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Interview: Meg Kissinger

by: Whole Beast Rag

​SPECIAL REPORTING BY ADAM SEGAL

Meg Kissinger is an investigative journalist for the Milwaukee Journal Sentinel. In 2009 she was a finalist for the Pulitzer Prize for Investigative Reporting for her writing on Bisphenol A, and in 2012 she won the Robert F. Kennedy Journalism Award for her Imminent Danger series on the American system of mental health. Kissinger has been writing about mental health for over 30 years, and in the wake of the Sandy Hook shooting was asked to write a piece—a new installment to the Imminent Danger series—in response to the tragedy.

I spoke with Kissinger this past month about writing difficult stories, about the need to humanize the mentally ill, and about the difficult question of assigning personal responsibility where mental illness is present.

WHOLE BEAST RAG: After the Sandy Hook shooting, there was and continues to be a public fascination with the tragedy, with the victims, with the perpetrator, with his motivations. People want to know who or what to blame, and currently there’s a nationwide fascination—or at very least a media fascination—with guns and gun control. So if you could speak out over everybody else; if you had a chance to make something clear to everybody taking part in this conversation, what truth or idea would you want everyone to keep in mind while they talk about it?

MEG KISSINGER: That’s a great question, and I think I was able to do that a little bit. My editor asked me to write a piece that appeared the Wednesday after the Sandy Hook shootings. My main point in that is that there are a lot of people who are vulnerable because of their mental illness; we don’t handle mental healthcare very well in this country, well, really anywhere. But if you had to boil it all down to one sentence, it’s that we need to do a better job of caring for people with mental illness. Which [laughs] is pretty basic, and not entirely a sophisticated thought, but that’s my observation. We marginalize, we demonize, we do terrible things to people with mental illness. And that leads to a whole host of other problems. It deters people from seeking out care, it allows cutbacks in funding, it cuts off the supply to mental healthcare. In a sentence: we need to do more to care for people with mental illness.

WBR: I read that, the article you wrote, and I really appreciated your appeal for people to think more about personal responsibility. In terms of being a family, a community, a nation: it isn’t just somebody else’s job, that we have to do it ourselves. I liked that. I was wondering: what was it like to write a story so soon after the tragedy? And what has the response been?

MK: It was an assignment. This came out of the fact that I had spent all of 2011 looking into the issue of how to predict if someone with severe, persistent mental illness is going to be dangerous. That was something I had been immersed in for over a year. It was brutal. It’s a very depressing question, one that I was very flustered by. I wrote the very high-profile series in 2011, the Imminent Danger series. And this tragedy happens a year later, and it was just too tough to be ignored.

For the first time in memory, I stayed up all night to write this. This was just such a heavy topic. And the writing of it was, in a way, excruciating, because you want to say something fresh, something meaningful, but not too heavy-handed. Something that is going to add to the conversation and not just overwhelm.

I thought: what can I say that’s different? I guess the value that I could add is that there aren’t too many people who have spent this many years as a journalist covering mental illness. It’s the one unique vantage that I had, so I played to that. What could I say, from my many years of interviewing people who have been touched by violence vis-à-vis mental illness? The huge warning is that you don’t want to associate mental illness necessarily with violence, because it can’t be said enough times: people with mental illness are more likely to be a victim of violent crime than a perpetrator. The reality is that there is a tiny subgroup of the population that is dangerous because of their mental illness. We can’t turn away from that. Even if it is not a conversation that you’d want to have.

WBR: Your piece was perhaps unfairly used by the pro-gun crowd, as an example of the argument “it isn’t our issue, it’s a problem of mental health.” Was this the case? How did it feel to have your writing used in such a way?

MK: Well, I know I won accolades from people I don’t usually win accolades from. [Laughs] You know, namely the conservative talk show circuit. And yes, it was a little unnerving. But I feel that this issue does not have an ideology attached to it. People can twist what you say however they will. It is worrisome that what you write is going to be used to promote someone’s agenda that you might not agree with. And it would be a shame if that were the trap door to a serious conversation about gun control. But I wasn’t writing about gun control. I was writing about getting more care for people with mental illness.

