by Janet Susin

"What's wrong with your son, Mrs. Susin?"

Those were the words I heard from our son's friends more than twenty years ago when I ran into them at school at the time he was first hospitalized with mental illness. As a teacher in the same high school where he was a student, this awkward situation occurred with some frequency.

I wish I could say I responded with an upbeat message such as, "He's being treated for a mental illness. I'm sure he'll get better. He really needs your support." More often than not I burst into tears. Hardly reassuring under the circumstances!

I decided to speak to his guidance counselor and encourage her to give his friends the message of hope I was incapable of delivering. She declined - because of confidentiality she said. Just as likely she was protecting him from the stigma that I was only dimly beginning to recognize.

Rebuffed by his guidance counselor my next step was to speak to the school health teacher. Surely, I assumed, they had learned about mental illness in health class. If I knew what they studied, perhaps I could broach the topic with his classmates without dissolving into tears.

What I learned was another lesson about the power of the silence that surrounds mental illness. Mental illness was not included in the curriculum because, she told me. It was a sensitive topic and she didn't know how to approach it in the classroom. But she left the door open to teach about it should someone provide her with lessons plans.

Well, that should be a snap, I thought. By then I had found NAMI, the National Alliance on Mental Illness, and was sure they would have lessons that I could share with my eager-to-learn colleague. I was confident that I would be able to fulfill her request.

Wrong!

I found, to my dismay, that NAMI had nothing to offer except fact sheets. Nor, as best I could determine, did anyone else. We needed more. So this dedicated colleague and I put our heads together and came up with a lesson she was comfortable teaching. And that was the beginning of what eventually came to be called Breaking the Silence: Teaching the Next Generation About Mental Illness.

With the help of three other members of our local NAMI affiliate, teachers who were also parents, we plunged into the daunting task of educating young people about mental illness and, just as importantly, encouraging them to treat their mentally ill classmates with greater compassion and understanding.

According to the Surgeon General's Report one out of ten children and adolescents has a diagnosable mental illness requiring treatment, but less than one in five receives or seeks out treatment. Whether young people or their parents are too ashamed or afraid to admit that there's a problem, or that mental health services are inadequate or unavailable, stigma is largely responsible for this appalling gap.

Clearly teaching school age children about mental illness was an idea whose time had come. When we first wrote our lessons in the early 90's, NAMI members around the country embraced the project and went to their local schools with our lessons. Then, in 1999, with the help of funding from our national leadership through their Campaign to End Discrimination, we were able to take the project to another level. It became BTS an educational package still in use today.

We update and add new materials every time we reprint, but the format remains the same. Educational packets are available for three grade levels -- upper elementary, middle school, and high school. They include user friendly, story-based lessons with scripted questions and answers, games, role plays, posters, cross-curricular follow-up activities, definitions, annotated book recommendations, and resource lists.

Since 2001, more than 25,000 lessons have been shipped and we have receive orders from every state and numerous countries. Breaking the Silence has even been translated into Spanish by a mental health association in Mexico.

Today we use the internet to get our message out and receive orders from agencies, schools, community associations, and mental health groups as well as NAMI's. Our online Toolkit to train advocates how to make the case for mental illness education has been downloaded by advocates in 18 different countries including India, Hong Kong, Nigeria, Argentina, and New Zealand Along with the grassroots here and worldwide, our work to break the silence has been recognized by the American Psychiatric Foundation, the Kellogg Foundation, and Friendly's, among others.

Despite all the recognition for an educational campaign to break the silence and provide serious education about mental illness, it is still an uphill battle. Subjects such as sex education, AIDS, and substance abuse get priority in the classroom. What often is touted as a mental health curriculum turns out to be lessons on stress and peer relations. No state mandates teaching about mental illness and much of what is included in the health curriculum is driven by federal or state legislation. So we are still very far away from a time when all students will learn the warning signs of mental illness, what treatments are available, and how to treat people with mental illness with dignity and respect.

I've thought many times about my son's school days and wondered what if he or his friends had learned about mental illness in health class. Would he have recognized his symptoms and sought help? Would they? What if his friends had told us, or the school guidance counselor, or the psychologist, or the nurse about their concerns? Would he have gotten help earlier and avoided the downward slide into psychosis? We'll never know, but it is my fervent hope that there are young people in our classes today who will be spared the pain of mental illness because their teacher made the effort to break the silence.