Women & Mental Health

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Women are twice as likely to suffer from depression than men. Sometimes women are so busy working, running the house and managing the family, they forget about themselves. Tipper Gore was no exception. After her son's near-fatal automobile accident in 1989, Mrs. Gore realized she had been "taking care of the emergency so well" that she had not been taking care of herself. She was later treated for depression, and recently went public with her story to promote understanding on this issue.

More than 50 million Americans suffer from depression, not counting the countless numbers of families and friends who support individuals with a mental illness. About 12 million children under 18 suffer from mental disorders such as autism, depression and hyperactivity. While many mental and emotional disorders can effectively be treated through treatment, only one in five people who have these disorders seek help.

On June 7, 1999, the White House hosted the first ever conference on mental health. With Mrs. Gore as the chair, the conference aimed at addressing a difficult issue that is making major breakthroughs in science, research and treatments, but little progress in changing public perception.

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Bonnie Erbe: "You've been at the helm of lobbying for mental health for many years and this certainly isn't your first achievement. What have you done so far?"

Tipper Gore: "Well, since Al became Vice President, so for the last seven years, what I've tried to do is advocate within the White House for advances in mental health policy. I have always volunteered with the mental health community for many, many years. So, I've tried to advance the cause in general in terms of insurance coverage, parity issues, de-stigmatization...trying to educate people about all of the major mental health disorders, but I would say that what we've been able to do in the White House is a number of things that may seem like small steps, but I'm still proud of them and I think they have amounted something. Everything from changing what we're asking on a form: have you ever been treated for mental heath, next to have you ever committed murder -- trying to move it to the health section. Also, eliminating it unless it's long-term. They used to ask if you've had marriage counseling, for example. I think those questions were invasions of privacy, so we made changes there on the security forms that, federal workers had to fill out. Of course the Parity Bill is important, that sets the bar high, and it calls for parity for insurance companies and a goal for the country to move toward. And, I think that each step is one that creates progress."

Bonnie Erbe: "Is it fair to say, then, that a lot of people that are getting psychotropic drugs paid for by insurance companies is a result of your lobbying? Is that a fair statement?"

Tipper Gore: "Well, I don't know where our work ends and progress begins. One can only hope that the more of us raise our voices together, the more that we work towards parity and fairness and try and bring these issues to people who are in positions to make a difference, the better off we all are."

Bonnie Erbe: "You were also one of the first ones out of the gate condemning violence and pornography in rock music lyrics and you got widely shot-down at the time. Has it been as tough or the same with mental health?"

Tipper Gore: "I know what you're getting at and what I would say is this: its always been difficult to work with mental health issues, to educate people, to talk to people how important they are, how prevalent they are...how unfair it is to discriminate against people and families who are dealing with it. That we should not allow insurance companies with capping the benefits for those kinds of issues...it's just an issue of discrimination and equity, actually. But I think what I've noticed is that it's gotten easier over the years...to talk about these issues. I think the public probably is in advance of Congress on this issue. I would hope that Congress would vote to strengthen loopholes in the Parity Law, to create laws that bring us into the 21st Century, with equity where mental health illnesses are concerned and integrate it into health care in general. But, I believe that since 1 in 5 American families will deal with a mental health issue in their families -- either chronically or acutely. 51 million Americans in any one given year -- as far as we know, there may be more--will deal with this issue. It's prevalent and it's time for us as Americans to integrate it, to recognize it, and really importantly, to understand that mental health illnesses are illnesses that are diagnosable and treatable. And in some cases, the treatments are even more efficacious than some of the other illnesses that we consider to be physical illnesses."

Bonnie Erbe: "But do you ever feel like a pioneer on this issue, and if so, what does that feel like?"

Tipper Gore: "There are so many pioneers on is issue..."

Bonnie Erbe: "In terms of coming out publicly?"

Tipper Gore: "There are pioneers in terms of coming out publicly, and I salute them because I understand that it is an extremely private decision. I think to talk about any medical illness that someone has...it's always hard to talk about that. I mean, let's think about the times that we used to not talk about cancer. And when some people came forward and talked about breast cancer and other people talked about other issues they dealt with. I salute all of them, and I just hope there is a day we won't be talking about this. That we will be concerned with all of these illnesses equally and we will not be ashamed to talk about any of them."

