Hiding in Plain Sight: Youth Mental Illness

[Wind whistling] Man: My wife found us a psychiatrist who was willing to take us.

The doctor--he meant this in a kind way--he said, "Look, I'm gonna be real with you.

"Your son has an incurable disease.

"He will never get better.

"He will have to take medications "that will make him gain 30, 40, 50 pounds.

"He will be suspect to diabetes.

"It's unlikely that he will ever be able to hold a job, "he'll ever marry, have kids, "and there's a high chance that he may have "an encounter with police and be arrested.

"May become homeless.

These are serious things.

"And, oh, by the way, people die 15 years earlier who have mental illness than the rest of us."

And I remember being devastated, and we left and I was talking to Kevin, and when I mentioned those things to him, he goes, "Dad, that guy's crazy."

It's a strange thing to look back on and think to myself, I really didn't care about anything at that point, not caring if I wake up.

That moment that nothing else mattered to me, that I just threw myself in front of a moving car?

I felt nothing.

I actually was, like, really scared.

And I went downstairs crying and I told my mom what I did, and then she brought me to the hospital.

Woman: I still had a whole future that I had planned.

I was planning this suicide but at the same time, you know, I was making plans to, like, go out to the movies with my friends the next week.

Boy: I asked my parents, "What would happen if I wasn't here?"

And I think that got them pretty worried.

My mom having an addiction herself, I hated her even though I was emulating her behavior at the same time.

Vinson: Rock bottom looks different for different people.

It's being able to identify that time or that instant where what mattered most to them felt the most threatened.

For some people, that may be their relationships with their parents, it may be their grades, it may be their sports identity, it may be their life.

Some people end up staying at that bottom for a really long time, and some people never get past it.

Woman on video: Mental health is an issue.

It concerns all of us.

Man on video: One in 6 young people experience a mental health... Woman: ...million U.S. adults experience mental illness in... Man on video: ...disorders are still common.

Second man on video: ...of Americans think there's a lot of stigma against people.... Third man on video: Suicide rate for adolescents ages 10 to 14 has nearly tripled in the last decade.

Woman: I really want to live, and I'm trying to make the effort and I want to have a good life, maybe one, two kids, not the white picket fence but something that's livable-- not this--but I want it.

And I just want normal and mundane and average.

Maybe a trip to Myrtle Beach every summer.

You know, I don't care.

I just, I'm sick of crazy, chaotic, up and down...mess.

Narrator: A mental health crisis can arrive without warning or develop over time.

It may be triggered by nurture or nature, through lived experience or genetics, or both.

It often occurs before the age of 25, and it can happen to anyone: a young woman who self-medicates and engages in reckless behavior; a teenager, who, despite her happy childhood, surrenders to addiction; a Native American who feels so isolated she contemplates suicide; a college art student who slips into delusional episodes; a high school freshman whose childhood hallucinations intensify after a series of assaults; a boy who is plagued by intrusive thoughts withdraws into his own world; a transgender teen who goes through periods of profound joylessness and substance abuse; and a healthy, everyday kid who suddenly experiences what his friends call "an emotional heart attack."

Pete: And then the reality hits, and it's your kid.

It's your kid who's hearing voices.

And it's your kid who's screaming and it's your kid who's crying and [clears throat] all of a sudden you are in a position where you have to deal with it, and it's like the difference between, you know, watching a war movie or a Vietnam movie and being in the jungle having someone shoot at you.

Narrator: Every year, millions of kids drop out of school, experience homelessness, or find themselves in jail because they didn't get the help they needed.

Help is available-- from a parent, family doctor, school counselor, or even a trusted friend.

For many who have suffered silently, simply reaching out may be the most intimidating step of all.

[Thunder] But the relief can be as indescribable as the pain once was.

Justin: It's like a perfect storm.

It's this powerful, you know, hurricane.

It gets intense.

It gets intense.

But you know, after that storm passes are some of the most beautiful sunny days you've ever seen.

You hear the first birds start chirping, and you look and the sun cracks through the clouds.

Everybody kind of just creeps out of their houses, see how everything's going.

"You got power?"

"You hungry?"

I see the silver lining in that and it's a beautiful thing.

Yanerry: It was one year I was depressed, and it became two and then it became 3 and eventually 7.

I kind of felt like God was punishing me, but after a while, I kind of realized this is just something that not only I have, but other people have it, you know?

While some people may look at it as crazy, it's crazy to you but it's normal to me.

I'm not crazy.

Boy: I came to live here, like, two or one and a half.

I don't remember anything from the past of that, but, um... let me...um...

I cannot think right now.

Woman on video: Hey, Gabe.

Woman: Gabe and Sasha, uh, they had a pretty tough life, they really did.

Just, you know, how young it does actually start.

How in utero, the baby's even affected.

If there's a lot of, like, domestic violence and stuff the mother goes through, you know, how that affects the baby.

When I'm mad on the outside, I'm mad on the inside.

Teachers say, "What is wrong with you?"

and then I just start breaking down like, "I don't want to talk about it."

Darla on video: Tell Mom where you're going.

Darla: I was working with the children.

They had some developmental delays, and so, I had been introduced to the family and was working with Gabe, but had no idea that we would soon have them in foster care and eventually adopt the children.

When I got really mad, it was mostly-- mostly I used to scream and slam my door, make pictures fall off the wall.

Man: He would go into a rage that it was like an out-of-body experience for him.

Gabe: I--yeah, just throw stuff at 'em, hit 'em.

Darla: He hit other children a lot.

Sasha, you know.

Ray: I would physically have to hold him down.

And then he would come back out of the fog and he would be normal.

You think you can love it out of them.

That will fix it.

No, it doesn't.

Man: My thing as a father, I was like, I gotta fix it.

I mean, I gotta fix everything, because what's gonna happen if I don't fix it?

Dunning: Parents are doing the best they can, They just don't know how sometimes.

When parents bring a child to me, they will oftentimes say, "I want you to fix my kid."

I will say, "How do you know your child's broken?"

Woman: We had no idea what we were supposed to do.

We took him to the emergency room.

And it was terrible.

Even just uttering the words to the front desk people, like, you know, we're here with Maclayn and he's having thoughts of ending his life.

They take all of his clothes off and they put on this, um, onesie, so that they can't hurt themselves, um, and it was hours and hours.

Vinson: Most often, emergency rooms are not set up to deal with mental health problems.

But you have nowhere else to go.

You're trying to navigate a system that isn't quite a system, um, and that isn't funded or configured in a way that provides easy access for you to get your children the help that they need.

Maclayn: It was rough.

And awkward for me talking about that kind of stuff.

Joe: He just begged us, he wanted to go home.

Mary: Yeah.

Joe: At that time, being there in that environment just--just scared him to death.

We're scared to death.

Mary: Are they gonna take him over to the psychiatric center?

Are they gonna send us home?

If they take him there...what is that?

Joe: We can't stay.

Mary: We can't stay.

He's 9.

Joe: So, the on-call doctor that was coming in said to Maclayn, "If you have a plan of "hurting yourself at all, in any way, "we have to keep you to observe you just to make sure you don't."

And I think that's when it was like reality crashed on him, you know, that's when he turned into a 9-year-old.

He realized, "Oh, my gosh, I can't stay without my mom and dad."

Mary: So, we took him home and they told us, "Take away all the knives.

watch him very carefully."

And I don't think we slept for months.

Disturbed: ...down with the sickness Get up...down with the sickness Get up...down with the sickness Girl: I think that being left alone with thoughts right after a manic episode can be pretty detrimental.

Among all of the chaos that I was going through and all the different emotions that cycled through so quickly, I didn't want to accept that I didn't really have any control over it.

So, I'd end up blaming myself.

I felt really lost.

But when I accepted that, OK, I guess I am bipolar, this is OK, I had also realized I'm not alone in this.

There are people that are living for me and I have all of my friends and family that I'm living for... and I can make a difference in other people's lives.

Do I have your permission to read this?

Amethyst: So, yes, I do have a reason to fight.

"At the young age of 18, "I attempted to take my own life.

"I never felt that my problems were a priority, "so I never spoke up.

"Suffering in silence, I felt "I was running out of options "until one day something clicked, "that I would one day rise above "the ashes of my depression and fight it.

"And I am forever humbled, grateful, and blessed that I was able to overcome my demons."

[Cheering and applause] Vinson: So, at rock bottom, you have an epiphany.

You can course-correct and go into this completely different direction in your life.

For people who are able to make that turn, you have to have the understanding that there's a problem with what you're doing.

But the illness itself can make it hard for you to see it clearly.

