One City’s Pragmatic Pushback Against Mental Illness

It's about breaking down the stigma and encouraging people living in despair to get help.
October 2, 2018
Downtown Fishers, Ind.
Downtown Fishers, Ind. (FlickrCC/Jim Grey)
By Scott Fadness  |  Contributor
Mayor of Fishers, Ind.

According to the World Health Organization, one in four people worldwide will be affected by mental or neurological disorders at some point in their lives. Mental illness does not discriminate. It's not relegated to the inner city. It doesn't favor people of a certain age. It transcends demographic and socio-economic lines. And too often, mental illness manifests itself in suicide: It's the 10th leading cause of death in the United States, just behind influenza, pneumonia and kidney disease. And, as the American Foundation for Suicide Prevention reports, for every suicide there are 25 attempts.

Vast amounts of money have been poured into research into the prevention and treatment of influenza, kidney disease and the other illnesses that make up that top-10 list. But while mental illness is slowly crawling to the forefront of public consciousness, there is nowhere near the level of financial and community support for people struggling with it.

The scope of the issue didn't hit home in our safe, suburban community -- we top Money magazine's list of best places to live in the United States -- until 2014, when we began looking at some troubling numbers in a systematic way. Fishers, Ind., has a population of nearly 92,000. In the last 20 years, we have had only three murders, but in the last three years alone 31 of our residents have died by suicide. Another three to four times as many have attempted suicide but were rescued by first responders. To further exacerbate our risk, Fishers matches nearly every indicator for communities that have experienced a school shooting.

Sensible regulations for gun ownership could reduce the number of suicides and suicide attempts as well as the risk of school shootings, but uncompromising ideologies on both sides mean that issue won't be settled anytime soon. And waiting is not an option: People are struggling, hurting and dying as communities grapple with what to do. So we asked ourselves a simple question: if we were to marshal our collective resources toward the issue of mental illness, what could we do and what should we do? The answer, and the effort over the last three years, has been substantive and systemic.

The city, our school district, clinicians, religious leaders and public-safety officials have accomplished 97 percent of the tactical objectives that we set out to accomplish. In one school year, the number of students who received mental health services increased more than 1,000 percent. Our public-safety officials report that immediate detentions of those at risk of hurting themselves or others have decreased by more than 30 percent since 2015. We are working diligently to change the culture and stigma around mental illness. We are committed to creating a community that encourages those living in quiet despair to get the help that they need.

We've learned a lot on our three-year journey. If you have a desire to address mental health in your own community, here are some pragmatic, actionable steps to help you get started:

Inventory your community relationships and leverage them: Key stakeholders may include your schools, religious leaders, policy makers, police and fire personnel, and social-service providers. Identify those you have strong relationships with and bring them to the table early. You will need them.

Understand the problem: Do not be afraid to take a considerable amount of time -- we took a year -- to truly understand the complexities and challenges of mental health in your community before rolling out a program to address it.

Become competent in response: Do a thorough assessment of your public-safety tactical responses to those in crisis and fill the gaps. For us, this meant combing through historic data to ensure we were properly addressing sensitive circumstances around mental health crisis situations.

Talk about it: The conversation about mental illness must be brought into the light, and it needs to be community-wide. Focus on bringing down the stigma.

Be substantive and systemic: This is an issue with life-and-death consequences. Understand that you will not make substantial progress on it overnight. Be committed to seeing it through even though the impact may not come to fruition immediately.

Engage with students: We've found that building up our students and giving them a voice in our fight for mental health not only has made an impact on reducing the stigma in our youngest generations, but also has motivated parents and other adults to begin learning more about mental illness, further breaking down the stigma.

This pragmatic approach is well documented, and I encourage anyone to review the Fishers Mental Health Task Force website as a resource. As with any initiative to bring about systemic change, patience and persistence is required. Your goals will likely take several years to accomplish and you must commit to continue striving toward them. Victory will never be complete, but there will always be progress to be made.