Bonnie Erbe: "Every woman in your position (the wife of a President or Vice President) picks a cause -- mental health being your strongest. How did your personal experience play into that decision? I know you've talked publicly about having suffered from clinical depression, but without going into that so much, what was it in your life that made you choose this as an issue?"

Tipper Gore: "Well, it's good to put the question that way because I actually became interested in the issue and became educated in it with an advanced degree thinking that I would practice in family therapy years before I personally dealt with clinical depression. So, I was interested in it, probably from college on, and my interest partially stems from the fact that my own mother dealt with severe bouts of depression throughout her career in which she was also a single mother working and being very successful -- and she likes to remind me...please tell them I've recovered. I have to say that, okay mother. But, because of that I wanted to learn more about human behavior, the disorders of the brain. I found it to be very very curious and interesting, and again, my life took a different turn with my husband's election to Congress with four children. I found myself volunteering with the National Mental Health Association, serving on their board, working with people who had similar interests in mental health issues."

Bonnie Erbe: "Women are twice as likely to suffer from depression as men."

Tipper Gore: "That's correct."

Bonnie Erbe: "Do you think if you were a man that you would care as much about this issue?"

Tipper Gore: "Well, I would hope that I would. My message -- I think the message that all of us should take to men, and perhaps as women we can help men with this -- culturally I think it's harder for them to admit that they have an illness and that they need help, and I think that's true for no matter what the illness is with them. I think it may be doubly true if it has a bit of a stigma attached to it. However, I think it's very serious and something I think we should take note of that often men who have serious untreated depression or depression that's not responding to treatment will take their own lives, will end in suicide, which is the end result of a depression. The person actually thinks that the world would be better off without them. It's a major trick your mind plays on you, and men are more likely to commit suicide. So, I think it's important to say this is a highly treatable disease and male or female, if you feel that you are coping with this in some way, don't do it alone, go to a mental health professional and get help."

Bonnie Erbe: "With all the violence we've seen with teenagers... the USA TODAY article watching for signs... In your mind, are America's parents doing a good enough job in your mind of dealing with depression and mental illness among teens?"

Tipper Gore: "I think that our whole society needs to stop and take stock of where we are in being honest with teenagers -- listening to teenagers and adolescents and even younger children -- and saying to ourselves: how can we better serve our kids? How can we intervene earlier? How can we make sure they have access to good mental health help when they need it? I think we can do a lot better than we're doing and I think that people who are in the field and are charged with that responsibility are absolutely swamped. They care, they're trying. There are simply not enough people and not enough people with the warning signs, the knowledge of symptoms to watch for--even in very young children -- and know when to intervene. Guidance counselors have waiting lists. They're doing everything they can. I've talked with guidance counselors who say they are forming triages -- which you usually hear about in emergency rooms -- in order to deal with kids that they feel are most at-risk of committing violence either on themselves or to others. If you talk to teachers -- and I know you have -- sometimes you will find they can identify a kid in first grade or even kindergarten that they know is headed for trouble. Think what a change we could make in that child's life if we listened to our teachers, and listened to our pre-school teachers, and listened to guidance counselors...and listened to the kids themselves who know who's in trouble...and then, act on it to make sure they were able to receive the kind of help that are comfortable receiving."

Bonnie Erbe: "What concrete steps would you like to see out of the White House Conference? Is it more educational in nature, or do you really want to push for legislative change?"

Tipper Gore: "Of course I would love to see people urge their Congresspersons to work harder for significant progress where mental health -- parity laws in particular -- are concerned and they are in the Congress. But that is not the real goal of the Conference. Number one is educational, to de-stigmatize. As I have talked to groups around the country and have listened to people that's what they have told me. That's the number one thing they feel that can help people where mental illness and mental health issues are concerned. De-stigmatize it. Take the shame away. Integrate it. Say that it's the brain that gets sick--sometimes chronically or acutely-- just like the liver or the heart and we have to respond the same way. And, here we are, going into the 21st Century...the science is there, the treatments are there, and yet, our perceptions our outdated and still in the Dark Ages. We need to bring those perceptions in line with reality. So I want to educate, de-stigmatize, talk about the fact that treatment works, and hopefully we are going to be able to have people there speak to the need of greater access to treatment, for more services available at the community level, in places that people feel comfortable getting those services. I just find that from e-mails and letters....I have some of my social worker friends saying finally people are saying that if Tipper Gore can take medication I guess I can. So, wow, that's good, because we know for so many people it will be helpful."