There were a couple points where I would look at myself and think, "OK, I need to get better," but then I don't act on that trying to get better.

Like, I'd convince myself that I didn't have a mental illness, that I was just overthinking everything and being dumb.

It's like you're screaming for help, screaming for attention, but you can't say straight up, like, "I need help."

I was in denial for a good 5 years that I even had a mental illness.

It's like a "flat-earther" not wanting to believe that the world is round.

Pete: Insight means that you understand that you may have a mental illness or you're not thinking clearly.

It's hard to convince someone who has no insight that they have a mental illness.

And so, we have to step in.

Alexis: I didn't really have anyone to go to after my suicide attempt.

I tried talking about it, and my family did try, but my mom, she was so worried and scared and confused.

She was like, "What's wrong with you?

Why would you ever, like, want to do this?"

I was like, "I was gonna kill myself and you're asking me what the heck I'm doing?"

And that was really hard.

Yaadieah: Whenever I called my mom, she would just get worried.

I felt bad that I was worrying her so much.

I just didn't know what else to do.

My dad knew I was doing hard drugs.

Now my dad knew that I was cutting.

But I couldn't talk to my dad about it, because he was so busy and tired and didn't have time for me.

Morgan: When you feel like you can't even go to your friends or your parents, because, yeah, at that age, how are you ever gonna admit, "I'm thinking of suicide.

"I can't see past tomorrow.

I want to cut myself."

Like, how can you say that out loud and not feel like someone is gonna judge you or even put you away in [laughs] put you in that crazy container, you know?

It's the number-one reason, perhaps, why they don't come to see a therapist or to tell their parents or to tell their pediatricians or to tell anyone in their life.

Vinson: There's a way that you may feel about a situation being hopeless, as if something can never change.

But talking to somebody else, even though it may not fix all the problems that you're dealing with, can still give you an opportunity to have a different perspective that's not shaped by the illness that is impacting you.

Maybe if I had someone, you know, whose job it was to care and listen, maybe things would have turned out differently.

Davidson: One of the things that we do wrong, we wait for the blatant "Hi, I need help," as opposed to the subtle things that are actually asking for help.

Samantha: When I started getting really depressed, I just felt like I didn't feel good.

I didn't feel like me.

So, I wrote a note to my mom and I, like, signed it, you know, with my name and I just hid it under her pillow.

She handled it pretty well, but she didn't really know what to do, and you just don't know where to go from there.

Joe: For us as parents, you know, what do you do when you don't know what to do?

You Google it.

So, we started Googling all this stuff, which is-- which is horrible.

Mary: Terrible.

Man: We don't fully understand how to support this yet.

There were so many patterns where we thought we were helping.

And what we were doing was really taking away her power.

Every time I try and fix something for her, she doesn't have to fix it for herself.

Lydia: When I was taking the pills, afterwards, I definitely felt a lot of shame.

It comes to a point where it is definitely so clear that it's self-medication, but I couldn't admit that to myself.

So, I would just, like, lay in bed all day because I was so depressed and angry.

So angry.

Alexis: I think the biggest part is just acknowledging to yourself that "My emotions have been really, really hard to deal with lately."

And once you acknowledge that, then you start taking the steps that you need in order to, you know, feel better again.

Once I really started looking at myself and, like, looking at how excessively I was doing these things, it wasn't normal.

It's not like this, like-- it's not, like, cute to, like, be popping pills every day and, like, overdose this many times.

Makalynn: I was using to deal with the symptoms and the suicidal thoughts that were popping back up, and the drugs weren't helping anymore, so, um, I--I needed, I--I needed out but I didn't know how to stop.

Kennedy: What's great about hitting your bottom is that you come to the realization that that game doesn't work for you anymore, and if someone is there who also sees that, and who sticks with you... well, that's, uh, that's powerful, because you're no longer alone, you know that they know, and that's called intimacy.

Makalynn: I was 16.

My mom, she texted me.

Word for word, she said, "Makalynn, "I know something's wrong.

You just have to tell me so I can get you help."

And I texted her.

I said, "Mom, I'm getting high and I don't know what to do about it."

It takes a lot to get to that point.

4 or 5 years I was dealing with this, trying to treat it myself, trying to make sense of it myself.

Insel: The delay in getting help is staggering.

It turns out that the delay for depression, for bipolar illness, is in years.

It's not in weeks or months.

And the reason for that is often that people don't understand that care can be so effective-- that treatments work--and so, they try to struggle on their own.

Thompson: When people tell me they don't have a problem, I start off, just a smile.

I say, "I know.

We all been there.

I know."

Somehow, I gotta get a conversation started.

So, I talk about me.

Next thing you know, we're talking to each other together.

Now we start comparing and then pretty soon, "Yeah, I might have a problem, you know."

"Yeah, I might have one, too, you know.

We just have one together."

That's when we come in to work with them to let them know that they can be helped.

I kept telling my mother I wanted to see a therapist, and then it's finding a therapist, then it's finding a therapist that takes your insurance.

We were told that if we, um, went to the emergency room, that you would have a faster response time in seeing a psychiatrist.

Um, but it took us 4 months.

We were calling doctors, we were calling nurses, we were trying to find someone to tell us what to do.

You've got problems of access, the quality of care isn't what it should be, the cost is--is insurmountable.

I mean, there's just this whole range of--of difficulties.

Most of the people who will benefit from being in mental health care are not actually in the health care system that we have.

I don't think that would be true for cancer, heart disease, arthritis, or asthma.

Pete: Can you imagine if you had a heart attack and were told, "Well, we gotta wait until you're a little sicker"?

We do not have a system that identifies people's problems early on, nor do we make it easy for a person to get into a mental health care system.

Woman: He started asking questions.

Did I talk faster than usual?

Did I have any problems in concentrating?

Had I had any visions or heard sounds or voices that other people probably hadn't seen or heard?

I was on the receiving end of a very thorough psychiatric history and examination.

The questions were familiar.

I had asked them of others 100 times.

I now found it unnerving to have to answer them.

Dr. Kay Jamison.

Xavier: They gave me, like, this weird, like, testing.

I just had to answer questions, how I felt about things.

I got diagnosed with depression.

Ooh, yeah, funny.

Also, when they found out that I was hyperactive, that's kind of lame.

No, I'm not.

[Laughs] I say as I'm playin' around with this-- is this a flashlight?

The only way for anyone to know whether they have an illness is, are their abilities being compromised by that illness?

Yeah, for sure, anxiety played a role in--in my grades dropping.

Are they disabled in some way?

It physically pains me.

It feels so real.

Are they being kept from doing what they would like to do?

I would go to school and hate my life at school, and then I would leave school and, like, hate my life going home.

Are they doing things that they would not like to have done?

I felt bad because I was stealing my dad's medication, my friends' medication, like, I wasn't being a good friend.

Kennedy: These are questions that, frankly, people can often answer for themselves as easily as they could have a psychiatrist or doctor, uh, answer for them.

Vinson: You come to a diagnosis by asking a lot of questions, making a lot of observations, gaining people's trust over time, and also by being open to the fact that your first thought about diagnosis may be wrong and that it's an ongoing assessment, uh, process.

Narrator: Mental illness is as old as civilization itself, and humans have always struggled to find ways to understand and explain it.

Almost 2,000 years ago, a Greek physician named Rufus of Ephesus identified different forms of melancholy based on symptoms, such as desire to isolate, mood swings, and eating disorders.

In the Bhagavad Gita, the sacred book of Hinduism, the human mind is described as a literal battlefield.

In 1621, the British philosopher Robert Burton published the 1,000-page book "Anatomy of Melancholy," in which he identified the symptoms of depression, mania, and phobia.

In 1952, in an attempt to categorize and classify mental illnesses, the American Psychiatric Association published an official glossary of mental disorders for clinical use called the Diagnostic and Statistical Manual.

That first edition had more than 100 diagnoses.

Today's DSM-5 lists hundreds more.

One of the first things that my mom did was to get me properly diagnosed, um, with bipolar.

My brother, he's also bipolar.

My mother thought I was bipolar at one point, knowing that my cousin was.

I had an uncle that had schizophrenia.

I grew up hearing stories about him.

Yanerry: I kept my hallucinations inside for 10 years.

The first person I told was a doctor because I felt like a doctor would really understand my symptoms compared to my family and friends.

He told me, "You're a high- functioning schizophrenic.

And you have this because of genetics."

And it's not just me that goes through this.

I finally spoke to my sister about it, and she told me, "Hey, I'm having those, too," like, "Hey, I'm seeing shadows, too!"

