This is what happens when you reach out and get help

15 June 2018
With the recent, much publicised suicides of Kate Spade and Anthony Bourdain, social media was flooded with messages urging anyone suffering depression or thoughts of self harm to reach out...get help. I know people mean well. But what help is there?

I've been hesitant to write this post, but what the hell, let's go all in. This is what happens when you reach out. If you call a suicide hotline - always promoted as the best option despite dubious proof of efficacy - or tell any sort of health or counselling professional that you are having thoughts of self harm, they are legally required to report it. Me, I was too tired to hide from my psychiatrist my utter despair. So they call 000, or the relevant emergency number. Ambulance officers arrive, and under the Mental Health Act 2007 here in NSW, are legally authorised to detain you if they believe you are mentally ill or mentally disturbed ("no, I'm not mentally disturbed, I'm having a completely justified reaction to the shit heap my life has become").

The ambulance officers will then take you to hospital. If you're "lucky", you might go straight to the mental health unit. Me? It was a weekday, mid morning, and the newly opened mental health unit did not have beds available. So. Usually, you'll have to go sit in emergency. I hadn't taken anything, physically I was fine, I just felt like an utter wreck. And there you have to sit, with an ambo to babysit you, surrounded by suspected heart attacks and falls and babies with suspected meningococcal. At some stage it was decided it was easier to knock me out, so they put me in a bed and put benzodiazepines in me, which I willingly took - believe me, I'm much happier unconscious. So that was a blurry six hours. A psychiatrist came to talk to me. I saw her report when I left hospital. She wrote in the notes that I look older than my stated age. Well thanks, that just made me feel fucking fantastic. Do they do that for heart attack victims?

After a prolonged time, and still semi sedated, I was moved to the mental health unit. They confiscate and catalogue all your possessions. Again, do they do this with heart attack victims? Go through their bags and take their squeez bacon? Mental health patients can't be trusted with their stuff, apparently. I mean, I can kind of understand; they told me phones are taken because people will call 000 and report they've been kidnapped. But all my books were on my phone. They told me I could read the books belonging to the unit. Jodi Picoult. I shudder. I asked for a bible. The didn't have any but the chaplain visits once a week. That's very helpful. I wasn't allowed to leave that day.

Look, apart from the comment about my age, which I'll let slide, the staff were all very nice. But it was still pretty gross and dehumanising. Some of the other patients were glad of the opportunity to connect with social workers and support, but I was tired and wanted to go home.

Then the next morning, I saw the psych team. I put on my cheerful face. Yes I'm feeling much better. Actually, I wasn't feeling any better, and miserable from being in hospital. But I put on the happy face and was able to go home.

That's all there is to offer. If you reach out, and tell someone you're contemplating self harm or ending your life, this is what will happen to you.

So, imagine feeling like you want to end your life, then being put through the demeaning, dehumanising process of a psychiatric hold. I want to be very clear on this: it is not working. It is not working. When you reach out and get help, the help system there is is broken. It might psychically stop a person from committing suicide whilst they are in the psych unit, but it is such an awful experience that person will lie, say they are fine, to get out as fast as they can. The NSW Coroner's website alone lists scores of inquiries into people who were recently discharged from psych units then took their own lives. The way we "help"  doing is making things worse.

There's a lot of misunderstanding about suicide, a lot of emphasis on the individual rather than a sick and broken society. The suicides of the rich and well connected prove it can happen to anyone. And this is true, but suicide is more likely to happen to the disadvantaged, the poor, the abused, the unemployed, LGTBI people. We don't hear about it as much, that's all. The photogenic girl from a caring family who commits suicide seemingly from nowhere gets the media attention, but it's the young person without the loving family and support network that is more at risk. 

For some people, mental illness and suicide ideation comes out of the blue, for no reason. But for many others, it's a reaction to abuse, chronic pain, isolation, poverty, unemployment. These suicides on the fringes of society are not the ones we know and mourn, but their lives matter.

We need to move away from a mindset that removes depression from its societal context and puts the emphasis on the individual to get help. We need to look at the problems in society that are causing all this pain - and the relentless push to be happy that further isolates those who are suffering; this is a great post about the toxic culture of happiness. A bit of research into the use of psychotropic drugs would be good, too. Because as things stand, if my mind gets filled with the black sludge of misery again, I won't be reaching out for help. There isn't any.


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