You know when you learn about something for the first time, and then suddenly it keeps popping up everywhere(that’s called the Baader-Meinhof Phenomenon, by the way, and I bet you’ll hear that somewhere else soon)… That’s been happening with the writer Sam Dylan Finch for me. He represents a slice of who I crave to become. He is the beautiful butterfly of a feminist, transgender, and mental illness advocate and writer. I am barely building the chrysalis where I will liquify into the goop of my potential.
When this article popped up on my Facebook feed today, I took notice. I read it. I re-read it. I went to work in a residential psychiatric facility. I had Kool Aid thrown on my new shirt. I kept someone from harming themselves but not from destroying their wooden bed frame. I guided a woman to the floor and used my hand to prevent her from hitting her head as she had a seizure. I came back home. I read it again. I starting writing this. I read it again.
I see myself in it. Then I look, and I see myself in it again. I look a little deeper, and there I am. I’m existing at all different levels in this piece, just as I’ve related to the mental health system at all different levels.
As a child
The first time I said I wanted to kill myself, I was on the playground. It was second grade. The recess monitor abruptly replied “No you don’t” and I continued to hang between the bars, imagining a vast expanse between me and the ground. I doubt she told anyone. I suppose if she had, there might have been some earlier intervention, and my life might have gone a little differently.
My parents didn’t really “believe” in mental illness. They saw me struggle. They saw me come home crying. They saw me gain weight. They prayed. They kept their distance, because I was pushing them away and they thought it was the right thing to do.
I wasn’t quite right, socially. I wouldn’t get diagnosed with Asperger’s until I was 19, but all the signs were there. However, I made good grades. I excelled in every subject I touched, except PE, where I was clumsy, apathetic, and unpopular. But when is came to Science or English I basked in the attention of teachers and other authority figures. These were the only people I could seem to talk to. My peers were just out of reach of my awkward rumblings. Somehow I was okay with that for awhile. Increasingly, I isolated. Increasingly, I became more and more difficult to reach out to.
This is how I slipped through the cracks.
As a patient
The seeds of potential in me had long been choked out by thorny tendrils of mental illness and substance abuse by the time my grandfather died. I had dropped out of engineering school and semi-flunked out of community college. I was living with my sister, drinking heavily and pretending that it was okay.
The years of 2012 to 2015 remain fuzzy to me. It’s hard to clarify timelines, or which hospitalization happened in what order. I went to treatment centers somewhere between eight and a dozen times, I believe. Some were partial programs, where I learned coping skills during day classes and then drank at night. Some were full hospitalizations, with varying levels of functioning. Once I was in the ICU for three days, knocked out following a suicide attempt. I had Electro Convulsive Therapy, also colloquially referred to as shock treatment(this is part of why by brain is so scrambled).
I started writing about my experiences not long ago, transcribing hospital records and frenzied scribbles in notebooks that are entirely free from metal binding or staples. I found statements from the psychiatrist in one of the partial programs I did. He said “I do not know how much she will get out of our program as it is impossible for her to think with any kind of speed.” This was a kick to the gut, which, coincidentally, also happened during my shift at work. I have never once been accused of being slow, it’s nearly universal that people who interact with me will make some off hand comment about how I seem smart within minutes of meeting me. It hurt to read. At that time, I was assessed with a GAF, or Global Assessment of Functioning, of 40. The scale goes to 100, for reference.
I have been a “bad” mentally ill person. Bruises from fighting against the restraints(I have no memory of this.) Someone trying to drag a necessary response out of me, but I was too busy staring at a crayon with tears running down my cheeks. Not waking up for any reason but to go to the bathroom, for days. Not remembering who or where I am. Being awakened for a blood pressure check to the croons of “well you’re just wrapped up like a burrito!” which became decidedly less charmed when we both(!) realized I was actually naked in my blanket burrito.