I also found out that a few of my cousins and an aunt of mine has schizophrenia.

Vinson: In thinking about nature versus nurture, what we've come to understand, um, is that it's not an either/or at all.

It is "both, and."

What happens to you as you're developing during your early years is going to interplay with those vulnerabilities that you may have come into the world with.

Angel: I recently got diagnosed by my psychiatrist with PTSD from my past experiences.

I was diagnosed with agoraphobia, severe social anxiety, generalized anxiety disorder, and depression.

Part of me had thought that it was maybe just linked to me being trans and not being comfortable in my body.

But I was diagnosed with anorexia nervosa and anxiety and depression.

Lydia: My first psychiatrist just diagnosed me with depression.

It didn't help me explain to myself why I was such a binge drinker, a binge user, and why I couldn't control myself when it came to specific things.

Bipolar is a label that was given to me by psychiatrists.

Said schizoaffective, some said bipolar, some said major depression.

Ava: I was diagnosed with depression.

And then a month ago, they said I might have had, like, bipolar disease or something, so, I don't know what I actually have.

Dunning: Over time, I will learn about you.

I've only met you for 60 minutes, 90 minutes, whatever it may be.

So, we need to work together so that you have an accurate diagnosis.

One of the things that, um, we know leads to doctors getting diagnoses wrong is when they prematurely decide they know what it is.

Julie: When I was age of 13, they said it was depression.

I was pretty-- pretty freaked out.

Pretty freaked out.

But it was also kind of like a relief, too, at the same time.

You feel very confused and you feel very lost and you're not very sure what's wrong, and then you get an answer and it's kind of really comforting.

Makalynn: When I was, like, 17 years old, the doctor's like, "You have bipolar disorder."

And describing the symptoms, I was like, "OK, that checks off," you know, "I can check that box, I can check that box, this is me."

It's not a relief to know that it's something that you're gonna have to deal with for the rest of your life, but it's a relief to finally make sense of it.

Some people, uh, do derive some kind of solace from saying, "I can put a name on this.

"I can call this depression.

I can call this PTSD."

And I think there's value in having those labels.

There's also a risk, and the risk is thinking that those labels explain something.

Someone once said to me that if you tell me that a person has schizophrenia, you've told me 5% of what I want to know about that person.

To just kind of be reduced to nothing but, you know, the two words "bipolar disorder," and people not understanding that I'm a whole person.

I just sometimes suffer from symptoms of this mental illness.

Some people don't want to have a label.

I don't like labels either, but for our health care system right now, I need to name it in in some way so that it can be paid for by the insurance company.

Vinson: Diagnoses are helpful, but it's important to point out that they're not the whole picture.

People's experiences are all different.

You can have the same diagnosis but have really different treatment plans, really different medications that you draw from in order to move in a different direction.

Newsreel Announcer: In this dramatic fight to preserve and protect the nation's health, modern medical practice enlists the aid of medicines and drugs, medicinal weapons to combat man's greatest enemies.

Meds, man.

They're to help manage you.

They're not a cure-all.

Newsreel announcer: Use only under professional direction.

Samantha: Medications are a resource and a tool you use to help better manage your mental health.

Newsreel Announcer: Daily, headlines tell us of their results, of lives saved by new drugs.

These developments... Amethyst: People like me who have bipolar, there's just something inherently different in their brain chemistry.

We do need medication because it's way more intense than just hormonal rage.

Insel: We have lots of medications to choose from.

I think we have about 30 medicines for depression, perhaps 20 for psychosis.

There is something like 7 or 8 mood stabilizers for people with bipolar illness.

Probably 4, 5, 6 medications for attention deficit hyperactivity.

So, that's quite a formulary, and a lot of things to choose from.

Maclayn: I do take medication, and it's for anxiety, I believe, and I feel like that helps a lot.

Leah: "Let's try Zoloft."

That was the money ticket right there.

That actually helped me significantly.

I've never taken any before, but I feel like I put myself into that stigma around taking medication-- "You take your meds today?"

Like, kids used to say that.

It doesn't mean you're bad, it just means that your brain needs a little help sometimes, and that's OK. Insel: They're powerful, sometimes they're lifesavers, and then there are many people who don't seem to benefit.

We don't quite understand why that is, and we're left to doing this empirically.

Trial and error.

I do take medication for my anxiety and depression.

I take Lexapro, and, like, since I've been taking it, I feel huge.

Lexapro did nothing for me, so, I was still just as depressed and stuck and hopeless.

Cymbalta is the one that's, like, making my mood better and actually gives me energy, but I still get panic attacks.

I am on a medication for depression, and I don't really know if it's helping me or not.

For some reason, it doesn't help me at night at all.

I usually just sit there all night, and I'm just like... just tap, that's all I do.

They put me on a antidepressant, which I think may have started making things a little bit worse.

Gabe: That pill in the morning, like, I just sit there, go... like, everybody used to tease me when I had that pill at school.

The psychiatrist would say, "OK, let's try this, "this, and this, see how it goes for a couple weeks.

If it doesn't work, let me know."

Let's try another one.

And it has to match with your other meds that you're already taking, so, it's complicated.

It was up to us to figure out whether it was working or not.

These are complicated disorders.

None of the medicines we have are curative.

None of them are perfectly matched to the problem at hand.

All of them have side effects.

Samantha: I told my doctors about how it was making me feel suicidal, and they said, "You just gotta wait."

Anytime I could have killed myself and nobody would have known.

When I stopped taking the meds, I stopped feeling suicidal.

Dunning: We may have to try another one, or another one, so, to keep people in the game, to keep people positive, to keep people focused on the outcome of something that they really were ambivalent about in the first place is a challenge.

Makalynn: It was about a year and a half of trying 11 different medications, and it was wreaking havoc on everything in my life.

So, there was one point where I just said, "No medication."

But I started using drugs again.

I know now that it is not an option.

No.

I need to be medicated.

God, that sentence sounds... "I need to be medicated."

I--I--I know now that medication is necessary.

I was born with a chemical imbalance.

We take antibiotics whenever we have a flu or a strep throat.

I have to take antipsychotic medication because that is what helps me.

Vinson: We do the best we can based on what we have, right?

It's always a matter of what's the benefit that they're getting out of it, and what are the side effects, and which matters more?

And that is going to be different for different patients.

Morgan: As a 15-year-old, I was on medications that they would put grown men on.

And...no, I was a zombie.

I was a zombie.

Any sort of desire you have for anything can be killed by some of these meds.

You're kind of a shell of the person that you were.

You look like a stereotypical person with mental illness.

Pete: He did continue to take the medication and after a couple weeks, he got better.

And then, of course, he stopped taking it.

And then he started becoming delusional again.

Kevin had been walking around the streets for 5 days.

He'd barely slept.

And I said, "Kevin, I will pay you $50 a week if you take your pills."

And he looked at me and [chuckles], he says, "Dad, I'm not a prostitute."

So, then I tried duplicity.

Kevin: My father crushed up some meds and put them in my cereal.

Pete: He looked at that, and he said, "You're trying to poison me."

Kevin: I was very angry with him after that happened.

But suddenly I found myself hospitalized.

I remember waking up and being in the psych ward and being like, "What am I doing here?"

Pete: We'd end up in the hospital, and he kept doing this over and over and over.

And this is what people say, "Oh, wait until they hit rock bottom."

Well, what is that?

Homeless?

Is it dead?

Or imprisoned?

Morgan: With my medications, I was like, "Mom, I'm not doing this anymore."

I took myself off of them, cold.

I don't think it's a fix or the answer to everything.

Each of our brains is wired differently.

Sometimes they're just so quick to write you a script.

And that's why I kind of stopped going to psychiatrists.

Vinson: People are often surprised when they talk to me as a psychiatrist because I think medicine is helpful but it's certainly not the whole answer.

It's not just about having the symptoms go away, it's about is this person engaging in meaningful relationships?

Insel: It requires work.

It requires learning.

Learning a set of skills to help you do things that you're currently not doing.

It requires therapy.

Man: There's an awful lot of hate in the boy.

Hate that's spreading over into his feelings about everyone.

Woman: Well, he's up against a lot at home.

Man: That's just what I want to hear more about.

Alexis: So, when I went to therapy, I expected, you know, like, you know, like the bed that they lay on, the bed chair, you know, you're just laying up there and they ask you, you know, "How does that feel?"

I didn't know how to talk.

So, she leaves and she comes back with, beads and, like, string and stuff, and she's like, "OK, so, just make a bracelet."

