Growing up on a tobacco farm in Knightdale, she saw how neighbors treated a cousin who often became too depressed to work. She learned that her family didn't speak about a certain aunt.

But it wasn't until her daughter was diagnosed that she realized that her family's silence stemmed from the stigma of mental illness.

These days, Akland spends most of her time talking publicly about the things that used to be whispered. As president of the Wake County chapter of the National Alliance on Mental Illness, she is the area's most visible advocate on the topic.

In the past four years, she has criticized the state's efforts to change the way it diagnoses and treats people with mental illness, fought for a clubhouse where people like her daughter could go during the day, and pushed WakeMed to run a short-term treatment center for the county.

Her tone is always measured but insistent. In e-mail messages to politicians, speeches at public forums and conversations with reporters, she sticks to a central theme: We know what to do, and we just need to do it.

"She's relentless," says Judy O'Neal, senior vice president for government affairs at WakeMed. "She's passionate about what needs to be done, but she's still open to looking at it from a different perspective."

As an advocate, Akland is inspired by the fact that many people with mental illnesses are too ashamed to speak out. She says she hopes that by sharing her family's story, she can get them help, and perhaps lessen the shame they feel.

"One of the things that keeps me going and makes me care so much is [fighting] the stigma," she says.

Reality sets in

As a child, Akland was not told about her relatives' struggles with mental illness.

The family secrets were so well-guarded that she never thought her children might be at risk. When her daughter, Kristen, began to act out as a toddler, Akland did not recognize the signs.

Kristen frequently cried for hours. She was violently afraid of swing sets, passing airplanes and the sound of a vacuum cleaner. She kept stacks of little notes and became upset if anyone disturbed them. Sometimes, she was violent without provocation.

Still, Akland and her husband, Gerry, clung to the belief that Kristen's problems were a phase.

"I just wanted to have that normal Gerber baby," she says. "Eventually, reality sets in that this is a real challenge of a child that you have. It's not something you can read about in Dr. Spock and then go fix."

Over the years, the couple tried everything to help Kristen: occupational therapy, group sessions and parenting classes. They enrolled her in a private school and took her to specialists, hoping that the right program would somehow fix her problems.

When Kristen was 17, however, she admitted to a psychiatrist that she had been hearing voices all her life. Some were friendly; others were mean. Often, they were a low-level hum, like the chatter at a dinner party.

Kristen was diagnosed with schizoaffective disorder, an illness that includes severe moods swings and delusions. Akland recalls that that was when she finally accepted she could not cure her daughter.

Instead, she decided to fix the system.

Taking action

After her diagnosis, Kristen began getting treatment through the county's social services.

Akland was surprised at how little they could do for her. She had assumed that there would be more programs where her daughter could get counseling or places where she could talk with her peers.

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