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Meg began to investigate mental illness and how it affects Americans. She discovered that hundreds of thousands of patients were released from psychiatric institutions in the 1940s and 1950s and consequently abandoned by the mental health care system. While President Kennedy signed a bill promising reform and community services, he was killed weeks later and many of his intentions were forgotten. Since then, there has been a chronic shortage of psychological help and access in the US, and those with severe mental illnesses are stigmatized. Meg traveled across the country, meeting people with mental illness and their families, compiling stories of real people affected by a failing system. She met an unhoused man whose mother felt powerless to help him and dozens of families whose loved ones did not receive the help they needed.
At the same time, Holmer and Jake joined a support group for people with loved ones who died by suicide, and the group created a quilt to honor their loved ones. When Meg and her siblings went to see the quilt’s unveiling, they found a patch for a woman who ended her life at age 87. Instead of allowing themselves to feel grief for their siblings and everyone else on the blanket, they laughed at the absurdity they felt they saw before them. Soon after, Holmer got engaged to a woman who had lost her husband and was looking for companionship. They planned a lavish wedding and honeymoon, and Meg worried that this new woman would be a risky influence on her already impulsive father. Meanwhile, Jake’s depression increased, and when Holmer’s new wife moved in, Jake was forced to move into the basement where he had found Danny’s body.
Over the next few years, Holmer and his wife lived a life of excess and accumulated massive debt. When Holmer called Meg, frantic over his uncontrolled spending, his wife would interrupt, and Meg never was able to talk to her father properly. Holmer’s wife accused Meg of having romantic feelings for her father and told Meg to keep her distance. She donated the family’s photos to a yard sale, and Meg’s relationship with Holmer suffered. At one point, Meg attempted to see a therapist, but after a single session, she found it too rattling and unproductive to analyze her past in such detail.
When Holmer and his wife could no longer afford to support Jake, Jake was forced to move into a group home for people with mental illness. After seeing the unsafe conditions and talking to local case managers, Meg discovered problems ranging from faulty plumbing to infestations and safety hazards. The more Meg saw, the more she knew something had to be done to improve the situation. One day, Meg was leaving a group home that she considered the worst she had ever seen and met an outspoken woman about Nancy’s age. As it turned out, the woman, Georgia, grew up in the same suburb as Meg, and they became fast friends. Georgia always reminded Meg of Nancy, and when Georgia died several years later, Meg was there to say her goodbyes.
At work, Meg wrote articles about the conditions at group homes and shelters, as well as a story about Georgia’s experiences of living in these places. The continuous attention eventually persuaded the mayor and county executive to build 1,000 new housing units. Around the same time, Meg had a routine mammogram and was informed that she likely had breast cancer but would need a biopsy. She considered the possibility of death and knew she was nowhere near ready, as she still had so much to live for.
While Meg underwent chemotherapy for her breast cancer, she felt weak and sullen. However, she was invigorated by a story she covered with a woman named Susanne on the harms of BPA chemicals and the political deals that fueled this problem. At the same time, Holmer borrowed Jake’s credit card, which Meg fumed about but had no control over. Meg’s breast cancer was cured, but she knew there was always a possibility it would return. When a report was released detailing the sexual abuse of patients in the Milwaukee County Mental Health Complex, it renewed Meg’s sense of urgency to expose and improve the conditions that people with serious mental illnesses live with.
Holmer was diagnosed with melanoma, which he fought for two years before dying. Holmer’s wife reluctantly called Meg and her other siblings to visit Holmer when he was nearing death. They all met at the hospital at the same time. Holmer looked fragile and could barely speak, a stark contrast to his usual boisterous personality. Meg and her siblings sang for their father and said their goodbyes, and he died shortly after. Some ashes were given to Holmer’s wife, and some were buried in the plot next to Jean. Meg and her siblings realized that both their parents were now gone. Jake, however, experienced severe loneliness afterward.
Jake’s mental health was in decline, and his caseworker told Meg that he was asking to live with family. She considered it, but complications around his disability benefits and his personal ties to Chicago prevented it from being a logical solution. Meg didn’t want to ignore Jake, however, so she was relieved when a trip to Mexico with Meg’s and Molly’s families lifted his spirits. Meg recalled a man named Jim, whose mental illness made it difficult for him to leave home. He died from an untreated bladder infection, and while Meg writing his story did inform others, she realized that it wasn’t enough to inspire compassion and understanding. After Holmer’s second wife died and sold off almost all the family possessions, Meg felt broken but grateful to still have her siblings. She realized that to heal from her past, she would need to dissect and write about her own life instead of just telling the stories of others.
In the second part of her memoir, Kissinger shifts her focus to investigative journalism while continuing to include information about her family and how their lives evolved during these decades. Because she had come to understand The Dangers of Concealing Pain, Kissinger was inspired to break the silence and shed light on the issues faced by people with severe mental illnesses and their loved ones. She knew from experience that people with severe mental health issues are often cast aside and ignored and that they and their families are blamed, and in this section, she puts these experiences in a larger context.
During her investigation, Kissinger discovered that “more than one third of all people with serious mental illness don’t get treatment” and realized that the issues her family experienced weren’t unique (200). She traveled to group homes and talked to people whose mental illnesses were not being properly treated, as well as to family members who were frustrated by this lack of support. She “discovered how [her] family’s struggles were eerily intertwined with pivotal moments in the history of America’s fractured mental health system” (202), like releasing patients from psychiatric hospitals with nowhere to go, the postwar boom of the pharmaceutical industry, and attempted but often failed reforms. Throughout the mid-20th century, funding for mental health was intermittent, and while some politicians did seek to fund quality care, their efforts were quickly overshadowed by other priorities. After writing for years about the disturbing living situations and substandard care for people with mental illness, Kissinger caused real change in her state government but recognized the persistent social stigma attached to mental illness. She realized, “You have to find a way to get [people] to see those who suffer as their brothers and sisters in need of our embrace, not strangers to be shunned” (253-54). This realization ultimately led her to decide to write her memoir, throughout which she speculates on what her family’s lives might have been like if mental health care looked different in those days and promotes Humanizing Mental Illness and Improving Care.
That Kissinger’s family continued to deal with the reality of mental illness even as she undertook her investigative journey provided her with motivation to forge ahead but also underscores the complexity of the issue. Jake still had lingering and untreated PTSD from finding his brother Danny, and Holmer impulsively married a woman who was a poor influence on him and his spending habits. In contrast to earlier chapters, Kissinger sees this period in her family’s life as a fraught and distant time, as she and her siblings were often prevented from connecting with their father without his wife present. The juxtaposition of this tension with the more hopeful tone of Kissinger’s research underscores that as important as awareness is, it is not a panacea.
That said, self-awareness plays a critical role in this stage of Kissinger’s journey. During this time, she had several personal realizations, including that she would need a therapist to help her write her memoir and that her coping strategies had kept her alive but not allowed her to fully thrive. One telling moment in this regard is the day that Kissinger and her siblings went to see the quilt for those who died by suicide. They could not help but laugh at one patch for an elderly woman whose suicide came quite late in life. While the moment was funny at the time, Meg looks back on this as an indication that she was still not fully processing her brother and sister’s deaths, illustrating that she was still coming to understand the dangers of concealing pain, even through a coping mechanism like humor.



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