WBR: There’s a piece by Richard Friedman in the New York Times in which he argues that we commit an injustice by focusing on the mentally ill when so few mentally ill people are actually dangerous, and when so few of the violent acts in this country are committed by the mentally ill. He suggests that we should instead focus on the “outwardly normal people in the grip of all-too-ordinary human aggression, to whom we provide nearly unfettered access to deadly forces.”

Friedman points to a statistic from the National Institute of Mental Health indicating that people with no mental disorder who abused alcohol or drugs were nearly seven times as likely as those without substance abuse to commit violent acts.

So I’d like to ask, what do you think of the suggestion that we’re focusing too heavily on the question of mental illness as it relates to violence?

MK: I think you can have both conversations. They’re not completely exclusive. I did read his essay in the New York Times, and it’s something that a lot of advocates really believe: that any discussion about violence as it relates to people with mental illness would be injurious to the mentally ill population. That was something we heard loud and clear in the aftermath of the Imminent Danger series. That really created a stir. There were many advocates who showed up at the forum [The Milwaukee Journal-Sentinel] held on that series. They were quite upset with the newspaper for framing the question as, “what do we do in the matter of mentally ill people who can be violent?”

Our answer to that was the same thing I would say to Friedman: When you talk about people with mental illness, it’s a huge group of people. It’s a very big tent. You have to be concerned about framing an argument in a way that’s not going to deny civil liberties unnecessarily. You do have to be concerned about that. But we don’t do anybody any favors by failing to acknowledge that there are people in this world like Adam Lanza, like Jared Loughner, like Seung-Hui Cho, who perpetrate these awful violent acts by virtue of their mental illness.

WBR: I’ve heard the argument that mass media encourages further shootings because of all the coverage it gives to such tragedies. I guess the idea is that we inadvertently turn these people into heroes, or we just give them much-craved attention. Do you suppose there’s any truth to the idea that, by reporting about a certain thing, by addressing it and discussing it…

MK: That’s an interesting theory, and I’d love to see the science on that. You know what I mean? That would require interviews with people who do commit violent acts like this. My hunch is that it’s really remote, and I don’t think it’s a very big factor at all.

News, by its very definition, is reporting on what happens. How do you not report on Sandy Hook? It’s not possible. The reality is that you’ve got the 24-hour news cycle now, which leads to all kinds of crazy mix-ups. Like in this incident, they got the name wrong. First they put it on his brother, because he had his brother’s ID on him when his body was discovered. You had it said that the mother worked at the school, that she was in the school when this happened, that was not right. So there is a lot of bad information, because it’s unfolding in real time. There’s all this pressure for everybody to get it first. That’s just a pitfall of competition in the 24-hour news cycle.

WBR: Do you think there are any ways to fix the system, to make it less about getting it first and more about journalistic integrity?

MK: In reality, I just don’t see how that’s possible. With Twitter and Facebook and so many different platforms now. It’s almost impossible to not release something. Because somebody is going to put it out there. And that’s going to give other people license to say “Deadspin reported this” or “Name-your-favorite-news-outlet reported that.” In the case of the [Gabrielle] Giffords shooting, NPR reported for almost an hour that she had died. So the buyer has to beware. Media consumers in the modern era just know—and it’s not that we got everything right back in the old days, we certainly did not—but when a newspaper came out once a day and that was it, or there were three networks and that was it, the lid was a lot tighter. The trade-off is that we now have a lot more voices, which is a good and bad thing.

WBR: Has the rise of social media affected your job personally?

MK: Not really. It’s easier to get a hold of people [laughs]. It’s easier to elicit comments from people. But too often they’re by way of email, which I hate. I love it for its expedience, but you don’t get the back-and-forth conversation that you and I are having right now.

WBR: Definitely. I’ve heard that you’re working on a new story about a community in Belgium that has, for a very long time, had a system of caring for its mentally ill that seems to be working. Could you tell me more about that?

