Two fish are swimming along when they happen upon a younger fish. The younger fish says, “Good morning, folks. Nice water we have today, eh?” The two older fish swim on. Eventually one turns to the other and asks, “What the heck is water?”
The point of the fish story, which I adapted from David Foster Wallace, is the most important realities are often the hardest ones to see, and it can take the fresh eyes of a younger generation to notice them. Such is the case with mental health.
Like the older fish in this story, I learned about this issue from a younger person, my daughter Katharine. She called me on New Year’s Day a few years ago. I answered, “Hey, Katharine, Happy New Year! How’s it going?”
A man’s voice asked, “Are you Katharine’s father?” When I replied yes, he said, “This is the Boston Police Department. Your daughter tried to kill herself. We are taking her to the hospital. You need to get here right away.”
My daughter, who had been a top teenage soccer player in America, had her life interrupted by an eating disorder, and after 10 years she had given up hope that it would ever get better.
It was a long, difficult quest for adequate mental health services. We experienced firsthand how mental health primary and specialty care are not integrated, and how the patient often falls through the cracks. We discovered the family must become the healthcare system for their loved one, and how this extra burden can be crushing, making you so tired you cannot get up in the morning and go to work.
It’s not just eating disorders: it’s depression, anxiety, addiction, post-traumatic stress, postpartum depression, obsessive-compulsive disorder, bipolar disorder, schizophrenia and many more. Although I am in the U.S., the problem is the same everywhere.
How is this like “water”? For one thing, mental illness is much more common than we realize. Among lawyers, for instance, the American Society of Addiction Medicine published a study in 2016 showing 28% suffer from depression (7% among adults overall) and 19% have anxiety (18% among adults overall).
This is how I came to be Johnson & Johnson’s first Mental Health Ambassador in February 2016. Since then, my colleagues and I have come a long way in creating a culture of inclusion and acceptance at work, at home and beyond.
For example, we created the J&J Mental Health Diplomats in April 2017, and in its first year, we recruited over 1000 employees in 32 countries and have trained over 350 in Mental Health First Aid. We also co-founded the Global Coalition on Youth Mental Health, which aims to amplify the many emerging voices on youth mental health worldwide, and One Mind at Work, a global coalition of public and private sector employers committed to workplace mental health.
The world we are trying to create is one where everyone can do what I did last New Year's Day: I hugged my daughter, who survived that suicide attempt and is thriving.
The good news is that when it comes to mental health, we have treatment options that work for many people, and research is bringing exciting new ones. The younger fish are also coming of age in high schools, universities and online communities, where these issues, this “water," are more openly discussed. This generation is spurring change. Now it is up to the older fish to join them in supporting a more inclusive, successful future for all.
Craig Kramer is Mental Health Ambassador and Chair, Global Campaign for Mental Health, in Neuroscience External Affairs at Janssen R&D, a Johnson & Johnson company. His team seeks to transform mental health care globally by raising awareness, reducing stigma, promoting research, improving access and ensuring better patient outcomes. Prior to this role, Craig held a variety of positions in global corporate and government affairs at J&J and worked as a lawyer in the U.S. Congress, a law firm and an international human rights organization.