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Uninvolved bystanders in Michael Jackson's needless death

July 16, 2009
by Ronald W. Manderscheid, PhD
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His untimely passing raises important questions for our fields

For almost two weeks this summer, all major TV networks and print media examined virtually every aspect of Michael Jackson’s unhappy life and untimely death.

On one hand, we have been treated to views of a child prodigy and an unequalled virtuoso performer—the King of Pop—who was exceptionally sensitive and who adored his three children.

On the other, we also have witnessed a psychodrama laced with early father-child problems, severe dislike of self and self-image, many broken relationships, prescription drug addiction that far exceeds our common understanding of that term, and even the alleged complicity of the medical personnel who treated Michael.

Had we cared as we should, we would have recognized and could have predicted clearly that Michael would die as he did. Just as Elvis Presley—the King of Rock ’n’ Roll—did.

My question is: Where were we? Were we asleep at the switch? Why didn’t we even have anything to offer after Michael’s death? I think that it is exceptionally important that we not let this situation slip away into the recesses of time without clear thought, comment, and commitment to action.

Back to my first question: Why did we do nothing to reach out to help Michael as we watched his health deteriorate for more than a decade? Hollywood has many psychiatrists and addiction treatment specialists who work with the royalty of the music and film industry. We all know one or more of these people. Not a single instance has been reported publicly in which any one of our professional colleagues reached out to Michael, his family, or his friends.

On the face of it, it seems to me that Michael had been crying out for our help for a very long time. It is tragic that none of us responded to his call.

One could pursue different avenues of inquiry around this issue. For example, we could ask whether our mental health and substance use colleagues in Hollywood simply operate well-polished boutiques, more interested in profit than in practice. Or one could ask why city, county, and state authorities did not intervene, since knowledge of inappropriate prescription drug use is a part of cocktail circuit conversation. The principal point is that no one did anything that might have prevented an obvious, predictable tragedy.

This situation reminds me of a very famous case in New York City more than 20 years ago. A young woman was murdered in full sight and hearing of hundreds of apartment residents in surrounding buildings. Her cries went unheeded by anyone. Why? Many have been perplexed by this question for the past two decades without a good answer.

Now to my third question: Why didn’t we have very much to offer after Michael’s death? In the trillions of words and images that flowed in the weeks after Michael’s death, very few instances were reported in which Michael’s tragedy was related to the broader problem of large-scale prescription drug abuse and addiction in the United States. The available data do show that these problems are at epidemic levels. (For example, almost 7 million persons used psychotherapeutic medications inappropriately last month.) Why did we not do more to treat this as a teachable moment? Perhaps we could prevent another unfortunate death from prescription drug addiction.

Finally, where do we want to go from here? I recommend urgently that we discuss each of these questions openly in our consumer, family, professional, and government groups. For us, this needs to be a learnable moment. We need to understand what it will take so that we can do dramatically better in the future. Once we have that understanding, we must act on it.

Before I close, I also would like to identify some potential strands for these conversations:

• How can we prepare and embolden communities to reach out and provide support and guidance when a community member is obviously suffering?

• How can we as peers and helpers participate in this process? • How can we train friends and family members to be appropriate first responders?

• How can we move our practices from the office to the community?

• How can we provide leadership to our communities, our states, and our nation on prescription drug addiction?

Answers to these questions have the potential to kindle a needed revolution in our fields.

I hope that I have convinced you that Michael Jackson’s tragic death should cry out to us as a glaring red flag for the mental health and substance use care fields. Are you still willing to accept the status quo?

Ronald W. Manderscheid, PhD, currently Director of Mental Health and Substance Use Programs at the consulting firm SRA International, Inc., worked for more than 30 years in the federal government on behavioral health research and policy. He is a member of Behavioral Healthcare's Editorial Board. To contact Dr. Manderscheid, e-mail ronald_manderscheid@sra.com.