The Brooklyn Rail

Disclosing your family’s deepest traumas is never easy. It risks rearranging how others see you, it often makes for an uncomfortable situation. Being honest, with yourself and with others, however, can be the first step towards repairing generational wounds.

In her new memoir, While You Were Out: An Intimate Family Portrait of Mental Illness in an Era of Silence, Meg Kissinger delves into her charmingly rambunctious family’s seldom acknowledged struggles with mental illness. Set against the backdrop of Chicago’s North Shore suburbia in the 1960s and ’70s, during a time before many people had a working knowledge of mental illness, Kissinger invites us into the family home. With the perceptive perspective of a middle child among eight, she strikes, as a narrator, a solid balance between the childhood naivete of a girl bearing witness and the contemplation of an adult with the privilege of hindsight and temporal distance.

Both of Kissinger’s parents struggled with alcohol addiction and undiagnosed mental illnesses, and as the siblings grow up a variation of these struggles crops up for each of them. Today, a flawed part of mental health awareness, due in large part because of the American emphasis on individualism, has been the framing of mental illness as a wholly personal healing journey. But nobody lives in a vacuum. What does it mean to love someone in the throes of severe mental illness? What happens when they can’t seem to heal? When it’s your family, what does it foreshadow for your own mental wellbeing?

Kissinger’s older sister Nancy spends years in and out of both expensive private care and the state hospital. She verbally and physically threatens herself and those around her, at one point chasing Kissinger around the house with a steak knife. This revelation is unblinkingly honest and hard to stomach. “When I looked at her, I didn’t see someone who was suffering and needed help,” Kissinger writes. “I saw someone who could kill me.” Balancing the realities that someone can be suffering and need help, and also able to kill you, is incredibly challenging.

After years of fear, pain, and stress for everyone, including Nancy, and nearly a dozen attempts, Nancy ultimately dies by suicide. Kissinger acknowledges her guilty sense of relief. It is a special form of powerlessness to watch someone you love deteriorate mentally, as the spiral downwards takes them out of school or work, out of independent living, out of their vibrancy, out of their most treasured relationships.

Seventh-born Danny’s trajectory is fundamentally altered by an ill-informed series of harassment-based hate crimes when he is in college, and his worsening paranoia and denial of his mental illness make him extremely difficult to help. It’s evident that Kissinger’s family is not well-equipped to address Danny’s troubles and that society’s ability to address Danny’s troubles doesn’t seem to exist at all.

Through her own recollections along with detailed reporting that involved the excavation of medical and police records and tapping the collective memory of those who were present, Kissinger is able to render her family and the ways that they fail each other in thorough, empathetic detail.

Towards the end of the memoir Kissinger zooms out, drawing the narrative line from her family’s losses through to her successful career as an investigative reporter for the Milwaukee Journal Sentinel, exposing the callous mismanagement and under-resourced set of policies and programs that we refer to as the mental health care system. The provision of care, housing, and other resources for the mentally ill often falls on the shoulders of family, but even those who can afford it are often faced with a lack of options, physical and emotional harm, and the intense pressure of trying to keep themselves and loved ones afloat. The promise of John F. Kennedy’s 1963 Community Mental Health Act, which intended to close psychiatric institutions and replace them with community support, remains unfulfilled. As Kissinger puts it, “we traded one outrage—the warehousing of our sickest psychiatric patients in conditions unfit for animals—for another, deserting them to suffer alone.”

Our mental health care system remains carceral, with calling the police often the only available option when someone is a threat to themselves or those around them. Cook County jail, where Danny spends four months and which Kissinger notes is considered one of the three largest mental health facilities in the country, is not a place where people find reprieve. Kissinger sums it up concisely: “No one seemed to give a shit.”

Kissinger emphasizes the necessity of shining a light on the horrifying conditions that the severely mentally often live under, destigmatizing and being honest about the day to day. The importance of forgiveness, openness, and finding peace are all underlined. It’s poignant to follow Kissinger’s father’s path from “if anyone asks, this was an accident” (in reference to suicide) to encouraging Kissinger to publicly write about her experiences. Hopefully people can start from the latter position now.

“Only love and understanding can conquer this disease,” writes Danny in his last note to Kissinger. This should be taken to heart at both the personal and political levels, which are always intertwined but particularly thornily at the intersection of mental health and systems of care. Scholar Dr. Cornel West said, “Justice is what love looks like in public.” If we took that seriously, what would mental health care look like, both in how we care for one another and how our society cares for everyone?

While You Were Out details the unique story of the Kissinger family while also ringing all too familiar for millions of Americans. For too long, the pain has been borne quietly, or coped with through humor solely, leading to “Another family secret… swallowed whole, undigested.” With the silence broken, thanks in part to works like While You Were Out, we now have the opportunity to figure out what to say to one another about mental illness, and most importantly, what to do.