So, as I'm making the bracelet, she's, like, asking me questions.

I was actually talking, and I didn't even notice it.

She figured that out for me.

After my parents got divorced in third grade, we started going to a counselor.

And that really helped me get all, like, the stuff off my chest I'd been wanting to say.

I think I don't actually give my therapist enough credit to how much she actually helps me.

Insel: We have therapies.

We have rehabilitative help.

But the reality is it's not that easy to find a specialist to get help with a mental illness, even a serious mental illness.

There's so many things about mental health care today which are fundamentally embarrassing for us as a nation.

Maclayn: The counselors I had before, I felt like they didn't really understand what was going on, and they didn't really show much interest, and that kind of made me even more upset.

Ava: They always ask the same questions, and I feel like it's just not helping me.

Just wasting my time.

It seems like she didn't really acknowledge anything that I said, so, it was a bit invalidating.

Gabe: Horrifying.

It was horrifying.

I was like, "Should I be saying all this?"

"Yeah, no."

"Yeah, no.

Yeah, yeah, yeah, no, no."

Just confusing.

They would give me, like, a sheet, um, that I would, like, bubble in of how I was feeling, but it kind of felt like I was talking to a piece of paper and not an actual therapist.

Justin: I had a doctor tell me that I'd never work again, that I'd never live a fully functional life, and that I was gonna have this disease for the rest of my life.

And I had just met him within 10 minutes.

Vinson: Mental health problems require a certain relationship that may not be present.

If I am asleep on an operating table and the anesthesiologist has a hard time relating to me, it doesn't really matter--I'm asleep on an operating table.

If I'm in a room with somebody and I'm supposed to tell them the most difficult thing that's ever happened to me in my life, the relationship matters in a different kind of way.

Pete: You know, of my son's 7 psychiatrists, only two have bothered to learn anything but his name and his diagnosis.

So, we lined up a therapist, supposedly the best therapist in Northern Virginia dealing with young men.

And my son took his chair and he turned it around and wouldn't talk to him.

So, after 3 sessions, the guy says, "Look, he's not gonna do anything, I'm not gonna help him."

Xavier: First time getting into a therapist is kinda awkward.

Just weird.

You don't know them and you're, like, gonna talk to them about, like, why you're sad.

He saw her for a couple of months, said, "This isn't for me."

Amira: He didn't want anything to do with it.

Like, he just wanted to be left to his own devices and to just be able to be mad.

Vinson: People sometimes are hesitant to talk about their mental health concerns, especially if you've had adults or even kids who respond to you in a way that isn't supportive when you've tried before.

Samantha: You gotta find that right fit.

Sometimes they just suck for you, and that's OK, you know?

Not every therapist is gonna be the one.

Dunning: Children and adolescents, I will say to them, "I know "that this is not even remotely "on your top 10 places that you want to be right now.

"Over time, I will learn about you.

"I have only met you for 60 minutes, 90 minutes, "whatever it may be.

"So, we need to work together "because I know that will help you.

I know it will."

Samantha: It was just talking and trying to figure out what exactly was wrong.

It was kinda like you put pieces together of a puzzle that we didn't really know where to start.

And it was a process, but it felt good to finally, like, put things together.

Yanerry: When I met my current therapist, she told me she had the symptoms that I had.

It felt so comfortable to speak to someone who actually can see the things you see.

She actually listens and gives me methods of ways to deal with my symptoms.

Now I kind of just see it as my normal compared to other people's normals.

Isabel: It was two years ago that he voiced needing help again and, uh, I went back and found him a therapist.

It changes over time, slowly as you just get to, like, know more of their personality and just how they do things and, you know, slowly it's like, you get comfortable enough and then just talk easier.

Dunning: There's just so much life and love in having that one person that's forever in your corner that'll just literally love on you.

It's just so joyful.

I say everyone should be in therapy.

Alexis: My parents would go to therapy with me, actually.

I was talking to my dad, and I was telling him, I was like, "Dad, I just don't know how to communicate and stuff."

He told me, "I had a lot of emotions that I didn't know how to deal with, either."

He said, "When you're feeling those overwhelming emotions, "just go outside.

"Go on the trail.

"Go talk to the horses if you need to, "'cause they're not gonna judge you.

"If you want to cry so loud, you could sit in the trees and you can do that."

And that's what I did.

We believe that all things are living, everything has a spirit, everything has a teaching.

You could learn a lot from nature for sure.

[Bird cawing] Samantha: I was probably 14 or 15 when I went into the crisis center for the first time.

I just went in not willing to work on myself.

I told them what they wanted to hear.

I just got a break for 9 days from reality, from the universe.

When I went in for the second time, I was ready to put the work in.

I got a therapist, I saw her all the time, twice a week, and then I saw my psychiatrist, my med doc, probably twice a week.

Now for over the past year, I've been in consistent therapy, and I feel so good.

So good.

Vinson: When you have some cases that are more severe, we think about higher levels of care to meet their level of symptoms and their level of distress, and that requires more intense levels of intervention.

Ray: The blow-ups, the rages kept happening more and more.

Mental support was not enough for Gabe here in our small community.

He needed a more intense therapy.

And that's how he ended up at the therapeutic centers that he went to.

When I was going to this mental hospital place, I was like, "No, please don't do this to me!"

Darla: Oh, was it hard.

I mean...

I couldn't even talk about it for probably the first 3 months without breaking down.

Yeah.

I mean, you just feel like you lost your child, that you-- Yeah, you sign some papers, and the hard part's driving out of the parking lot.

The ride home the first time was horrible.

Gabe: First day, I got there and got in a hold.

The hold is, like, when, if you hit a staff or a kid, they run up towards you and wrap your hands.

Like, literally hold you like this, and they lay you down and hold your feet so you can't kick them, and you just sit there till you're calm.

This staff member held me as tight as he could, and I'm like, "Brah, chill."

Vinson: Inpatient psychiatry or inpatient mental health treatment is given with the idea that you're going to help somebody get better or, at the very least, keep them safe during a time when there are reasons to be really concerned about their safety.

Darla: The facility Gabe had went to, the residential care, they pretty much took him back to being an infant.

Feeding him, holding him, rocking him, carrying him around in a backpack.

You know, and he was 9 years old.

But it really helped to take him back, you know.

Gabe: I was like, "I cannot do this anymore.

"This place is horrible.

I better get through this."

Ray: The therapeutic center was 400 miles from here, so, every other weekend, we drove 800 miles.

We'd leave Friday afternoon and we'd come home Sunday night, so, he knew that we didn't abandon him.

Gabe: My mom and dad used to hide notes everywhere in my room, and I'm like, "These make me sad.

You shouldn't do this anymore," and that's exactly what I said to them.

And they were like, "Just trying to make you feel better."

Vinson: By its nature, inpatient mental health treatment is very disruptive.

It takes you out of school, it separates you from your family, it makes you sleep in this strange bed, and it can undermine some things that are very basic, like connection and autonomy, while trying to keep people safe.

[Door lock clicks] Morgan: I thought after I woke up from my overdose that I could just go back home.

No.

I was sent away to an inpatient children's mental hospital, psychiatric unit.

It felt strange being there, knowing that you're out of school and in an actual hospital.

So, I begged my mom to take me out of there.

One of the girls was like, "You don't look like you should be here, you don't look like you're depressed."

And that always stuck with me because, like, what do my looks have to do with anything like how I'm feeling?

Yanerry: The first time I went to the psych ward, I was there to prevent a suicide attempt.

It's kind of just like the room you stay in and you see a psychiatrist and if you say you're feeling sad, you stay another week.

Lydia: It was October of 2018, and I overdosed on Xanax in school.

My parents told me, "You're gonna be sent to a residential facility for 30 days," and I threw a fit.

I was, like, punching walls, I was screaming and crying, and then I was like, "I'm gonna fake it till I make it."

I finally ended up, um... in a kind of desperation.

Nothing was working.

It seemed like she was getting worse.

Lydia: From that residential, I got "gooned," which is picked up in the middle of the night, and I got sent straight to the wilderness.

It's like a paid, legal kidnapping.

It's--it's--[laughs] it's terrible!

We had to hike almost every day with, like, our huge packs on.

We slept on sleeping bags on a tarp on the ground under a plastic tarp.

I was in the wilderness for, like, 3, 4 months.

[Laughter, crying] Hi, sweetheart.

Erick: When she came out of the wilderness, she was radiant.

I think she had started to do that work of being OK in herself.

It was incredible to see.

I mean, really, she came out of the wilderness... [Sniffles] Wasn't even the old Lydia.

It was like this new Lydia.

