The following suicide note was left by J Timothy Hogan for his sister, Althea Davis, on May 10, 1998. Davis read it last September on The Infinite Mind, a programme by Lichtenstein Creative Media Inc of New York, hosted by Dr Fred Goodwin. Lichtenstein is producing a TV documentary on Hogan.

No one who has not experienced a severe episode of depression can really understand what it is. It's like a woman trying to explain childbirth to a man. Or a black man trying to explain to a white man what it is like to live with racism. Or the blind, the deaf, or crippled trying to explain to a healthy person what it is like to live with a disability. You can explain, but the other person can't truly understand.

So it is with depression. It is real and totally disabling. It is not merely feeling low or alone. It is overwhelming. It doesn't happen only to those with a screwed-up life. I have a loving family and close friends. I am well-educated, successful in business, and financially comfortable. Yet I have this tremendous depression. So why not get help? I tried and tried and tried. The healthcare system completely failed me.

When I moved here, I contacted my mental-health doctor in Pennsylvania for a referral to someone to see in Massachusetts. He was not able to provide one. I tried to find a doctor on my own but didn't want to pick one out of the phone book (not that it would do any good, I later discovered). I called the Massachusetts psychiatric referral line. It was not in service due to "staff turnover". With no other number to call, I called the local hospital referral line. I got voicemail. I made an appointment with a general physician. I tried to get a referral from him. His office tried to set me up with an affiliated doctor, but their mental-healthcare doctors didn't take my insurance. I said I would pay CASH! They said they didn't take cash, because it is too expensive. I called the HMO. They had four doctors. I called each one. The earliest appointment I could get was a month away. I called my GP back to see if he knew any of these doctors. He said, no, sorry, I can't help you.

So that is my story. I know I am sick. I tried to get help. No one wanted to help me. It is no wonder that there are so many suicides in this country. My only hope is that my death will awaken the healthcare community and that lives will be saved in the future.