Commentary––

Our Response To Child Abuse Must Transcend Entertainment And Profit

By Jeannie Pasacreta

As the alleged sexual indiscretions of Michael Jackson unfold in the media, I am alarmed by the voyeuristic preoccupation with his tragic circumstances. It is ironic and sad that public discussion centers on who and what to believe despite ongoing apathy regarding the serious underlying issues.

Perspectives on child abuse, psychological frailty, and a search for justice serve the purpose of entertainment and profit. There is little attention paid to the individuals, communities, and populations affected by these frequent yet horrific realities of modern life, even less regard for the consequences of relentless and irresponsible reporting and less attention still on a discussion of remedies and solution to the endless cycle of child maltreatment and psychiatric illness.

As a mother of school-aged children, and a provider, educator, researcher, advocate, and consumer of mental health services, I am an impassioned observer of this media circus.

Over many years, we have seen Michael Jackson’s appearance eerily changed as we have watched his bizarre behavior frequently directed toward children unfold before our eyes. Be it eccentricity, mental illness, celebrity, or his own alleged experiences as a victim, few would contest that he has demonstrated marked psychological vulnerability in blatant and public terms. If celebrities represent popular culture at a particular point in time, Michael Jackson’s plight is a sad representation of American life.

Obsession with appearance, the enormous wealth, personal cost and idealization of celebrity, intolerance, indifference and mockery directed at individuals with mental illness, uncertainty about what constitutes appropriate behavior between adults and children, the vicious, generational cycle of abuse, its contribution to psychiatric morbidity, and the inadequacy of the child welfare and mental health systems are just a few of the social maladies that Michael Jackson’s unfortunate circumstances raise, whether the allegations against him are true or false.

Child abuse is a vicious cycle that produces abusive parents. Most abused children never receive professional services, in part because of the secrecy and shame that accompany severe yet often invisible injury. Much of the cost of child abuse is incurred as the untold human suffering and financial burden associated with mental illness. Child sexual abuse is widely regarded as a cause of psychiatric disturbance and there is abundant literature linking it to child and adult mental disorders including depression, anxiety, substance abuse, eating, dissociative, and post-traumatic stress disorders.

Despite these realities, a complex and fragmented mental health system poses formidable barriers to effective mental health service delivery. Within the context of economic wealth and spiritual enlightenment that many Americans claim coupled with unprecedented scientific strides, it is puzzling that financial barriers, stigma, and ignorance are widening the gap between what research has shown to be effective mental health treatment and what people actually receive.

Drug companies increasingly dictate the therapies that are deemed effective in treating psychiatric illness because there are huge profits at stake and we are a society in need of instant gratification and easy cures. Psychotherapy as an alternative or adjunct to drug therapy is becoming obsolete because it is resource and time intensive, requiring a longer term problem-solving approach to change. Similarly, schools and social service agencies have increasingly adopted a punitive/law enforcement model to address common psychological problems including violence, bullying, and abuse. Ultimately these problems are community based, complex issues that can only be addressed through multidimensional efforts aimed at enhancing communication, problem solving, tolerance, and social reform.

I urge concerned citizens to stop watching television and to take an active role in advocating for our nation’s children and our collective mental health. Stop the media from exploiting a growing societal vulnerability that allows us to use others’ misfortunes in the service of entertainment and numbing out own pain. There is no quick fix here.

Child abuse and its associated mental health consequences are complex problems that require long-term effort, commitment, and resources. We must foster hope — one relationship, one child, one problem at a time. We must get involved with schools, communities, vulnerable children, adults, and families. We must pressure managed-care companies that withhold reimbursement for psychiatric services, to pay for them.

We do not quietly accept inadequate cancer or cardiac care yet we repeatedly tolerate marginal services targeted to vulnerable children and adults who are faced with abuse and psychiatric illness. The obvious discrepancies between mental and general health care may be explained by the fact that affected individuals are often incapable of advocating for themselves, particularly when under extreme stress or experiencing acute symptoms.

In light of these unique circumstances, concerned individuals must take responsibility for promoting mental health services within communities and to their state representatives even if they are unaffected and wish to separate themselves from such problems.

We must actively stop the cycle and consequences of abuse. We must raise awareness to make funding for child advocacy and mental health services a national priority or we, too, will soon be victimized by our own indifference.

(Jeannie V. Pasacreta, PhD, APRN, of Ridge Road, Newtown, is an associate professor, psychiatric mental health nursing specialty, at Yale University, New Haven.)