And I felt it.

Lydia: But right as I got back into New York City, I slipped right back into the same old habits.

Kennedy: You pay attention for a short period of time, you think you're better, you forget that this is a chronic illness and that you're never out of the woods.

Your only chance of staying out of the woods is to pay attention to this and treat it kind of one day at a time in an ongoing way throughout the rest of your life.

Justin: They hospitalized me and they started giving me medication.

The doctor comes in, they give me my pill, "How do you feel?"

"Well, people are out to kill me, al-Qaida, the mafia."

I mean, you name it.

This goes on every day, and all I know is that people are leaving that came in after me.

So, one day, I just lied.

I said, "Hey, man, I feel great!"

They discharged me with a month's supply of medication.

It wasn't until my 23rd birthday that I thought, "You know, I feel OK. Why do I have to take these meds anymore?"

Makalynn: I was admitted to a dual diagnosis facility for adolescents.

They specialized in mental health treatment and substance abuse disorders.

I think it's very uncommon to find somebody who has just one form of mental illness, so I was lucky enough to have substance use disorder and bipolar disorder at the same time.

Complete sarcasm there.

[Slide projector advancing] But I think that I had bipolar disorder first, and then that turned into using the drugs to cover up the symptoms of the bipolar disorder.

It was just, I mean, a--a vicious--a vicious cycle.

The fact that addiction is a mental illness... Hello!

News flash!

You can't really distinguish between the two.

Lydia: Addiction is a disease.

It's not something that you can control.

You can't choose to be an addict, you can't choose not to be an addict, it just-- it's in your genes.

Each time she would come out of these-- these places... what next?

And then she falls down, goes backwards, it's all the more painful.

And, that said, of course she falls down.

Breaking out of the cycle of addiction...

I think it's one of the most challenging things anyone can ever do.

Lydia: I graduated The Wilderness, and then--ha ha!

I, um, relapsed.

I overdosed on Adderall, and now I'm here.

[Slide projector advancing] I had been, like, thinking about, "Oh, I need to change this time, "and this time needs to be different.

What am I gonna do?

What am I gonna do?"

As a part of therapy, we do yoga 2 or 3 times a week.

I thought the sound bath was kind of cultish and weird and just, like, creepy.

[Reverberating tone] But when I let all my expectations go, I could really enjoy it and just relax... [Reverberating tone] and not focus on the outside world.

[High-pitched tone] [Light, tinkling tones] I've heard of my friends who have been in lockdown facilities where it just sounds miserable.

[Loud reverberating tone] Morgan: When I was in my freshman year of college, I overdosed again and went to a really scary one.

It kind of reminded me of jail.

It was actually terrifying.

I was completely institutionalized.

I was put into a box, basically.

Our only real requirement was to show up for 3 meals a day.

That place got me away from the drugs, but, it was-- it was damaging.

Morgan: I just remember white, a lot of white walls.

It was very... [Heavy door opens, then closes] So we'll have DBT skills or recovery skills or adventure therapy, equine.

It depends on the day.

It's kind of amazing.

I never expected to feel better by opening up to an animal.

So I just think, like, taking chances and opening up to people who you don't expect will really help you is a big takeaway from equine.

I think that this place is more effective because there are little things to look forward to.

[Loud reverberating tone] Makalynn: We basically were given some construction paper and coloring pencils and a TV.

We would just color all day and watch movies.

And it was terrible.

Yanerry: We couldn't even watch cartoons.

It felt like I was losing my mind in there.

[Lydia laughing] Lydia: It does look like a rich kid's facility!

But just because it's fancy-schmancy doesn't mean that, um... you have to be rich to come here, you know?

Everybody from here comes from different backgrounds.

My parents?

We just all talk to each other openly.

Makalynn: I was living in a house with 13 other girls, ages 12 to 17 years old, so talking about, like, puberty and emotions running, and then you've got, you know, add detoxing from drugs on top of that.

Group therapy would turn into, you know, who was fighting with who that week.

I was the only teenager there.

Everyone looked at me as, like, a little kid.

It's like, "What are you doing here?"

Morgan: They had older kids, 14-, 15-year-olds with 6-year-olds.

You can't get proper care with that.

Erick: She's been now to 6 of these centers.

And when a 15-year-old spends 320 days in rehab, there's no part of me that thinks it's gonna be easy.

And the truth is, nobody recovers until they own it, and it has to be yours.

Lydia: You have to trust yourself, trust that the process has taken you as far as it's going to, and your next step is to be on the outs.

Ahh!

Work on yourself in a community.

This is just one part in my story.

It's not gonna stop the rest of my life from happening.

It's actually giving me life, because I'm still alive because of this place!

I want to [beep] live.

I love being alive, dude!

Girl: Bye!

Lydia: I love living.

Gabe: When I finally got home, it felt like I was adopted again!

Yeah, I was like, "I can start over."

And then, like, a year later, I'm, like, back to the stuff I was.

Did the same exact thing, said the same exact things.

Ray: We realized that he needed more help.

Dunning: She'll tell you to quit.

No, like, she tells me to shut up or something, and then I just look at the TV, what Dad's watching, and I-- Dunning: You are being told no.

Gabe: Kee is my therapist.

No.

Because I got mad at-- We talk about anything.

All right, but you didn't-- Dunning: When kids come to see me, most often, they are mad, because they will say, "That's my mom," or, "That's my dad."

"They wanted me to come.

Why don't you see them?

'Cause they're really the ones that have the problem."

I say to that, "Absolutely, I bet you they do.

"So why don't you kind of just tell me how I can help you "get to them, and then we'll all convene, and we'll see how we can work some things out?"

Over the course of the... Darla: Family therapy, we will have that with Kee every once in a while.

When we do a family one, it's pretty interesting because it's-- It's--it's brutal.

It's--yeah, but we did see things through the kids' eyes.

Dunning: Family therapy is crucial.

The power of that in holding the mother or the father accountable to the same rules that you would to the patient is profound.

Everyone has a piece in the puzzle.

The other therapists that we seen, uh, it wasn't that they didn't care.

It's just...they didn't have the expertise.

Family therapy is... man, it's--it's hard to get, actually.

In an ideal world, we would have many more kids in family therapy than we have in individual therapy.

[Slide projector advancing] Dunning: His biological mom, she came into our session.

That was one of the things that changed his life forever, being empowered to say to your biological mother and to ask her why she hurt you in the way that she did, to have that opportunity in a safe place, safe place, in which to do that, to find your words.

Gabe: She's good at changing families' life.

My family life was like that, and now it's like that.

[Slide projector advances] Leah: We had a family therapy session with my mother... and it was me, my sister, and her, and I had to tell her, you know, I--I hated you.

I hated your guts.

And there were so many times that I wished that you were dead instead of continuing to hurt me.

All the years and years and years of built-up frustration towards, you know, the situation that she put me and my family through, and it all kind of came out at that family therapy session.

And that was the first step towards me forgiving her.

Are you crying?

Don't cry.

Of course.

I love you.

Julie: My relationship with my daughter now versus then is so amazing.

My relationship with life itself now is so amazing, you know.

[Match strikes] [Man singing in Ojibwe] Alexis: I think it's so hard to find an indigenous person that hasn't dealt with mental illness or some sort of abuse.

That's within my DNA.

I wasn't taught my Ojibwe language because it was literally beaten out of my great-grandparents.

The things my ancestors went through, it's shown through alcohol abuse, addictions, non-stable families, toxic relationships.

It's everywhere.

That's the burden that indigenous youth deal with... every day.

You're just born into it.

Birthright.

Makalynn: There is a deeper stigma for people with mental illness who are minorities, so they don't talk about it.

In society, we're already the underdog, so to add another tier of something that could be viewed as a weakness would just further complicate life in general.

Girl: Turn all around Vinson: There's a way that things that are woven into society become background noise, and so we pay attention to them in the same way.

When we have things like inequity and racism and gender discrimination and all of these things, it's such a part of how we're taught, of how things are framed to us, of the language that is used.

We don't recognize it because it's just part of how we operate.

If one of my friends was, like, really anxious and she was, you know, upset and, like, yelling at people or whatever for her anxiety, people would say, "Oh, like, she's having an anxiety attack, that's why she's doing that."

Whereas, if I experience the same behaviors, it would be, like, "Oh, she's an angry Black girl.

She's just doing what Black people do."

Makalynn: Whenever the person of discussion has mental illness and they are white, we definitely focus on that individual and what they have gone through in life that could attribute to that.

Vinson: People who are Black who have a mental health problem, there's a way that it can be minimized, just like you as a person are minimized.

