Dissecting the mental health safety net (content warning)


Image: “cliché” by shando. is licensed under CC BY-SA 2.0.

It’s amazing how much can change in a year. It’s also amazing how much a milestone can change how you approach a day. While nothing specifically happened to discern this day from any else, I still carried myself with a strange mixture of unease and relief.

That’s because as of this writing, I’ve hit the anniversary of my largest and final suicide attempt, meaning that I’ve been free of suicidal depression for a year. It’s the longest I’ve been healthy since I was eleven.

My experiences with mental illness wasn’t something that came immediately and all at once. Rather, it began with a slow roll and was only identified years after the seeds have been planted. For me, it was the first time I tried to starve myself in middle school. After that, it progressed without anyone really becoming aware to what was going on.

I tied my first noose at 16, and at 18, I first tried to drink myself to death. At those times I didn’t think anything of what I was doing. It honestly felt at the time like I was sleepwalking. When I was 19, I was finally diagnosed with Major Depressive Disorder with suicidal tendencies, Generalized Anxiety Disorder and Panic Disorder. I had begun an extensive regiment of therapy and medication that seemed to work. Then, on April 17, 2018, I was admitted to the Brandywine Hospital Psychiatric in patient unit.

It’s not something that I talk about often, and when I do, I mostly make off -hand comments about my trip to the hospital, and people can usually fill in the blanks. It’s not because I don’t trust people with my experiences, but I have noticed a lot of societal pressures and problems that come about from being honest about mental illness.

We’ve come a long way from when I first started experiencing my symptoms. When they began, it was 2009 and no one ever really talked about suicide. I had a few kids in my school kill themselves, but they never really stopped to discuss what exactly was going on. A couple of my classes did have a therapy counselor come in, but there’s only so much one person can do when they’re in front of 30 preteens for 45 minutes.

And when they did come in, they spoke in a tone that could basically only be described as victim blaming. I was told that suicide was a selfish act. The person made a dumb mistake, and they used a permanent solution to temporary problems. I was told a suicidal person hurts others more than they help themselves. Before I was even able to express the feelings I had I learned to be ashamed of them, to never be honest for fear of disappointing or hurting those around me.

But even for all the progress we’ve made, as mental health becomes more and more of a focal point on the mainstream conscious, there’s still a lot that needs to happen before I can consider the mental health system and the culture around mental illness as anything but broken.

Though we’ve begun to recognize the problems that people experience with depression, we still don’t have a firm grasp on how to deal with people who have any kind of mental illness beyond that. Terrorists and people who kill are still brandished as mentally ill in an effort to dehumanize them and brush aside any kind of relatability that a “normal” person may feel towards them.

And as much as I love these movies, psychological thrillers love to point at mental illness, not radicalization, as the fictional cause of events like these. After all, it’s easier to pin the blame on something only a portion of society has than to have the uncomfortable conversation that humans are capable of killing due to rational thought.

On top of that, we don’t train police officers on how to deal with the mentally ill. People who go untreated are 16 times more likely to be killed by law enforcement. How did it get so bad? The answer is simple: We toss aside those with any form of illness and leave them to their own devices, very often forcing them into homeless shelters or on the street due to a lack of support systems. Then, as their mental state deteriorates, they become more and more likely to be noncompliant when put into a situation with a police officer who sees them more as a threat than as a person who needs help because they hear voices or are psychotically paranoid.

It’s not just the police, though. The general public is never really taught how to converse about mental illness, either. Take, for example, a mental health “professional” that my sister recently had come to her high school. The person told her class to approach people who are alone and ask, “I see you’ve been looking miserable lately, have you been contemplating suicide?” She was also told not to use graphic words, like “shoot” or “hang” or anything that might give the person ideas.

We’ve created a caricature of the suicidal and mentally ill that is detrimental to helping people simply because it’s not true. In an effort to understand, people have tried to make suicidal tendencies relatable, so they tell kids to watch out for people who are sad, or have just gone through a breakup, because everyone can understand what those emotions feel like. Those children then throw around the same corny lines that Logic, creator of the famed suicide hotline song, likes to respond to the depressed, that they should be happy because they’re alive and breathing and life is just a wonderful thing, man. That’s all the depressed need, to remember how to enjoy life. Wow, thanks. I’m cured.

When I was in high school, I was really worried about getting a date to the prom. I was bullied when I first got there for being weird so it was one of the few things I was determined to do. So I found someone and asked her. After she said yes, I was ridiculously happy. I also went home that day and tried to hang myself. I’m not going to tiptoe around the wording, it’s what I did.

See, my problem was that I was experiencing daily psychosomatic pain. Whatever of the plethora of emotions I would feel throughout the day, I would feel a burning sensation in my head that I could really only compare to the pain I felt from when I broke my leg.