MK: Sure! It’s this little town called Geel, outside of Brussels. For 700 years they have had this practice of foster care for people with significant mental illness. It started in a medieval way: there’s a legend about a princess from Ireland [Saint Dymphna], and there’s all this zany lore. The town took it upon themselves to build a shrine erected in her memory. Whether or not she really existed, no one really knows. But anyway, their local custom was just to embrace people with mental illness and care for them. So at a convent, these nuns built a sick house for the mentally ill, and these people were cared for. When people from all over Europe came to the Geel community, the sick house filled up quickly. The people in the town were called to take the mentally ill into their own homes. So this practice became part of the fabric of the town.

And sure, some people had less-than-noble ambitions, i.e. to get free farm labor. And so I’m sure that there was more than one instance of someone living in a barn outside of Geel, doing 18 hours of farm work a day. But over the years there have been tweaks to the system, and the state government has taken oversight. Because it’s not fully an agrarian community anymore, and it’s rare now to have a mother and a father in a home, that tradition is beginning to fade. It’s not as thriving as it once was, but the model of care has inspired different kinds of community movement here in the States.

I first came to know that because in Milwaukee, in May, there will be a fundraiser and walk, called the Geel festival. There’s a place in New York City called the Geel house that is fashioned after this model. So we just thought, when working on this project, to look into the place that has the conditions for the most holistic, best care.

WBR: Sure. So you said that it’s beginning to fade, though? The tradition is falling away?

MK: Well, you know, there’s not as many people in rural roles. In the heyday, which was the 1930s, something like one of every five people in the town were people called “boarders,” the people with pronounced mental illness. But now there are fewer than that; there just isn’t much availability for people to take others into their homes and give them care. The modern style doesn’t really lend itself to that kind of commitment.

WBR: When we’re talking about the numbers of mentally ill people in the United States, I believe it’s somewhere around 4 million. Is there any way to make a working model—obviously it would have to be smaller, more spread out—is there something from that we can copy on a larger scale? I guess it would mean facing up to the stigma and getting rid of the fear of mental illness.

MK: That’s exactly right. You just said it perfectly. Because, I guess we’ll see. Can this model be duplicated? Wouldn’t that be great? Tomorrow I’m going to a lady’s house on the east side of Milwaukee who runs what’s called the Blessing House. And she’s just this nice little old lady who has taken it upon herself to bring people into her home. Neighbors are really nervous about it; she has to keep it on the down-low, because she doesn’t want people busting her for zoning code violation. They might invoke HIPAA, they might allow her to become part of an organization. It’s going to try to be like Geel, but there are all these roadblocks. It’s not a very American model, to have community care like that.

WBR: In a lot of your writing you use a rhetorical tool in which you plainly make an analogy between a mental illness and a more “conventional” illness. I looked at the transcript from the internet chat you conducted. You responded to a question with “family members have to take a big step back for their own peace of mind and safety. That feels so counterintuitive. Can you imagine ignoring a husband or daughter or cousin in the throes of cancer? That’s why mental illness is an especially cruel disease.”

Do you think there ever will be a time—obviously this is the hope—do you think a time will come when people see mental illness in the same way they see more bodily illness? Will we ever think that this doesn’t have to do with a person’s character, that it’s something they simply can’t control?

MK: That would be fantastic, and that’s what keeps me going at this really depressing job [laughs]. I’m hoping that someday people will see them as the same. Many people do now, and many more than, say, when I first started writing. But it is still stunning to me, there is still that barrier. Even my hero, John Stewart. On the Daily Show a couple weeks ago, he was doing a riff on this business of gun control and mental illness. Even he was talking about “the crazy people.” I’m just as irreverent as the next person, and like in anything, I do see the need for levity. But even he spoke, I just thought, too flippantly, too marginalizing, about people with mental illnesses. As long as people do that, we’re going to put “those guys,” people with mental illness, off in the corner.

So the goal is to treat everyone as human beings. To afford them the inherent dignity, and the inherent right to be treated as an equal, as a full-on person. So if you compare it to diabetes and heart disease or cancer, that is something that does help people figure it out.