It can be, um, met with, uh... "othering" just as you as a person are met with "othering."

Yaadieah: I have to sort of tone down my mental illness not to make my community look bad.

And I just feel like many times Black people don't get to be mentally ill because just--their behaviors are so picked apart.

So when you're Black, the range of emotions that you're allowed to have in society are smaller.

The room for error you have in society is narrower, And so the range of emotional expression that other people enjoy, you can't without things like "angry Black woman" or "angry Black man" being sort of brought up.

You kept saying "It's boy time."

Dunning: What in our own thinking would give us permission to think for one second that because we are brown, because we're Black, because we're Native, or whatever, that we would not still have the same challenges?

Some people look at Hispanics as, like, loud and crazy and full of drama, and that kind of affected my mental health a lot.

Dunning: In my practice, Native Americans in our community, they're struggling, and I will ask them, "What don't I know?"

Alexis: A lot of kids on the res, they want to be indigenous, they want to be Ojibwe, but then you go somewhere else, and it's like completely frowned upon.

That's tough as a teen.

There's a lot of stigma, there's a lot of stereotypes against us.

You're just coming into life and everyone's like, "Yeah, you have to deal with alcoholism, drug abuse, poverty, the worst of the worst."

When you tell a kid that, how do you expect them to succeed on a reservation where you're not meant to succeed at all?

It's exhausting.

It really is.

It's exhausting.

Yaadieah: I just want to open up the conversation more.

It's not just a disease for rich, blonde, white girls.

It doesn't discriminate.

It affects everyone.

[Jail door slams] Makalynn: I think that there are far too many other issues that society likes to focus on with minorities to talk about mental illness at this point in time.

Vinson: The issue of race and mental health cannot be disentangled.

So much of what makes people sick and so much of what makes people well has nothing to do with their medication or their therapy or the mental health care system.

It has to do with where they live, work, play, learn, grow.

[Crowd chanting] Girl: "My eating disorder cannot be separated "from my queerness.

"With all these constraints of what a nonbinary body "is allowed to look like, it should come as no surprise "that trans youth and young adults have significantly higher rates of eating disorders."

Woman: "When I was 19, I had my first PTSD episode "when I experienced psychosis.

"And because I didn't have language or money, "receiving queer-affirming mental health was impossible.

"I started drinking to cope with my symptoms "and spent 5 years oscillating between stability and keeping it together."

Billie: There's a lot of nonbinary kids that are depressed.

That's because of the way that we're treated.

It's not a symptom of being nonbinary, it's a symptom of being marginalized by a society that doesn't accept us.

Dunning: I have had people that are afraid to get medical health care, let alone mental health care, because they were seriously afraid to go into a doctor's office and be who they are.

How sad is that?

[Birds chirping] Maclayn: If people asked me if I'm gay, "Yes, I am."

My parents kind of always knew and therapy helped me figure it out.

I told everyone that I was gay and if they had any questions, they--feel free to ask me.

I'm gonna have an amazing life.

People love me and care about me.

Mary: You know, coming out as a--as a gay child is hard.

You want him to-- to find love.

You want him to live a happy life.

You want people to accept him for who he is, and, you know, not only is he gay, but he also struggles with mental illness, which is gonna be a long journey as well for him.

When I first went into theater, I told my parents that I found my people.

I like acting because you can express, like, your feelings to other people and you can make other people smile and laugh.

[Cheering and applause] Billie: Being nonbinary, transgender, gay, LGBT, what--whatever you identify as, it has nothing to do with mental illness.

Don't be afraid to express yourself and be who you are.

Because, honestly, not as many people are looking as you think.

It's scary putting yourself out there because you're setting yourself up for others to judge you, and that opens you up to criticism, but it also opens you up to love.

Dunning: We all judge, make no mistake, You do.

I do.

I could be judging an adolescent, a child, for something that they are doing or that they aren't doing or that they should be doing.

But what don't I know?

What don't I know about their life?

Xavier: I actually don't know anything about my father's childhood, but, um, yeah, I do know he was in a war.

His dad had been recently diagnosed with post-traumatic stress disorder.

You know, he served in Iraqi Freedom.

And that could've possibly affected the way he is, or maybe something happened to him when he was younger that caused him to hit us for seemingly no reason.

We all have stuff, we all have struggles.

You can drive by a house and it can look pristine and no one knows what goes on behind that front door.

But until they open that door and let you in, you don't see that the inside of the door is destroyed and that the inside of that room is a mess.

[Handcuffs click] Insel: What can happen to people with a serious mental illness is that, just like a serious cancer, it can metastasize.

It turns into disability.

It gets complicated by substance abuse.

It creates a whole realm of social problems, including incarceration at various times.

Julie: Well, during that 10 years in my active addiction, I did a lot of petty thefts, trade goods for crack.

I've had my--my head cracked open, I've had guns pulled to my head, and got caught up in a criminal justice system.

Leah: I actually got arrested with her.

[Siren] Yeah, so... we were both shoplifting, and I had cocaine in my purse at the time, which was really stupid.

Who goes shoplifting with cocaine?

But, you know, I was dumb and young and I didn't-- I wasn't thinking.

If I didn't get arrested, maybe, you know, that would be me.

Maybe I would be my mom.

Julie: I wanted to change, I just didn't know how to do it.

So when I went into that store to--to steal those two, um... curling irons that I was gonna steal, I wanted to get caught that night.

So when the cops arrested me and took me in, that was the beginning of my recovery, that night at Walgreen's.

Ha!

Not all men and women in jail are criminals.

A mental illness can put you in a place where you have no business being there.

What's going on with your mind puts you in a criminal area.

Justin: I stopped taking the meds.

I relapsed on my symptoms, and I was arrested in April 2007, and I was booked in the Miami Dade County jail on a felony.

I had a complete psychotic breakdown in their cell.

And then, um, they transferred me to the 9th floor, which is dubbed "the forgotten floor."

[Inmates screaming] And there's just a whole wing full of people screaming, I mean, screaming at the top of their lungs.

The corrections officers, they start coming around, and they tap on the glass every 15 minutes.

And they go... [Knocks 3 times] And they say, "Show your face" because they want to make sure you're not gonna commit suicide.

That's 4 times an hour, every hour, 96 times a day, somebody is coming around, smacking on this glass.

It was terrible.

I said, "Where am I?

Where the hell am I?"

After about 6 weeks in jail, somebody got me to sign up for treatment.

Vinson: When it comes to mental illness, the criminal justice system in the United States is one that demonstrably is not just.

Rather than the mental health care system being in a position to step up and provide interventions for people, they end up falling into the system that always has doors open and is willing to take more people, and that's the criminal justice system.

Pete: People get stuck in this cycle of constantly in and out and in and out of jails, prisons, or hospitals.

[Slide projector advances] Kevin: When I was sick, everything was black and white, good versus evil.

It didn't feel like reality.

It felt like a fever dream or something.

I thought I was some sort of prophet who had some sort of role in surviving Armageddon.

Pete: One day, he slipped out of the house, and he happened to go toward a house of a former friend of his, long ago moved.

Kevin: And to me, if I had gotten in that house, I could go to sleep, and then when I woke up, Armageddon would be over and there would be peace on Earth.

So I took a potted plant and I threw it through the window.

[Glass breaks] Pete: And he went in and he turned over the photographs of the family because he thought they were staring at him.

I had this notion that I needed to be invisible, And how do you become invisible?

You disrobe.

So I got completely naked, and I'm walking around in this stranger's house, and then I have to cleanse myself from sin because the Armageddon's happening.

So I go up and I draw a bath, and I cleanse myself.

I lay down in the bed, and I fall asleep.

And suddenly these police dogs come, and they jump on my arm... [Barking] and then there's about 10 or 12 police officers who surround me and pin me naked to the ground, and when they put me in a paddywagon, it started to set in a little bit, the reality of what I had done.

It was humiliating.

You're physically as raw and as open as you could possibly be.

The owner had a gun.

My life was spared because the day I broke in just happened to be the day they were on vacation.

Pete: And I got a call.

Kevin had been charged with two felonies.

So we go to court and we're told, "You have to make a decision right now.

Do you want to plead guilty or not plead guilty?"

Complete strangers who have no knowledge of who he is are gonna make this decision in a matter of 5 minutes, and "This is my son!

"This is his future.

He's sick.

Why are you going to ruin his life?"

I tried to get him help and was told by the law, "No."

Now that same law wanted to punish him for a crime he committed when he was sick.