Suicidal tendencies aren’t built from sadness; they’re built from pain, and pain doesn’t care about your emotions or what you were doing. A broken ankle doesn’t feel any better because you won the game; it’s still a broken ankle. The pain would then seep into my daily life. My mental state was deteriorating because of it, and since I couldn’t find an outlet or remedy, I would be drained day in and day out. I felt empty inside; not because I was sad, but because, and I can’t overstate this: I was in a ridiculous amount of pain. I honestly couldn’t tell you why I hurt, but I could give you the excuses that I was told were acceptable. I would have told you I was sad or lonely, even though that wasn’t the reason I was suicidal.

It wouldn’t matter if the caricature just stopped at high school, but it permeates our lives to the point that I wound up in the hospital. I was one of the lucky ones, because when visiting hours came, I had visitors. Lots of people who wind up in the hospital are abandoned by their loved ones and spend most of their time during visiting hours hiding or trying to find something to do while the others have their family and friends check in on them. When the time was up, I would get weird looks from the nurses, one of whom condescendingly called me “Mr. Popular” after a particularly busy day. A nurse bullied me because I wasn’t cut off from my loved ones like was expected of me.

It felt like they were treating me like an imposter because I wasn’t sad or lonely and I had people I could turn to. They were the people in charge of helping me get better, and they expected me to go through the act of a suicidal person because it’s what we’ve become accustomed to, rather than be honest about why I was there. I got treatment for things I didn’t need treatment for. Not only did they take one glance at me and quintuple the dosage of my medication, I never once had a therapist talk to me that wasn’t in group, barring a five second conversation with the psychologist. If the group therapists weren’t made up of specialists and peer counselors—meaning they were admitted in the past — I may as well have just asked to be in jail for a week.

Riverview Hospital” by Tjflex2 is licensed under CC BY-NC-ND 2.0.

In fact, the only other people that I felt I could truly relate to were the other patients around me. We all did something that millions of others refuse to do. We asked for help. When we became broken, we were sent to a place where we were forced to be open about it, where we couldn’t just drown ourselves in work or friends or alcohol like the rest of the world.

At the end of the day, we were all we had left. The safety net that is provided to the mentally ill is subpar. Every site that you could look up to talk about mental illness has the phone number of the National Suicide Prevention Lifeline (NSPL) plastered all over it. While they do noble work, the NSPL is a crisis hotline, meaning that they’re only really trained in how to deal with the last stage of an attempt. I’ve called them many times throughout my life, and most of the time I was only in the planning stage. I’ve been hung up on more times than I should ever be comfortable with. All because I started the phone call with the easiest lie I’d ever told: I wasn’t suicidal. If someone calls the suicide hotline and tells you they’re not suicidal, they’re lying. They know where they’re calling.

So what happens when the one remedy that people always shove in your face doesn’t work? What happens, Logic, when I cannot relate?

Well, you can try the hospital, but once you leave, they’ll let you in on an interesting statistic. People who are suicidal that go to a psychiatric ward are three times more at risk to kill themselves, because once the hospital doesn’t fix them they can’t find any other way to find a cure besides death. That was the last thing I heard from my social worker before I was released.

Once you’re out you are assigned to an out patient program, which is usually much longer. I spent a week in the hospital and about three months in group Cognitive Behavioral Therapy.

Also, upon release, you’re expected to reintegrate into society almost immediately. Attend therapy, get back to your job if your stay wasn’t long enough where they could let you go, which is illegal (but that doesn’t stop some employers), and get back to school. There’s nothing to stop you from just not doing any of that either, as out patient is voluntary (provided you’re not out on parole) and something you have to go out of your way for. If you don’t like your therapist or don’t like your group you can just decide not to go, and then you have nothing. The only consequence of ignoring out patient is a prolonged stay in your next in patient program.

This leaves many patients with a choice. They can either stay in the system that barely helps beyond over-medicating, or choose to leave on their own devices and pray they don’t wind up back in the hospital. It takes a level of determination that only a few can have to get out and stay out, and even though I’m healthy now I’m always aware of the possibility of the next visit looming around the corner. Psychiatric ward patients are, after all, 60 percent more likely to recidivate after discharge than prisoners.

So what can we do about it? First, establish a conversation that is more than just about being sad. Then, expand the safety net. Educate children about mental illness and how to handle certain situations that a psychosis can bring on. Lobby for rehabilitation homes that don’t lock patients away from society, then lobby for police training to deal with the mentally ill. Restructure Big Pharma to not overmedicate psychiatric wards with overpriced medication. There’s so much more that needs to happen before we can say that we treat the mentally ill as we should. This should be everyone’s concern, because even if you don’t feel empathy for the ill, all it takes is one traumatic experience before you could become part of the system, too.

Eric Ryan is a fifth-year student majoring in English writings. ER821804@wcupa.edu

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