Sundance Review: BEDLAM
Lisa Gullickson, our roving reviewer is back on the road and this time it’s the snowy roads of Park City, Utah and the Sundance Film Festival. She’ll be sharing her thoughts on a whole range of movies from the front line of the festival. As always you can find them all here at The After Movie Diner.
Bedlam is the documentary passion project of Kenneth Paul Rosenberg, MD, who was inspired by the illness of his older sister, Mearle, to become a psychiatrist. When he was fourteen years hold, Mearle was diagnosed with schizophrenia. As he became an adult, he watched his family, in conjunction with her doctors, struggle with caring for Mearle at home as her condition worsened. After his parents, and another sister, Gail, passed away responsibility fell on Rosenberg to check in on her while fostering his own career and living his adult life. She lived alone in her parents’ house and continued to have episodes until eventually succumbed to her disease. While it was his sister’s challenges that inspired him to go into the study and treatment for mental illness, he ultimately ended up with a private practice where he treats patients with less severe, more manageable disorders.
Rosenberg is currently a Clinical Associate Professor of Psychiatry at the Weill Cornell Medical College and New York Presbyterian Hospital, and a Distinguished Fellow of the American Psychiatric Association. He has written two books, and has been listed in New York Magazine and U.S. News and World Report in their “Best Doctors” and “Top Doctors” lists. He’s won the Peabody Award for his film-making and has made six films for HBO and three for PBS all about mental health issues. Since watching his sister slip away and his family fall to pieces, he’s has dedicated his life to educating people about mental illness to help remove the stigma that makes these disorders unmentionable and unmanageable.
Rosenberg carries a lot of familial, and professional guilt for the tragedy that was Mearle’s life. She was diagnosed when she was 21 years old and passed away at 55. Through the course of this documentary, Rosenberg tries to reckon with how evolving policy surrounding socialized mental healthcare, the medical system, and the network familial support ultimately failed his sister and so many Americans with lifelong, unwieldy, debilitating mental disorders.
A person only has to walk through any urban, or densely populated area to witness the American mental health crisis. Bedlam primarily focuses on the homeless population in Los Angeles County that rotates through the Psych-ER of Los Angeles County+USC. The film walks us through how, between the terms of President Kennedy and President Reagan, policy kept passing the fiscal responsibility of caring for our nation's mentally ill in subsidized, extended-care institutions between Federal and State budgets until they eventually fumbled leaving the 350,000 Americans who would otherwise be in these facilities under specialized around-the-clock care on their own, in the homes of their families, or on the streets. California was one of the first states to de-institutionalize, and when Reagan repealed President Carter’s Mental Health System’s act as part of the Omnibus Budget Reconciliation Act, Mental Health Institutions were being defunded and shut down so quickly that this film includes news footage of abandoned patients being released into the streets in their hospital gowns with no money or identification. Patients without any sort of familial support system ended up in a continuous cycle of living on the streets, visiting the LAC+USC psych-ER, and prison. The film follows up with activists who have been working intersectionally with the Black Lives Matter movement to get mentally ill out of cells and into hospitals and with policy makers and influencers like Democratic Governor of California, Gavin Newsom, and former member of the House of Representatives, Patrick Kennedy, who see the injustice and are railing against the indifference it takes to lump disabled persons with criminals.
The film also follows a few patients that have cycled through the LAC+USC psych-ER and followed up with them at intervals that span over three years. These are people with varying support systems and degrees of need, but none of them can afford the full time supervision and expertise their conditions require. When we first meet Johanna, she is in a full-on manic state. She is talking lightening fast, spewing paranoid delusions and repeating a percussive motif of syllables - “bidi-bidi-bum.” She is sitting cross legged on a chair, rocking slightly, prophesying to a medical resident. The resident then goes to Dr. McGee and they talk through the side effects of seroquel. Dr. McGee reminds her that it does cause weight gain, and Johanna is a young woman, so she should keep that in mind. After treatment, Johanna is sent home where she lives with her dad. Through the course of the film, we see that weight gain. We see her on her meds and off her meds. We hear her talk clearly about how she wants to go back to school, but she just can’t seem to manage her disease. We see her with symbols drawn all over her face, wearing a purple cape and marching back into the ER.
Dr. McGee is an angel whose wings are clipped. She is professional and as patient as she can be while a homeless patient, Todd, threatens her with violence. She explains to him why she had to call the police, why he needs to be strapped to the table, but he’s been to prison before and traumatized by violent cell extractions when he is having an episode. He wants help, but he doesn’t want to be sedated. How is McGee, a petite woman probably in her 30s, supposed to reason with a sick person with unreasonableness as a symptom? She is exasperated with what she calls the “merry-go-round” of treating people and releasing them just so they can go off their meds and return with the same problems. The film interviews multiple medical professionals who all feel that the system is broken. They have taken a vow to do no harm, but where their passion really lies in making people better. There is a lot of burn out in the psych-ER.
Even though the mental health care crisis is visible, we give it a wide berth every day on our city streets, we deal with it as best we can in our families, we occasionally even hear about it in the news or in documentaries, those who are facing it everyday on the front lines are not particularly hopeful about solving it. We put our mentally ill citizens through the ringer - hospitals, streets, poorly equipped homes, jails - and expect different results, as Dr. McGee puts it, “it’s the definition of insanity,”
Dr. Dias, who works with Dr. McGee in the psych-ER as well as in pediatric psychiatry, lays out the crux of the issue for Rosenberg in the most salient terms. First he turns the table on the interviewer and asked Rosenberg how long Mearle lived with schizophrenia and what amount of time was his family actively and attentively caring for her. The answers were, thirty years and “a fraction” Dr. Dias goes on to explain that families give up on their ill family members every day, “who says society as a whole isn’t going to give up?”
In Bedlam, Kenneth Rosenberg, along with producer Peter Miller (Jews and Baseball, Projections of America), does the exhaustive and extensive work of pointing to the political root of the issue as well as sharing the stories of a handful of maligned victims of these heartless policies and those who care for them. The film-making is dynamic, engaging, informative, and thought provoking. Mental illness does not know race, gender, sexuality, or social class. It is as indifferent and as devastating as a cancer cell. Hopefully this film and those inspired by it can join the ranks of the currently too few advocates for this cause. Rosenberg can not rewrite the ending of his sister’s story, but with this film, he does arm us with the only weapon against this nations willful and systematic apathy - empathy.