While You Were Out: An Intimate Family Portrait of Mental Illness in an Era of Silence

Meg Kissinger’s memoir, While You Were Out, tells the story of her family’s experiences with mental illness and uses these to explore the larger social and political attitudes surrounding mental health in the United States in the mid to late 20th century. Following World War II, United States veterans and their families felt the demands of modern living, the trauma of the losses of war, and social pressures that affected their mental health. This postwar period saw an increase in attention to mental illness and the end of psychiatric hospitals known for brutal patient abuse and neglect. While these were positive changes, the rise of the pharmaceutical industry and the boom of psychiatric and psychological treatment also facilitated the exploitation and overmedication of millions of people. Antipsychotics and antidepressants of this era were intensely effective in sedating and numbing people but did not necessarily address their underlying mental health. In addition, acknowledgment of mental illness was socially taboo, and people like Jean and Holmer didn’t discuss their mental health conditions, wanting to preserve their social images while convincing themselves that their problems weren’t as severe as they seemed. Substance use disorders also rose during this era as people sought to mask their mental and emotional hardships.

During this time, political and social reform surrounding mental health was significant. With the formation of the National Institute of Mental Health in 1949, the paradigm shifted toward community care (social work, group homes, and therapy) and humane treatment for people with mental illnesses—efforts to help people with mental illness live in the world instead of locking them away. In 1963, President John F. Kennedy passed The Community Mental Health Act, but while reform occurred, it happened at a slow rate because policymakers and society often viewed people with mental illness as a lower priority. In the end, only 700 of the 1,500 planned community centers were built. 

Currently, mental healthcare generally seeks to strengthen community support for people with mental illness and their families, destigmatize mental illness, and provide the necessary support for people with mental illness to work, thrive, and live full lives. Each year, almost 25% of Americans report experiencing mental illness, but millions do not have access to support, either due to financial or practical reasons. In addition, stigma continues to prevent many people from speaking out about their own or their loved ones’ struggles. However, an increased focus on preventative research and care aims to identify and treat people with severe mental illness in their early stages, with the hope of decreasing lifelong severity. Kissinger recognizes destigmatization as crucial to these efforts as she interviews people with mental illness and begins to understand the challenges they and their families face. Her own experiences with The Dangers of Concealing Pain fuel this exploration, and she also recognizes this exposure as the key to destigmatization.

Current social trends indicate a reduction in stigma and an increased willingness to discuss and understand mental illness. Memoirs like While You Were Out contribute to this paradigm shift by humanizing mental illness, making it personal and inspiring people to care, to learn, and to act for change.