This is my child, and you're telling me you're not gonna give him help because you don't think he needs it and he's not dangerous enough.

How dare you?

We luckily delayed it, and then the homeowner didn't show up for the second hearing, and we were able to get two years of probation.

Do I see myself as a criminal?

Um, I think it's hard for me to say yes because when I was arrested, I originally wanted to plead not guilty by reason of insanity.

But I think the answer is yes.

I do feel accountable, and you just feel regret and embarrassment.

Once something is done that's wrong, in your heart, you want to fix it, but you can't.

Pete: The fortunate ones have been able to get back into the community and get services and living well, but the sickest of the sick have been abandoned on our streets and are locked in our jails and prisons.

Insel: By treating this like a criminal justice problem instead of a health problem, we've turned our hospitals into prisons.

At the same time, we've turned our prisons into mental health institutions.

One of the largest mental health institutions in the United States is the Cook County Jail in Chicago.

There's something surreal about that.

[Brass band playing] [Whistle blows] Collin: We were affluent, upper middle class.

We felt invincible.

We were 15-year-old athletic kids that were comfortable, doing good in school, we were OK. We didn't--we didn't think that this was possible.

We thought that we were immune to stuff like this, but it's not true.

This happens to anyone-- any way, shape, or form.

It doesn't matter.

And that came as a big surprise, too, for sure, but only after the fact.

Everyone in our town knows what happened...now, and everyone was affected by this.

Wednesday, February 7, 2018, Nathan Bruno died by suicide.

Collin: The last time I saw Nathan was in lunch at school the day before.

It was just normal Collin and Nathan activities, really.

Nothing was different, and that's what scares me.

Rick: I knew Nathan was off.

I had a few conversations with him about what may be bothering him.

And I went through a list of things.

Is it bullying?

Is it sex?

Is it drugs?

Is it peer pressure?

The only thing he said to me was, "Dad, I just feel like kids have it harder nowadays."

Collin: It was an emotional heart attack.

It was just like my entire world exploded in front of my face.

I didn't know what to think anymore about anything, about anyone.

It started with a prank made towards a high school employee, which Nathan took full responsibility for, although there were influences from other kids.

Lucas: The football coach who was getting prank-called by Nate put pressure on all the kids and said, "You're not gonna play on my team and you're not "gonna participate if you talk to this kid and associate with this kid."

Nathan would sit down at the lunch table, and all the kids at the lunch table would get up and move away.

He felt like nobody was ever gonna talk to him again.

Rick: At 15 years old, that can have a profound effect on your mental state.

Angel: The situation that had happened, I was getting blamed for something that I really didn't do, And I blamed Nathan for that.

Last time I spoke to him, I was texting him very angrily, mad at him.

And doing so, I felt like I played a part in him getting to that breaking point where he felt nothing and decided to take that decision to kill himself.

Rick: The last time I saw Nathan, Nathan and I exchanged some words about, you know, how serious things like this can be.

He was sitting on this couch watching TV like he did most evenings.

Angel: Nathan's house is right on the way to the school.

And as we're all driving past, everyone sees an ambulance and a stretcher with a white-- white blanket over it.

He was just a joyful kid.

And he was hilarious!

So...

I think Nathan was the most charming, most funny, most charismatic kid I ever knew.

He knew how to brighten up any room, no matter how dark it was.

Hey, watch this.

Watch me.

Lucas: The way Nathan was as a person says a lot about the nature of suicide.

It can be in anyone, and anybody can have these thoughts and feeling of being alone and no one to talk to.

It felt like we got hit with a wrecking ball basically, in a way.

Everything for us changed.

Collin: It sent the school into a spiral, just out of control.

Boy: There was a couple of us in gym class, and we just like, all started crying.

So I went to, uh, Guidance, and they were kind of like, "Uh, well, you have to schedule a meeting."

The guidance counselors are not trained in that field.

They didn't know what to do.

None of our teachers knew what to do with us.

High school is one of the most stressful things that someone goes through in their life.

Anyone watching this that is in high school right now can attest to that.

There is so little help for people struggling like this.

There is so little counseling available, especially in school.

Vinson: So school counselors may have specialized training when it comes to education and vocational issues, they may not have it or even have clinical licensure when it comes to mental illness or mental health disorders.

Owen: Right after Nathan, I probably had like 25 kids in my basement, and we literally didn't leave the basement for like 3 days.

Angel: We began to learn how to help each other in our darkest times.

We all really needed each other at that point.

Angel: It was really the beginning of us understanding each other and talking about our feelings.

We were just sort of talking about different things about Nathan's death and different things around it, and it sort of turned into talking about mental health as a whole and educating ourselves on everything about it.

Collin: We kind of said, "Something's not right.

"You know, something needs to be changed.

We can't watch this happen to anyone else."

Rick: His friends said, "We want to do something about what happened.

We want to make a difference in the name of Nathan."

Collin: It's all about speaking and talking about it.

I think that could have saved Nathan's life, and it could save anyone's life that is feeling the same way.

And that's where ESI came from.

Ava: Before the incident with Nate, the school never talked about mental illness at all.

They never talked about depression, mental illness, and stuff like that.

Now we talk about what ways you can do to help someone, talking about coping skills and red flags, and it really helped me.

I've grown to know how to help people now.

Girl: I started to be involved with Every Student Initiative because I was just really, I guess, proud of what they were doing and how they respectfully were doing it.

I had a mental illness, and I knew about it, and I wanted to express it and be in that kind of space where I felt safe to talk about it.

Angel: I started to realize after the grieving period of Nathan that I needed to talk to someone, I needed to get right with myself.

So I started to see a therapist.

It kind of was like a, uh, epiphany in a way.

Collin: We also had the idea for Nathan's Law.

The mission is to review, revise, and create policies and programs to improve social, emotional support in schools and communities.

A structured support system in every school.

Collin: We brought it to the State House the first time.

It didn't make it out of the committee, but that didn't stop us.

We know what can help and what will help.

This law, we strongly believe, can stop this from ever happening again.

Reporter: This morning, Governor Dan McKee signed a recently approved suicide prevention bill at the second annual Be Great for Nate Fundraising Gala.

Last night's event at the Ochre Court in Newport was in honor of Portsmouth teenager Nathan Bruno who was 15 years... Collin: This is the story of a thousand little towns just like Portsmouth.

Insel: There are a million suicides every year worldwide.

For every suicide, there are 11 victims.

One is the person who died, and 10 are the other people who will never be the same.

Rick: I believe it takes such an extreme event because it gets our attention, but this isn't the story I wanted.

Collin: I wish I could have done this without Nate dying by suicide.

But if Nathan didn't pass away, someone else would have.

I wish I could have told Nate he meant the world to all of us, and if he could see us now, what we would have done to stop what he did.

I wish I could have given my best effort.

I could have tried to stop this.

I could have gotten him help if I couldn't help him myself.

That's what I would tell him.

And that's what I would say to you.

There is always someone that cares about you that much that they will do anything for you.

They will do anything to make sure that doesn't happen to you, too.

[Thunder] Amethyst: I definitely think mental illness is something hiding in plain sight because there are so many people dealing with it.

It's definitely a part of life.

People who go through this kind of thing, they would never wish it upon anybody.

It's just something that we certainly can't help.

Not everybody has such an accepting family as I do, and not everybody lives in an area where mental illness is widely acknowledged and accepted.

Woman: Overall, the general conversation about mental health it's getting better, but I don't think it's addressed enough.

I think almost everybody I know knows someone that has either a family member, a spouse, a child, a friend, a coworker, somebody.

They may not personally have mental illness, but I guarantee that somebody that they know does, and humanizing it, bringing it home, makes it more real to people.

Draiman: Our world is plagued by an epidemic.

Amethyst: I was very excited to see this concert, because I think if everybody could just see how many people there are that are going through these things together... Draiman: Addiction and depression are incredibly powerful demons.

Amethyst: then there would be a lot more acceptance... Draiman: They are diseases.

Amethyst: once we realize how big it is.

Draiman: Mental illnesses... they're no different than cancer.

By a show of hands, how many of you have struggled with the demons of addiction and depression yourself or know someone that has?

[Crowd screaming] Keep those hands up.

Now take a look around this arena.

[Guitar playing softly] You are not alone.

[Cheering] Amethyst: Thousands and thousands around me that all felt similar things to what I felt.

So it was really a moment of realization of, "Wow, I'm not alone in this."

I had realized at that moment that there were people I know that go through this.

I definitely feel inspired to go out and try to make a difference in other people's lives.

One person can just get the word out and then more people will just spread, and it'll just all...

