Don’t Say a Word, a Review of Helen Cochran Coffey’s Book About Her Daughter’s Suicide

Anubis, jackal-headed god of mummification and protector of the dead

Death of a loved one by suicide changed the orbit of Helen Cochran Coffey’s life.  That her daughter Heather died in such a way exposed Coffey’s raw frustration with a mental health system  that, according to Coffey, for twenty years misunderstood, misdiagnosed, and mistreated her child.  How could this happen?

Coffey believes that this tragedy was the result of the incompetence of mental health evaluation and treatment, and she wants the system repaired so others do not suffer the same.  So with the support of the National Alliance for the Mentally Ill and the Survivors of Suicide, Coffey wrote a book about her daughter’s journey through the dark forests of depression, borderline personality disorder, serious substance dependency and treatment.

Is this book worth reading?  It depends on what you’re looking for.  If you’re looking for definite signposts of mental illness in the early years of life, you won’t find them here.  In fact, the first several chapters describe what seems like a normal childhood lived by a very likeable child up until high school.  They provide a sunny backdrop in stark contrast to the black storms coming.  But it also raises a question about Coffey’s reactions to typically stupid adolescent behaviors, reactions including having Heather arrested at school and subjected to an inpatient emergency psychiatric evaluation.  Heather was “diagnosed” as possessing stupid adolescent behaviors and over-controlling parents, and was released.

By chapter five, though, Heather’s life unglues.  Read this book if you want see how a hard-working, conscientious young woman and mother begins to wobble on her axis and careen into an ugly universe of addiction, depression, divorce, failed treatment efforts, failed liver, job loss, and then ultimately alone  in her garage one cold February morning uses a leather belt to hang herself.

If you are interested recognizing mental illness and getting direction for it, fortunately Coffey’s book doesn’t end with suicide.  In an effort to help others recognize impending mental illness, she includes lists of “symptoms” or behaviors  as possible indicators demonstrated by Heather from her earliest years.  Some of the behaviors listed might unnecessarily alarm.  The fact that Heather kept her room neat, for example, doesn’t give her a compulsive disorder.  Some of the behaviors, however, are concerning and worth reading.

Coffey recounts the numerous treatment facilities Heather attended although this book is not much of an endorsement of those services.  Coffey lists other support groups as well.

Finally, Coffey runs through a series of idealized scenarios questioning the law enforcement system, the legal system, the mental health system, the laws, treatment professionals, treatment facilities, treatment plans, and almost anything peripherally related to mental illness.  The question is, basically, if all of these things were different (perfect?) would Heather’s outcome have been different?  The implication seems to be, “yes, so shame on everyone.”  Her point is advocacy for change.

But whether the outcome would have been different is hard to say.  All the systems, even operating at perfection, depend on scientific knowledge about mental illness, the ability to diagnose it, and having tools to treat it.  Frankly, we just don’t know that much yet.  Heather’s case in particular seemed extremely difficult to name, especially as complicated with depression, substance dependency and life-threatening alcoholism.  Somewhere along the way someone threw in “borderline personality disorder,” too.

Could Heather’s outcome have been different?  We can only hope. This book, if nothing else, is thought-provoking.

About ghostofvangogh

Advocate for mental health care and services, and for ethical treatment of other human beings.
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