Understanding Her Sister’s Mental Illness

“Cursing at the Sun,” a documentary on mental illness by Petra Brando, an attorney who graduated last year from USC Law School, will be screened Thursday in the Los Angeles City Council Chambers for city leaders, mental health workers and organizations that provide care. The documentary is scheduled to air simultaneously on Channel 35, the city’s cable channel outlet, at 1 p.m. In this column, Brando, 27, the daughter of actor Marlon Brando, describes her journey to understand and document mental illness.

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When I heard that my sister, Cheyenne, had been diagnosed with schizophrenia, I hardly knew what the word meant. Until then, I had never known anyone who suffered from a mental illness. As she struggled with her illness, I struggled to understand what the future had in store for a person I had loved and admired for as long as I could remember.

My sister was among the 2 1/2 million people in the United States who have schizophrenia, an illness with no real cure that is also badly misunderstood by the public. Psychotropic drugs may suppress the symptoms, but they are far from perfect. Their side effects can be so unpleasant that some patients find them almost as unbearable as the illness itself. My sister was one of those, regularly going on and off her medication.

For every sufferer of mental illness, there is another set of victims. Family members and close friends try desperately to help, wanting to provide the best treatment, whatever the cost. Some watch mental illness drive their loved ones out of their homes and onto the street, or into the killing embrace of drugs or alcohol.

I felt helpless dealing with my sister’s illness. As she slowly withdrew, I struggled to maintain the bond we had always shared. A feeling of alienation set in when I began to understand that the dark journey through mental illness is an individual one that I could not enter or share and that she must travel alone.

In 1996, I enrolled at the USC Law School, where my favorite course became mental health law. My professor, Elyn Saks, took us through the history of de-institutionalization, the reform movement inspired by abuses in mental hospitals. The reformers sought to replace institutions with a network of community centers offering more humane care closer to patients’ homes. In 1963, President Kennedy signed a bill calling for 2,000 such community clinics. Only 740 ever opened.

We also studied the 1969 Lanterman-Petris-Short Act, a California law that permits the state to force treatment on the mentally ill only when they can be deemed dangerous to themselves or to others, or are gravely disabled.

Indeed, this issue of forced institutionalization is still one of the most gut-wrenching issues facing families and advocates for the mentally ill.

Our class was about evenly split on the subject of involuntary treatment. Some students embraced civil rights. Some advocated early intervention to prevent the necessity for more severe action later. Others argued that public safety was paramount. Many cared exclusively about the patient’s best interest.

I was undecided. I valued civil rights, but I recognized that early intervention was the best course. Was the only choice between two sets of indignities life on the streets or life in institutions?

I wanted to find a solution that appeased these competing views. So I approached Saks with a proposal: As a final exam, I would make a documentary about these issues. She agreed. Two of my childhood friends, siblings Jennifer and Michael Carroll, who had expertise in filmmaking, signed on to direct the project.

In two years of research and filming, we found that the failure to construct community facilities in the wake of de-institutionalization has turned many of our nation’s hospital emergency rooms into de facto revolving-door mental health hospitals, where seriously ill people are simply stabilized and released. With no follow-up services for monitoring or maintaining care, many untreated mentally ill people end up in the prison system. The Justice Department recently reported that more than 15% of the inmates in the nation’s jails and prisons have some form of mental illness.

In any given year, 5 million Americans suffer from serious brain disorders. But that statistic has no meaning until we see the many faces of mental illness. In the documentary, we interviewed several homeless people, of course, but also an actress, an outreach worker and a naval officer.

Each experience was different, and not everyone agreed on whether they would want the state to intervene during a psychotic episode. Still, our subjects agreed on the need to end the stigma surrounding mental illness. And all felt profoundly how few treatment options were given them.

One clear message emerged: While treatment should be voluntary, providers cannot just wait for patients to walk in. They must get the word out to patients and meet them face to face in their communities.

I was impressed by the Los Angeles Men’s Place, a nonprofit service provider for the mentally ill on Skid Row. The organization’s aggressive outreach program endeavors to win the trust of potential patients so they will seek help on their own. The organization provides meals, shelter, medication and counseling. This is one center with a true sense of community and a staff free of what many patients encounter elsewhere: outside indifference or insult.

Sound great? We thought so, too. But in a city that could fill 2,000 beds, Men’s Place has only 20.

Under a bridge near Skid Row, we met a man diagnosed with schizophrenia. He described how his illness was such a blight on his life that he began each day by waking up and cursing at the sun. To us, that phrase summed up the inescapable weight of mental illness and its daily burden for the homeless man, the naval officer, the actress and my sister.

And so to the man under the bridge we owe the title of our documentary, “Cursing at the Sun.”

And to the millions like him who lay down their heads at night knowing they will awaken the next morning with the same pain, the same curse in their hearts, we all owe the decency and the dignity of our concern and our care.

* The Thursday screening of “Cursing at the Sun” will be followed by a discussion led by panelists Elyn Saks, USC professor of law; Jim Preis, executive director of Mental Health Advocacy Services; Dr. Glenn Currier, director of emergency psychiatry at County-USC Medical Center; and Gerald Minsk, consumer and outreach worker, Los Angeles Men’s Place.

* For information on mental illness, including emotional support, referrals and information, contact the National Alliance for the Mentally Ill at (800) 950-6264 or https://www.nami.org.