I feel like eventually everybody will be understanding and loving of everybody else for who they are.

Thompson: The human body needs light to perform.

When that light comes inside your life, now you're able to do so many things.

It makes you think better, it makes you see better, so you do more things in the light.

It's so important to realize that people do overcome having a mental illness and they go on to do spectacular things in their lives.

[Slide projector advances] Makalynn: I've been clean since the day I went in treatment, 7 1/2 years now.

And that's because of a support system.

My entire family, they were there for me and then getting--getting involved in NA, so a 12-step program that created a whole new family for me.

Samantha: I'm seeing my therapist, I'm seeing a psychiatrist, I see my regular, um, primary care physician.

They all kind of work together, which is really nice.

I have a support team here, but it took years to get.

[Slide projector advances] Kevin: The fifth time you get hospitalized, nobody wants anything to do with you.

My brother basically told me that if you want to be involved in your niece's life, we don't want you to be the uncle who we can't trust around her.

For some reason, that sunk in my head and I got tired of being that person.

For me, I know it's utmost necessary that I'm on medication.

Lydia: I found an AA sponsor, and I found myself again.

Everything fell into place.

I feel like there is ground underneath me and like I know where I'm going, I know where my future is heading, and I feel good.

But it's still something that I have to deal with every day.

Isabel: Looking at Xavier now, he's still struggling, but he has his moments that are better, having learned coping skills.

He's now able to, like, "You know what?

I'm feeling depressed.

I'm gonna get out and do something else."

Xavier: When I'm skating, I'm not, like, overwhelmed by my situation.

I think I feel better.

I don't know.

Guess it gets to a point where I'm like, "Oh, hey, look.

I guess I'm not sad, but I still am."

I don't think he's much different now.

I think he just knows how to carry himself.

Take time to learn how your sibling communicates, because you can understand what triggers them, and it--it makes a-- a good, comfortable space for them to want to, like, grow and continue to talk to you.

That's really important.

So, I like to show up to skate.

I just wanted to be there and, like, be around him and, like, watch him shine.

Morgan: After the storm's the prettiest.

It's true.

You're gonna get tossed around, but that's what makes all of us who we are.

I can't sit here and say that I'd be talking about any of this with you guys if I hadn't gone through the pain myself.

Justin: Don't hold onto that resentment, that pain, that fear.

Don't hold onto that 'cause it makes you sick and there's a whole life out there just waiting for you.

Maclayn: I'm just...me, and I can't do anything about that.

I just am who I am, and that's, like, the best gift that I could be given.

I like the way I am, yes.

I agree that I do.

I am not Bipolar Disorder.

You know, I am not mental illness.

Have a conversation with yourself about it, and that way it could help you feel more comfortable to speak to other people.

Reach out.

Use your words.

Use--just say something.

I know that in the past when I've heard other people tell their stories, um, it makes me feel more validated to know that they've also gone through this really difficult thing in their lives, and it's, like, reminder that things can get better.

So I hope my story helps others.

Alexis: What you do today affects 7 generations ahead of you, so you have to make sure what you're doing today is good.

Not only is trauma embedded in my DNA, but so is resilience, so I know for a fact that my ancestors and my elders, they're rooting for me and they want me to do good.

So I'll share my story over and over again.

I'll go through those emotions, like, a million times if it helps one person.

At the same time, in some ways, it heals that little-- that little scar that's in me.

Kennedy: At the end of the day, the great equalizer are these illnesses, and when you share about your common experience, there is a bond in that, a fellowship in that, that people who find it don't ever want to let go of it because it's what they've always been looking for.

They just didn't know they were looking for it.

Kevin: I was the guy who pushed the shopping carts at Home Depot.

And then my case manager came up to me, and she said, "I got a job for you.

I want you to be a Peer Support Specialist."

Suddenly, I was given this job because I had a mental illness, because I had a criminal record.

Be a voice for people who are going through the similar struggle as to what I went through.

...was necessary to go through them to arrive where I am now.

An incredibly important part of the mental health workforce, increasingly, is going to be people with lived experience who have recovered and who want to share that experience with other people to help them recover.

Vinson: They're able to draw from their lived experience with mental illness to identify a mission of helping other people who are in that place that they were in, and of helping those people understand that that doesn't have to be the way that their story ends.

My name is Leah Reed.

I'm 27 years old, and I'm a peer specialist with the Felony Jail Diversion Program in Miami Dade.

My name is Justin Volpe.

I'm currently 35 years old, and I'm a certified recovery peer specialist at the Jail Diversion Program.

These past 12 years, I've helped over 1,000 people get out of jail and get them linked in the community and help people recover.

I graduated with my psychology degree from UNC Charlotte.

I plan on either going to college and becoming, say, a social worker or getting a degree in psychology and coming back to the community and helping out kids in Portsmouth.

[Slide projector advances] Makalynn: I think that my interest in criminal justice started with my dad being incarcerated in and out and then me learning that he isn't just a bad guy.

He's not just an inmate.

He's a person who is struggling with something, and our penal system found it best to incarcerate him rather than, um, you know, order him to a treatment center for his addiction.

I'm a graduate student.

I'm getting my masters in criminal justice right now, and I want to work with offender re-entry in some way.

Justin: One candle can light thousands of candles.

That's all we can do.

We can't do it for people, but we can help guide them and suggest what has worked for me and thousands of others.

Kennedy: This is the public health challenge of our time, much more than in terms of medical disability.

It's in terms of lost relationships, damaged communities, tragic pain and suffering.

When is the suffering going to stop?

Insel: The problem of mental illness is everywhere.

We are in a crisis, and that crisis has to do with our inability to provide the kind of care that people with mental illness need and to provide it in a way that they can use at a time when they can use it.

I think that American society has... tremendous resources at its disposal and that our lack of progress is less a matter of, uh, resources and more a matter of will.

It's not that we can't address things in a meaningful way, we just haven't chosen to.

Thompson: If you're feeling hopeless and feeling there's not a chance for you, and everything is lost and gone, I will tell you everything is not over for you.

I will show you that, and hopefully you can show me back, and we can show each other together and work on our mental illness.

Because you can't go through it alone because I have it.

So you're not lost, because I have it.

You're not alone, because I have it.

And you're talking to me, so now you have someone that's the same as you who's ready to go with you.

That's what I would tell you.

I will show you that it can be done.

Lydia: I feel for you.

I...I really do.

I have been in your place and I know how hard it is, and I know it feels like nobody understands and nobody-- nobody knows what you're going through, but I do.

And I--it's a really hard place to be at, and I understand.

Woman: Ooh ooh ooh ooh ooh ooh ooh ooh ooh ooh Ooh ooh ooh ooh ooh ooh ooh ooh ooh ooh Kevin Earley: I've been in the back of a squad car Handcuffs digging in my wrists, not far From feeling suicidal My life up and down like a seesaw Late at night, I ask God for a response But it's like a dropped call Or one placed on hold My heart pumps cold, blood bold So much turmoil I want to curl up into a ball... Announcer: Learn more about the "Hiding in Plain Sight: Youth Mental Illness" film and explore mental health resources at pbs.org/plainsight.

Also join the conversation online with #PlainSightPBS.

To order "Hiding in Plain Sight: Youth Mental Illness," on DVD or Blu Ray, visit shopPBS or call 1-800-PLAY-PBS.

This program is also available with PBS Passport and on Amazon Prime Video.

Woman: Whoa oh oh Oh oh oh ohh ohhhhh Earley: I've been in the mental hospital Looking at the judge like, "Drop the sentence" Parents crying, asking for his forgiveness Face the verdict, now I've been convicted I've been in the back of a paddy wagon Dragged out of my home kickin' and screamin' By policemen, taken against my will Been fragile, doctors prescribed pills Been in the mental hospital Talking to other patients about life issues Met schizophrenics in drug clinics Abusers who misuse, suicide girls I fight demons, trying to stay out of trouble 9 to 5 stressful, but that's survival A piece of the puzzle, they tell me I'm "crazy" Maybe I'm "crazy," nobody understands So I talk to the planet, my theories are abstract Watching TV, and I start hearing voices America telling me, "It's all about the money" But it sounds funny, 'cause I know I got choices I've been to the mental hospital I've been to the mental hospital I've been to the mental hospital And if I'm crazy, that's how the world made me I've been to the mental hospital Been to the mental hospital I've been to the mental hospital And if I'm crazy, that's how the world made me And if I'm crazy, that's how the world made me And if I'm crazy, that's how the world made me And if I'm crazy, that's how the world made me And if I'm crazy, that's how the world made me