WBR: What do we do with the truly difficult cases, the extremely violent cases, in which a person’s actions come across as so reprehensible that sympathy is out of the questions? In a shooting, when innocents are killed, how do we reconcile that, and still think of the perpetrator as another victim? It’s seems naturally counterintuitive to think of it that way. Even if it is the ideal thought.

MK: I suppose Adam Lanza is the ultimate in this regard. We don’t know anything about Adam Lanza, because his mother is dead, and he is dead, and the father and brother are nowhere in sight. We don’t have a lot of history on him. We know a lot more about Jared Loughner, from Tucson, and James Holmes, from Aurora, and what we know is that these were young men, also Cho from Virginia Tech, these are young men who grew to manifest clear signs of mental illness and were very disturbed. People tried to get them help, and they didn’t succeed.

So I feel sorry for those people. The more you learn about them… I’ve read stuff about Loughner now, he fell into this stupor, and when he came to, and realized what he had done, he was just grief-stricken. It’s this whole tricky area, an utter lack of insight. People who are psychotic, one of the hallmarks of that is an utter lack of insight. So I know the civil libertarians wrestle with the question: can you compel someone into treatment? There is a lot of testimony from people saying “I didn’t want to take my medication but I got better when I did.” Either by virtue of medication or however. When the side effects of psychosis subsided, they realized that they were so sick, and they could see it clearly then. How can I not feel bad for somebody like that?

WBR: David Eagleman published an essay in The Atlantic adapted from his book, Incognito; the essay is called “The Brain on Trial.” It begins with a quote from Charles Whitman the shooter—

MK: Yeah, the shooter at UT.

WBR: Yes, and you may have come across this: he left a note before he committed the murders. Whitman wrote “I talked with a doctor once for two hours, and tried to convey to him my fears that I felt overcome by overwhelming violent impulses. After one session I never saw the doctor again and since then I have been fighting my mental turmoil alone, and seemingly to no avail.” This is just one of several other parts of the note that makes it clear that this is a man having serious problems with his own sanity. When you look at it that way, it’s almost hard not to feel sorry for him. When looked at not as “this is the crime he committed” and rather as “this is the struggle he was going through.” So it is extremely complicated. I don’t know.

MK: Oh yeah. In a way it’s like proving a negative, you know? How do you know that somebody is violent if you suspect it and you intervene, and ultimately nothing happens? It’s really tricky stuff. We should be able to look around and notice the mental health of those around us, and be engaged in that. Mental illness is a very isolating illness. And that’s where a lot of people come to harm.

One of the stories I’m working on right now is about a guy who died last summer in Milwaukee, a 42-year-old man, who died of hypothermia. He had schizophrenia, and by virtue of that illness, he was isolated. He was afraid to go outside of his apartment. It was wicked hot, and he had an air conditioner in his apartment but he didn’t turn it on. His mom and dad had stopped by the day before, urging him to take a shower, but he didn’t keep cool, and so he died. And that’s really difficult. He’s not going to show up on anybody’s roster, that he died directly because of mental illness, but it certainly was at the root of it. If he hadn’t had an impeded ability to sweat, if he had been able to feel the heat and better regulate his body temperature, he wouldn’t have died.

So all that is to say, we can help a lot of people by recognizing the signs of mental illness and being more proactive in getting people into care.

WBR: Do you think maybe there’s something about mental illness that makes people uncomfortable, in which the question is asked: if someone with a mental illness is less responsible for their own actions, to what extent am I responsible for my own? It seems to get at this really uncomfortable question of where responsibility lies and where choice lies, and to what degree are we all driven by the chemistry of our brains.

MK: I think a lot of it is just ignorance. And mean-spiritedness. Although it does go into the question of “shouldn’t we all be allowed to be eccentric?” Alberta Lessard, the woman I profiled in the Imminent Danger series, a schoolteacher from West Allis, whose case it was that established civil liberties on a national level for people with mental illness; she is one kooky lady. She’s 94 years old now and she’s still going strong.

