American Tragedy: A New Film Puts The Need For Youth Mental Wellness On The Big Screen

Apr April 30 Tue 2019

Stanford faculty, staff and members of community organizations all concerned with the mental wellness of young people gathered to view a new documentary called "American Tragedy: Love Is Not Enough," based on lessons learned from the 1999 Columbine High School shooting.

The April 25th Stanford screening, within days of the 20th anniversary of that unforgettable day in Littleton, Colorado, was hosted by the Department of Psychiatry & Behavioral Sciences in the auditorium of the Lucile Packard Children's Hospital, followed by a panel and audience discussion.  While Columbine is two decades behind us, the need for this issue to remain top of mind is a critical one with school shootings and youth deaths by suicide both on the rise.

"American Tragedy" uses the story of Sue Klebold to illustrate how a young person's mental health challenges can easily go undetected, particularly suicidality, with heartbreaking results.  Through the process lens of two decades of reckoning with the reality that her beloved son, Dylan, was one of the perpetrators of the Columbine shooting, Klebold emphasizes how she saw no recognizable signs that her child, well loved and cared for, was sliding toward violence and on a path to end his life.  Her message is that love alone cannot prevent mental illness or tragedy.  Only knowledge, prevention, and intervention can.  Following Columbine and Dylan's death, Klebold had her own experience with depression, calling living with a non-functioning brain "Hell" …leading her to grieve that until then, she hadn't known what to look for in Dylan.

"American Tragedy" Producer Lisa Sabey says her mission in telling this story is to drive a paradigm shift in mental health care and illness prevention.  As the name of her non-profit production company, "Parents to Parents," suggests, she wants mental wellness to become a family-centered practice, taking the driving force of it out of the professional-clinical setting and putting it in the home.  After her own experiences navigating the health system for her daughter which Sabey found lacking, parents, she says, should be empowered to teach children how to care for their mental wellbeing just as they teach them to maintain their physical health.  Moreover, she wants to see families and schools equipped to recognize and intervene in mental health challenges when they first begin. "American Tragedy" is crafted to support Sabey's proposition, pairing insight from mental health professionals and parents whose children have died by suicide, citing their experiences with lack of access and support in the current model of care.  

Those gathered for the screening brought the film's premise to life by participating in the panel's discussion of these challenges, and how to best address them.  Moderated by Dr. Victor Carrion, Vice-Chair of the Department of Psychiatry and Behavioral Sciences and Director of the Early Life Stress Program, Sabey also joined the panel along with Dr. Tom Insel, Adjunct Professor of Psychiatry/Public Mental Health & Population Sciences and President/Co-Founder of Mindstrong.

Panel and audience all agreed more is needed; more access, more care, more support, and more education.  There were also calls for a shift in how we use the resources already allocated to mental wellness.  Dr. Insel, seen in the film, pointed out the U.S. spends more than three trillion dollars annually on healthcare with most going to treatments, little on prevention, while most of those conditions treated could have been prevented. 

Dr. Carrion followed with staggering figures on access," 85% of kids who need mental health care aren't getting it.  Moreover, at least half of the conditions we treat start before the age of 14."

The issues, he says, are systemic, including an inability to even train enough people to meet the clinical need. That means we have to look at different models of services with the addition of a peer system of support.  

Sabey expanded on that to re-emphasize her goal of shifting mental health wellness out of the medical office and into the home, going so far as to claim that access will remain a problem as long as the system remains professionally based, "it should be family-based with professional support, not the other way around. As a mother, I can teach mental wellness, mindfulness and anxiety control. That's a revelation for a lot of people."

However, both Dr. Carrion and Dr. Insel discussed the power for improvement which lies within a systemic, encompassing plan which includes all stakeholders.  Both agreed that California enjoys political leadership and financial investment in mental wellness, but it's currently a piecemeal approach and not having the impact it could.  A coordinated public policy plan is needed, one that directly takes on the issue of suicide. Also, one that when implemented by a leader like California could be turned into a national movement.

"What if every 7th grader learned mindfulness and how to manage emotions. In Australia, kids are educated about good mental health practices and maintain them through life," says Dr. Insel. "They call it Future Proofing Kids, not just mental wellness. It will mean great social change."

Future Proofing Kids is a term Dr. Carrion likes because it's inclusive, enlisting and benefiting everyone in the community. "Teaching skills early means it doesn't even have to be an 'intervention.' It just becomes a state of being."

While "American Tragedy" is centered on Sue Klebold and her experiences borne out of the Columbine School shooting and her son's role in it, she neither excuses Dylan's actions nor conflates violence with mental illness.  But, unquestionably, the question of violence in America, and the easy access to guns come into play in the search for solutions to young people and suicide.

Clear answers were elusive in the panel discussion, as they seem to be in the nation.  Dr. Insel, a former Director of the National Institute of Mental Health, pointed out that it is worth looking at the data.  County by county maps of gun ownership compared to the same maps detailing the number of suicides show the highest rates of suicide are in states with the highest rate of guns and gun violence. 

Like America's racial issue, Dr. Insel says our problem with guns is unlike anything he's seen in other countries, "Solutions will have to come out of political and social change. We're not there yet."

To view the trailer for the documentary, please visit: