deal with the anger. He didn’t like to drink, but that’s just how his family dealt with problems, Russell said.
“I come from a family of alcoholics. During holidays, that’s what we’d do. They’d put their money together, and they got drunk,” Russell said.
Today, he’s sober, and he wears a tie daily to add some professionalism to his routine, but there are still some lingering after-effects from earlier struggles.
As a grandfather today, he’s worried about the next generations falling into the same cycle. Because he never celebrated a birthday, he makes sure his children and grandchildren celebrate, and they get whatever they need whenever they ask. One of his three daughters, however, sits in jail, and like any parent, he worries about how she got there.
When those negative thoughts come, he doesn’t pick up the bottle anymore though. He picks up a phone.
“Whenever something goes wrong, I want to take a drink, but now I have people to call,” Russell said. “I never liked drinking. I drank because I was angry. I ain’t angry no more. I got Maha.”
Zehery added, “People always ask me: ‘What do your clients look like?’ I say: ‘They look like you and me. They don’t have a third eye.”
Sometimes, Russell hears the men at the mission and shelters cursing angrily about their problems or how they were mistreated. He can empathize well enough, but at 68, he doesn’t have much reason to be angry, he said, especially when he has food, family, shelter and God’s support.
Addiction and stigma
Many of the others working at Changing Seasons have stories similar to Russell’s. A past trauma will often lead to addiction, which creates larger problems.
In Tammy Gould’s case, she didn’t know that pain pills could be addictive. An abnormal psychology class had sparked some repressed memories of sexual abuse. Soon, she couldn’t sleep. Migraines had become standard procedure, so she asked for some help from her doctor, who prescribed pain pills.
She later became addicted.
Years later and clean, she still has to live with the past trauma, but now, the past addiction has been added to the daily struggle.
“(The anxiety) smacks you in the back of the head,” Gould said.
Coping mechanisms help in some respect. When paranoia and anxiety come up, she can better recognize such thoughts and reach out accordingly. A support team provides a listening ear and some advice.
It took her a few months to take all the advice to heart. Before taking medication to deal with her anxiety, she had to move past the idea that it was somehow detrimental. The stigmatization of mental health care had her convinced that she didn’t need any help from pharmaceuticals.
“I was dead set against it. It took months of talking, months, from those who supported me,” Gould said. “I didn’t know anything about mental health. To me, it was seeing things on walls.”
National Alliance on Mental Illness Ohio Executive Director Terry Russell said stubborn attitudes against medication stem from many not recognizing that mental health is a substitute term for physical health related to the brain.
“It’s no different than any other illness,” Russell said. “We’ve treated these people as outcasts, and they’re just suffering from psychological brain disorders.”
It took Adler a suicide attempt before she recognized her need. A close friend broke down in front of her, and she made a change to move past the flashbacks of rape that plagued her nightmares.
“It’s a heaven pill for me. I don’t think I would ever sleep,” Adler said.
For Annie Edwards, a three-day self-imposed stint in solitary confinement convinced her to start healing her past traumas.
“Multiple times over the years, I had medicine, and I didn’t want to take it. A lot of times, I thought I didn’t need it,” Edwards said.
Edwards ended up on the wrong end of her short fuse while serving time more than four years ago. In a packed cell, she felt on edge as if she needed to get away from the group, and the only place available was in solitary.
In three days of solitary confinement, her brain played loops of past physical and sexual abuse until it was more than enough to recognize that the alcohol, anger and violence she had relied upon suffer through past experiences wasn’t enough.
“I fought (medication) for so long.” Gould said. “I would have started a year before I started. My life has changed 100%.”
New dollars and new solutions
Despite centuries-old stigmatization, Russell said there have been some positive signs of change in the mental health field. As suicide becomes more prevalent among the youth, Russell said younger people have lessened the stigma often associated with mental health. Student groups such as the “Gatekeepers” in Wapakoneta and Ada have set up to create positive environments in schools, and there’s been a wider willingness to talk about mental health and suicide.
On the state level, Russell also spoke positively about Ohio’s latest budget, which sees a major $675 million allocation to support services for public school students.
“The funding that (Gov. Mike DeWine) is providing to local communities will help save millions of taxpayer dollars and untold amounts of pain and suffering by people with mental illness,” Russell said in a NAMI press release.
As for those at Changing Seasons, they’ll keep doing what they have been doing — pushing forward.
“To me, (alcohol) is a way of escaping,” Edwards said. “Of course, the problems are still there when you’re done.
“You got to play the loop from the beginning.”
Reach Josh Ellerbrock at 567-242-0398.