Now, should she have lived her whole life in a mental institution? No. But her freedom put her into contact with a lot of people that she annoyed, pestered, cajoled. But you know, also delighted. People with mental illness can be really obnoxious. And not everybody has the patience to abide that. I think that the world is a lot better off because they are allowed to be different. But it is kind of hard to put up with sometimes.

WBR: I read the article you wrote about Jim Hankin. I think one of the important things you’re doing with your writing is the act of humanizing… there’s a woman you quote in the article who you talked to at a party, who dismissively says “Well, he’s insane.” As if that’s a catch-all, end-all, don’t talk to him, don’t take him seriously sort of thing. And I think it’s important that you’re writing about him as a man, who was eccentric, and you’re honest and you say that he was difficult. But I’m curious. At what point is he eccentric and at what point does it speak to illness?

MK: Oh yeah, and that, oh boy, I felt so awful. Because, you know, I blew him off. It was simple. I just did. He asked me to drive him to the doctor and I begrudgingly agreed. And when he cancelled, part of me was relieved, and part of me was really worried too. I made an honest effort to get him there, and then I was pissed. I was pissed off at him for dying. “You didn’t let me take you to the doctor.” It was awful to stand there in the back yard while the cops went inside, and I made the mistake of reading the medical examiner’s report, and how he died, it was horrific. So, there’s no delicate way of talking about that. It was nasty. He was really a delightful guy, too. Like with everything, people are made up of many different parts, whether you have mental illness or not. Maybe mental illness amplifies the parts of you that are quirky and cute, and obnoxious and annoying as well.

WBR: So I have one final question, I don’t mean to bring this back to dark territory but it’s something I’ve been contemplating a lot. Last year I followed the Anders Breivik trial pretty closely. One thing about the trial that fascinated me particularly was that the prosecution wanted Breivik declared insane, which would have led to a lesser punishment, while the defense wanted him declared sane and thus to bear the full brunt of the punishment. One of his lawyers said, as quoted in the New York Times, “To make his act something pathological and sick deprives him of his right to take responsibility for his own actions.” There’s something really troubling there, because the prosecution wanted to give him the lighter sentence, the one that was more centered on rehabilitation, and it’s hard for me, first to reconcile the idea that someone who could kill 77 innocent people could deserve anything other than the harshest possible punishment, and second to accept the concept of someone being able to kill that many innocents, and still be declared sane.

MK: I can’t figure that one out either. And that raises another question too: do you have a right to be mentally ill? The question of insight: how much of this was an informed choice, and how much of it was a byproduct of his illness? That was really bizarre, and maybe the system of justice is different in Norway. But that’s the opposite of what I would expect from a defense lawyer. Every defense lawyer in America would be trying to cut the best deal for their client. I don’t think those lawyers served him very well if they were trying to take a stand on a broader issue. Because their charge, legally, is to defend their client.

WBR: Yeah. It feels so wrong. On the other hand, they were defending his interests. Because he felt…he was trying to prove a point. The murders were committed because of this ideology that made sense to him rationally. So he wanted it clear that it was sanity, not insanity, that drove him to murder. To me, I can’t see someone (outside of the realm of warfare) killing so many people and still being, finally, sane.

MK: Yeah. I agree. I hear you.

WBR: Well. Let’s try to end this on a lighter note.

MK: [Laughs]

WBR: I don’t want to end so dark. [Laughs] You’ve been writing about mental health for 30 years. So do you feel happy with the way things have been going, have you seen improvements, are you positive about the future, and do you think this is an issue we can tackle?

MK: Hm. Tackle? I don’t know. We’ve worked, and we’ve improved. I’ve certainly seen a whole lot of understanding and enlightenment. So yeah, I’m hopeful. I have to be. I think that shining a light, wherever we can, when looking at a marginalized population, is going to be a good thing. I have enough faith in human nature to think that people care. And I know they care. When I wrote that story on Jim Hankin, there was a great outpouring of sentiment. People can really relate to it. So I do believe that people are compassionate, by and large, and willing to view people who suffer from mental illness as people in need of care, and not to be made fun of or to be hidden away. Yeah. There are a lot of reasons to be hopeful, and a lot of opportunities to show a better way.