By Debra Z. Roth

Immediately after the world learned that my friend, Democratic advocate, environmental photographer and Falls Church resident, Drew Klebrink, shot himself to death, the usual questions came in. The answers this time, however, are different. His legacy, in the hands of advocates like me, is to create a happy ending.

How could he do such a thing? Why didn’t his doctors help? Could we have prevented his suicide?

Two years earlier, another local activist and artist came close. Three years before, a local teen tried and failed. All begged for help.

Last year, the son of State Senator Creigh Deeds took his life. Deeds worked toward swift changes that improved access to treatment in Virginia mental health facilities. But what about people who don’t need a hospital? And how can we prevent them from feeling so desperate?

In the case of Drew and the other City activist and artist, they suffered the side effects of drugs prescribed to help them. Medications were the key treatment for physical ailments that led to depression and addiction. A friend described this depression as something no one could ever comprehend without going through it. Others who experienced deep depression described it as “crushing,” being “trapped in a void or black hole” and as having “the spirit sucked out of them.”

“I’d wake up, feel the weight of anguish and sink back down. Eventually I’d pull myself out of bed and into the shower because the hot water was the only thing that felt good. I’d think about all I could look forward to despite my challenges and it didn’t matter. My life was full and, yet, I felt I had lost my life,” said a victim of depression and prescription sedative addiction who required anonymity so as not to risk losing her job.

Yet, despite health care reform making insurance more affordable, access to psychiatrists is severely limited. Only 55 percent of private-sector psychiatrists have been accepting private health insurance and only 55 percent are taking Medicare, according to a December study released by JAMA Psychiatry.

Affordable coverage is only part of the challenge. If an insurance carrier covers a particular psychiatrist, the next step can be like being stuck in quicksand. Getting into a psychiatrist can take one month or more, per a survey.

Immediate relief might be found from a prescription medication but some meds take six weeks to work. Most of the patients in the survey said their psychiatrists suggested they obtain psychological care but they were too depressed to begin the search, and despite expressing that to the psychiatrist, were not offered help. They were told to “try,” be “patient” and see if “friends or family could help.”

Just about half (59 percent) of U.S. adults with a serious mental illness received treatment in 2008, according to a Substance Abuse and Mental Health Services Administration study.

A full life presents a myriad of conflicts and loss that can make even the most mentally healthy person cave in. Perhaps your doctor prescribed Prozac or Ambien when you faced fear from a job loss or divorce. Whoever you are, you are likely only one house away from someone who has fought depression.

The last time I went to my dentist as part of my every six-months checkup, I was told I needed a wisdom tooth removed. I left the office with contact information for three specialists, one who had been already called by the receptionist and whom, I was told, accepted my insurance and could see me within one week.

Our teeth are clean but our minds are allowed to madden.

Starting the first year of school, every child should be required to get a mental health checkup. Checkups should be free, as a part of preventive care, as are mammograms, pap smears, prostate exams and colonoscopies.

And every individual seeking treatment should have the right to a case worker – mandatory when potentially dangerous medications are prescribed – who would navigate the system, help the patient holistically, coordinate service and payment, assure there is transportation and follow up.

If insurers balk, they need to examine the cost of the multitude of illnesses caused by mental stress. To start, the government could initiate funding – note that revenue would come in through the new case worker jobs produced.

Mental health care is not about restricting the rights of those with mental health issues. Worsening the stigma makes it even more difficult for an individual to seek help.

Not sure how you can help a friend who seems down? Help make mental health care as normal and accessible as getting your teeth cleaned.

Debra Z. Roth, a resident of the City of Falls Church, is an activist who works professionally promoting health care and economic opportunities.