Then there’s the egotistical nature of depression. I was quoted in one of my charts as saying that I was the worst person in the world. God, how arrogant. But to truly believe, right down to the base of you, that that is true, is absolutely wrecking. It reflects in everything about you. You don’t care about a damn thing. Eating, showering, moving, taking meds, appointments. You have to be pried out of wherever you are in order to be forced to do anything. And there’s 25 other people on the unit in various stages of recovery that need to be handled too. And guess what? Staff would do a phenomenal damn job. And I’d still be back in three months again.
I have also been the “good” mentally ill person. I was grinned at and asked what I’m doing for the next art competition by about 5 staff during one stay. I always made sure to give them a baffled look and respond “The 16 hour days from the LAST one landed me back HERE again, what makes you think I wanna do more giant art?!?!” I’ve been the bright, relatable, engaged one, who will hold a conversation while meticulously coloring. I’ve been asked what hair color I’m gonna do next, and quipped about how I hope they don’t get to see it. I’ve made a girl nod sheepishly when I asked if she was pregnant the last time I was there.
There was a point where I was a revolving door patient, but I was liked. I was cared about. They prescribed the name brand stuff and made sure to give me a stack of samples on my way out the door. They signed special notes in the cards that we all got with our Christmas bags. They tell me to come back and visit sometime when I’m NOT suicidal. Give them an update. Maybe someday I will.
As a provider
Things have changed a bit lately, and I’ve turned the corner well enough to be able to actually work in the mental health field as a care provider, and that provides a different perspective.
One, you have to consider your safety at all times. Allowing your preconceived notions about who might be a “good” patient to lower your guard just means that you will be attacked. Yay, you didn’t suspect it! That probably means your injuries are worse.
Two, your patients crave connection, and the staff will most likely try to connect to the ones they relate to most. This means the “mostly normal” one who has a substance abuse problem is going to get better treatment than the person with schizophrenia. This is an unfortunate reality of bias. I try to compensate for it every day, but it’s something that workers need to be actively conscious of.
Three, the mental health field is othering as all get out. I have Borderline Personality Disorder. Every-Single-Training that I went through specifically called out people like me. There were multiple instances of failure to use person-first language, “You might be dealing with schizophrenics or borderlines.” This occurred in the class that brought up using person-first language. Even in Van Safety, the watered down two hour driver’s ed class, “One in four people have experienced a mental illness, there’s seven of you in here, I bet at least one of you has anxiety or something, raise your hands.”
The “Trauma Informed Care” training referred to individuals with trauma as “broken” and says that we are to be there for them while they put themselves back together. THIS IS THE APPROVED CURRICULUM OF TRAUMA. INFORMED. CARE. Broken. Seriously. I was mildly uncomfortably during most of the training, but he had provided coloring sheets so I was keeping pretty chill. Some people were stepping out because the videos were triggering. But the second he said that, my brain went on a loop. Broken, broken, broken. I scribbled it all over my carefully and brightly colored paper. I went up to him afterward and expressed my concerns. He diplomatically explained that this is how traumatized individuals are to be viewed through this approved and regulated curriculum which cannot be changed.
I guarantee you, every time I had a concern in one of these classes, I brought it up the the trainer afterwards. I can also guarantee you that I was not the first to notice or be made uncomfortable. I was probably not the first to complain either. There are systemic mindset issues in the field of mental health. Fortunately, the type of people drawn towards that kind of work are usually compassionate and often touched by mental illness in their own life somewhere, so they make efforts to improve. Awareness is where it starts though.
Okay, what was it, four? This is tough work. You will be kicked, punched, spat at, and insulted on a regular basis. Anyone that doesn’t do this is a welcome respite.
So yes, being able to function as a somewhat “basic human” can make you a “good” mentally ill person.
The thing is, high functioning, low functioning, a number on a GAF scale, these are indicators of illness, of danger. If you have a GAF of 20(which you do, if you are clearly suicidal) you are Stage 4, man. Appropriate interventions are planned and made to save your damn life.
That guy screaming for help? He could have established attention seeking behaviors.
You never really know.