When one of our social work interns suggested bringing Miss New York State to a family shelter for Mental Health Awareness Day, our initial response was less than enthusiastic. How could our clients, we wondered, possibly relate to Miss New York State? Tennessee native Jessica Lynch, who wears the crown this year, anticipated such a reaction. At the beginning of her talk at Jackson Avenue Family Residence, she asked for a show of hands: “How many of you, when you heard that I was coming here, thought, ‘What could Miss New York State possibly have to say to me?’”

As it turns out, she has a lot to say. Ms. Lynch, 25, has suffered from severe depression since she was 9 years old. One morning, she started crying and couldn’t stop. By the time she was a teenager, she was anorexic and was constantly bullied in school. Her parents finally sent her to a psychiatric hospital. After 30 days, however, she was released because her insurance company refused to pay. At that point, her father sat her down and told her she was dying.

The Depression Roller Coaster

“We had a conversation I never forgot,” Ms. Lynch said. “He said to me, ‘You’re dying. Your body is eating away at itself. And you’ve bankrupted the family. Our only option, if you don’t get better, is to put you in foster care so you’ll be eligible for Medicaid.’” Faced with such a choice, Lynch started taking her antidepressants regularly. By the time she went to college, she felt good—good enough to try stopping her medication.

Depression quickly descended again. Ms. Lynch describes the mental illness as “like being in a fog. You feel like you’re walking through water. … I felt so bad about myself that I couldn’t see anything else.” She turned to alcohol to make her feel better, and never went to class. Her life was out of control, and she was repeatedly told she was destined for failure. The roller coaster continued for several years, as Ms. Lynch went back on medication and off again.

Back on Track

Now, Ms. Lynch takes care of herself, physically and emotionally. She takes several medications each day, and surrounds herself with friends who make her feel good. As Miss New York State, she travels around the state talking about her experiences and lobbies for mental health-related laws. She knows now that she cannot defeat depression—she will struggle with it for the rest of her life. Her message, however, is clearly one of empowerment. “No one expected me to succeed,” she said. When her talk came to a close, she said, “If I can make it, anyone can,” and we didn’t doubt she was telling the truth.

Care for the Homeless planned Mental Health Screening Day to publicize our services while confronting the shame and stigma associated with depression and other mental illnesses. Social Workers Lynette Verges and Amy Rodrigues worked overtime to organize the highly successful event. Small gifts were distributed, and lunch was provided after the talk. The day coincided with Mental Health Month, Children’s Mental Health Week, and Women’s Health Week.

Screening for Mental Illness

The event also dovetailed with our attempt to use tested, objective screening instruments in our practice. We know that depression is a serious problem for homeless people—mental illness can lead to homelessness, and homelessness can exacerbate mental illness. But we want to measure the problem more accurately. Before Ms. Lynch spoke, our social workers and medical personnel from the Montefiore/Care for the Homeless team conducted brief mental health screenings with the clients who attended, and counseled them on how to find help. Of the clients who completed the screenings, 23% have symptoms consistent with severe or moderately severe depression, 18% with moderate depression, and 27% with mild depression. Our social workers will follow up with those who are not currently in treatment, and help them access care through our shelter-based mental health services.

In anonymous evaluations distributed after the event, clients gave the day high marks. Clients were asked if they could identify with the speaker. On a scale of one to five, with one being “a little” and five being “very much,” almost all circled four or five. One wrote that this event “should be every 3 months. Depression is a very serious issue and it should be spoken to everyone because at one time or another you would be affected.” Another client wrote, “It was a very nice thing for those who needed the help like me.”