Reading Between the (Head)Lines

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McCready's Suicide: No One to Blame; Much to Learn

What to blame for McCready's suicide? Fame, celebrity rehab, guns? No, no & no.

Already, people are trying to find someone, or something, to blame for country singer Mindy McCready’s tragic death at just 37 years of age. They are pointing to the fact that she had a gun in her home, and lumping this sad story in with the massacre at Newtown, Connecticut, and the recent murder-suicide of Kansas City Chiefs linebacker Jovan Belcher. Some are saying it’s due to the pressures of fame. Others are even trying to suggest that celebrity addiction specialist, Dr. Drew Pinsky, who had Ms. McCready on his “Celebrity Rehab” show, is somehow at fault. 

But they could not be more wrong. When someone has mental illness AND an addiction problem, what we in the field call a “dual-diagnosis,” those are the factors that pull the trigger. Even with treatment, these conditions can be lethal, and anyone as determined as this mother of two apparently was to end her own life will find a way, whether it’s through an overdose, a weapon, or some other means. That is the cold hard truth -- when people decide they are really going to end their life, they will find a way to do it and there is nothing that you, or I as a psychiatrist can do about it.

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Ms. McCready had already made two suicide attempts that we know of, including when she was pregnant. She was in a custody battle over her children, facing a tangled web of legal problems, and in a state of grief and shock over the death of her boyfriend, record producer David Wilson, who shot himself a month earlier. These circumstances are bad enough when you aren’t struggling with a drug and alcohol problem, as well as what appears to be an underlying depression. But for Ms. McCready, they created the perfect storm, and no one who knew her was surprised to learn that she shot herself on the front porch of her home in Arkansas. The exact same spot where Mr. Wilson, the father of her youngest child, ended his life.

Addiction is the great leveler. It doesn’t matter if you are famous or have access to the best mental health care money can buy. Most people who try to kick drugs fail many times, and often never succeed in getting clean. And those with depression commit suicide, in fact depression is the number one risk factor for suicide- alcohol/drug abuse is number two. The famous get all the press of course, especially those who make it onto “Celebrity Rehab,” but it’s common across all demographics.

That Ms. McCready is the 5th graduate of the show to commit suicide proves that point. Dr. Drew is getting bashed in the media for this, and quite unfairly. These were hard cases for anyone to treat, and most who do succeed cycle in and out of numerous rehab programs before ever getting and staying clean. Although we could question (I do not) the wisdom of treating mental illness and addiction in front of the world, the opportunity for exposure may well be the only thing bringing the fame-starved into rehab in the first place.

It’s odd, sad, and slightly contradictory that Ms. McCready recently checked out of a psychiatric hospital before completing treatment because, according to Dr. Drew, she feared the stigma. But many addicts just need the slightest excuse to give up. More than likely, by then she’d already begun the spiral into suicidal despair.

One thing I’ve learned in my 25 years of practicing psychiatry is that, as hard as we try, as hard as we treat, mental illness plus addiction is a very high risk condition and there will be casualties. Just as an oncologist who does everything in his power to treat cancer must acknowledge that sometimes the cancer wins, we in the mental health field must do the same.

Of course we don’t wish to acknowledge that cancer, mental illness and addiction are similar- all chronic long term diseases with potentially fatal endings. No, we want to say that suicide is within our power to stop, completely preventable and when it occurs there must be someone/something to blame! Sometimes all the treatment in the world is just not enough.

Mindy McCready’s death was a tragedy to be sure, but there is no one and nothing to blame- except the mental illness. So instead of using her sad story to further an agenda, let's just mourn the loss of this beautiful and talented young woman.

Dale Archer, M.D., is a clinical psychiatrist and author of The New York Times bestseller, Better Than Normal: How What Makes You Different Can Make You Exceptional.

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