A generation ago, it seems as if everyone smoked but no one spoke openly of cancer. The word was whispered, its existence a family secret. But then, so too was the existence of a gay family member, or of suicide, rape, birth of an “illegitimate” child or mental illness in a family. All were seen as a source of shame or a sign of a weakness of character.

Much, but not all, of that has changed. Cancer victims and survivors discuss their experiences and march publicly to support funding for treatment and research. Smokers are viewed with pity or scorn, and kept isolated by their nicotine addiction. Out-of-wedlock children are accepted, their mothers given help. Educated society knows that homosexuality is not a choice but the reality for millions of Americans. The widespread and growing acceptance of gay marriage occurred at a pace almost unheard of in the annals of social change.

The exception has been mental illness, which, at some point in life, affects one in five people.

That, too, is changing, but not nearly fast enough.

As a result, New Hampshire, which a quarter-century ago had the best and most progressive mental health care system in America, has fallen way behind. The vaunted community support system that was supposed to allow the thousands of people in the state hospital and former Laconia state school to be “deinstitutionalized” began eroding for want of funding before it fully came to pass.

Today, support services, substance abuse treatment programs, appropriate housing, and mental health counseling and support are all sorely inadequate. The support system has all but collapsed. Finding and getting help for a mentally ill family member is extremely difficult.

For a person in the throes of mental illness, it’s all but impossible.

That made New Hampshire the perfect place to roll out the Campaign to Change Direction, a national initiative to teach people to recognize five basic signs of mental illness and encourage them to discuss the issue as openly as they would a heart condition or any other health problem.

Leading the campaign in New Hampshire is John Broderick, a former chief justice of the New Hampshire Supreme Court, and Dr. Barbara Van Dahlen, a clinical psychologist who, in response to the Sandy Hook Elementary School shooting, founded Give an Hour. The nonprofit was created to encourage professionals to donate time to mental health counseling and individuals to reach out to family members and friends showing signs of mental illness.

Broderick is the ideal spokesperson. He bravely admits that he and his wife failed to recognize the signs of mental illness in their adult son until after, in an unhinged moment, he broke a guitar over his sleeping father’s face. Broderick’s advice: “Don’t do what we did.” Know the five basic signs: not feeling like yourself, feeling agitated, growing withdrawn, giving up grooming and other ways of caring for oneself, and suffering feelings of hopelessness.

Mental illness knows no economic or social class and no religion or political party. It affects every family. Learning to talk openly about it without shame, the campaign believes, is the first step to preventing suicide; catching mental illness as soon as possible; reducing police and school shootings and other tragedies involving mental illness; and creating a system of easily accessible treatment and support.

We’re optimistic, given the rapid change in attitudes and cultural norms surrounding gay rights, that increasing awareness of the signs of mental illness and bringing it into the open won’t take very long. But society can’t wait until that day to begin rebuilding the once strong mental health support system that New Hampshire, in its penuriousness, allowed to collapse.

Concord Monitor