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June 25, 2020“Can you imagine being locked up on a psych unit?”
“Can you imagine having to tell your employer that you were committed to a psychiatric hospital?”
“Would you hire someone who was seriously mentally ill?”
Now that I am a mental health professional working in a psychiatric hospital, well-meaning people, who are simply trying to convey the level of challenge that this often cruel and stigmatizing world poses for our patients, ask me this often. It is a hypothetical question, and I don’t think any of these people expect an answer. Yet, I consistently am tempted to respond “Actually, I can imagine.”
There is a great deal of variance between the experience of most of my patients and myself, and there are many realities of their life that I will never truly understand. I have never lived with a thought disorder, experiencing hallucinations and/or delusions and enduring treatments with side effects almost as disruptive as the symptoms themselves. I’ve been privileged to have a loving, endlessly supportive family and access to early medical care and mental health intervention. I have never been arrested, as many have, for symptoms or behavioral manifestations of my mental illness. And yet, when I look at my patients, I think “there but for the grace of God, go I.”
Because although it is a fact I have told almost no one, the cold, hard truth, is that I have been in a psychiatric hospital. In fact, psychiatrists have tried to commit me to one more than once. I do know what it’s like to be locked indoors on a unit with a dozen or more peers experiencing psychosis. I know what it’s like to sleep in a sterile room with a camera, where all the furniture is attached to the floor and you are awoken by a flashlight every half hour as you sleep. I know what it’s like to be treated like you lack intelligence, like your physical symptoms are not valid because of your psychiatric history and like you are a drain to the overworked healthcare system.
Throughout my 17-year, often intensive struggle with major depression, eating disorders, anxiety and in recent years post-traumatic stress disorder (PTSD), I have been treated at many levels of the mental health system: from the ER, to inpatient medical hospitalization, to outpatient, to numerous eating disorder treatment programs, to the ICU, to a locked psychiatric unit as a 13-year-old. In graduate school, I experienced a depressive break that quickly became just as scary and debilitating as my worst ones.
I was told by a mental health faculty member that they had been watching me spiral for weeks and had seen it coming. Then I was referred by a wonderful and well-intentioned therapist to a free crisis center where I could receive help and medication adjustment. Because of my history of a suicide attempt and the severity of my current state, they tried to admit me against my will into the acute psychiatric unit for many hours, and would only allow me to leave after my outpatient therapist physically came to the facility to pick me up.
The irony that my horrifying, traumatic experience as a depressed teenager with anorexia in a locked psychiatric facility had come full circle during a time when I was supposed to be recovered, supposed to be almost a professional, was not lost on me. I looked through the plexiglass window on the door to the unit for which a staff member had brought me my set of hospital issue scrubs and socks, and I started sobbing as I took in the scene of symptomatic people sleeping in sterile chairs in the dayroom, our non-skid socks uniting us all like a depressing sports team. I can assure you after that day that, in my experience, the care in acute psych facilities has not improved much since 2003. The next day, I went to class and pretended to be OK. I could not believe I was back there, in this place of unrelenting darkness, in the land of professionals not trusting you and with another pair of non-skid socks to show for it.
Stigma and shame is all too common in the world of mental illness, but it can be for our own survival, our own protection. Who will take you seriously when you admit that you’ve been locked up on a psych unit? Who will believe you that you are navigating grief or sadness, but do not intend to kill yourself? Who will understand that you are not a dangerous, incompetent or untrustworthy professional?
Now that I am a member of the mental health field, I want to do more to actively change public perception of those with mental illness. “Actually, I can imagine,” I want to say when these people ask, followed by sharing just a snippet of my experience and making a minuscule stride to counter the stigma. And then I remember the shame I feel every time I visit the doctor, every time someone at work asks “would you hire someone who was seriously mentally ill?”
Instead I shake my head “no,” and say nothing.
