Last night I watched Forest Gump with my family and I was struck by the contrast between the lives of the main character, Forest, and his best friend/best girl, Jenny. While Forest has cognitive and social delays, and has an estimated IQ of 75, Jenny is a biologically normal, healthy girl from a troubled family. We might expect Forest to be the one in the movie, then, with the tragic life. Forest is different, physically and cognitively. His legs are in braces and his back is “crooked, like a question mark.” He is called “simple” and he often fails to comprehend life’s challenges. He relies on others, from his mother to his circle of friends, to insulate him from the harsh realities of life.
Jenny is developmentally normal. She is bright and compassionate, aware of the social expectations and dangers of others around her. She seems to have a better chance at a normal life.
But there is more to the story of these 2 people’s lives than the destiny created by their biology. Forest lives in a loving home with a parent who would go to any length to provide him with a normal life. She wants him to have every opportunity a “normal” child would have. His mother is loving, kind, and encouraging. She continuously reminds her son that he can do anything he is determined to do, and Forest lives this out time and again by having the courage to try just about anything. By contrast, Jenny’s home is impoverished and abusive. Her father is shown raging at her with a bottle of liquor in his hand, and the audience is led to assume he may be sexually abusive toward her. Jenny’s life becomes tragic while her disabled friend thrives in parallel. She suffers with shame and a life a sexual acting out and substance use.
This movie portrays accurately what treatment professionals, researchers, and educators still seem to get wrong: life outcomes are more affected by the presence or absence of a loving, nurturing environment than simply by underlying neurobiology in the brain.
Whether a child suffers from an Autism spectrum disorder, dyslexia, anxiety, or any host of other cognitive or mental health issues that onset in childhood, when the child is steeped in an environment of support and encouragement, s/he can live a life of difference rather than one of disability. If, however, a child is bullied or abused in the home (kids with developmental disabilities and mental health problems are at higher risk for abuse), the risk for long term emotional and behavioral problems is heightened.
We’ve come a long way toward supporting kids who are on different developmental paths. Inclusion programs in school, education and support for parents, but we need a paradigm shift in the treatment world. Clinicians need to believe, and teach families, that all kids can achieve good outcomes and have good lives. While medical treatments have steadily increased and improved for decades, we can’t lose sight of the underlying source of our worst outcomes: unhealthy environments.
Treatments in mental health must teach families and communities how to encourage and support those with mental health and neurocognitive disorders to live full and healthy lives of independence and contribution, not disability and alienation.