Sunday, January 8, 2017

Snapshots of a Mental Health Crisis Worker



(1) Melanie*

She was trying to escape – as she lined the pills up on the counter top and stared at them. She forgot the trees, the wind, the flowers, the earth waiting outside her door – the breeze, the stars, the rain, and grass – only tears existed in this moment, only anger and sadness overwhelming her body, which was the world. A text came from Mom asking how her day was going and apologizing for needing to go to work. Her heart broke and the cracks pushed tears out her eyes, non-stop. She had searched for pills in the house - organizing them in a row on the counter. The phone rings, her boyfriend breaking the barrier of anger in her body; a human voice asking if she was okay. “No, I’m not fine,” she said, picking up five pills and swallowing them, “I just took pills.” His voice turns to nerves pushing words out into her ear that she must drive herself to the hospital. She drives to the hospital, the sun beating down on her 1988 Corvette. She is confused at how she could feel this way.

The wind, the rain, the sky, and the sun, are still there – moving around her car, her hair, and her eyes on the road. The flowers are there, the grass, and the mountains. The world is watching as the universe inside her mind expands and retracts, swirling in confusion, her stomach tightening. She has been feeling the world too much lately, weighing on her neurons, constricting her heart and soul. Maybe she took the pills to kill the emotions – to retaliate against the heaviness of the days. It makes sense and it doesn’t make sense.

(2) Bethany*

The curtain of crisis is drawn up and I walk onto the stage - with my laptop and smile - walking into a hospital room where a girl with turquoise/purple hair lies on the hospital bed, forearms covered in red slits. She seems calm now, in a room and a place designed to offer a safety net. It’s 3 AM and the call came into my phone at 2:30 AM. “Agh, I hate this,” I thought, as I got out of bed and changed out of my pajamas, “I hate night shifts.” I had just left the ER at 11:00 PM to come home and go to bed. It’s always like this – I have an intense love/hate relationship with my job. I can’t get over the human in me – the piece of me that wants to stay in my warm, comfortable, bed and be asleep.

I knock on the door of room 8 in the ER to find a girl resting on the bed, her friend sitting next to her and her caregiver standing by the bed. The mood feels light while the girls’ arms bear the most cuts I have ever seen. None are that deep, they look as if she had just stepped out of a cat fight. The girl has hair that resembles a perfect turquoise/purple gradient – really well done; I like it. Although getting out of bed is hard, as soon as I walk into the ER, I feel fine. There’s a feeling in the ER of purpose – of getting s*%& done – well, and also of chaos, too. I know why I’m there and I feel like a mental health superhero. Let’s hope I can save the day.

The girl is sweet – as they often are – and I feel like she is open with me. People often seem open in crisis. It’s like a big balloon has popped and everyone can now see everything that was inside. The stigma is lifted and I can normalize talking about suicidal thoughts, depression, anxiety, self-harm, or whatever the youth may be tackling. Often, parents, family, and friends, feel on board to help and do what they can to clean up the mess. This mess of emotions, feelings, and behaviors – to understand and support the mind of another that has convinced itself to cope with life a certain way. Mental health is a fragile thing. I am a mental health EMT.

The girl tells me all about her life – filled with moving around the country, abuse, bullying – there is too much to untangle and keep up with as I try to grasp the important details. She is funny and jokes with me, she’s articulate and talks about enjoying writing and art. She talks about feeling like a mother to her younger siblings as she’s helped raise them during her life. She strikes me as someone who would be an excellent writer. She is smart. I like her.

I told my supervisor that we just need a magical place for kids to go to get the support and help that they need, and, “Who's working on that?” There is so much we are still learning about the brain and mental health. I hope for the day when we can do neurological surgery and untangle the crossed wires of trauma in a person’s brain, or perform surgery that would somehow lift the fog of depression or tone down the intensity of anxiety. Sometimes I feel like a doctor working during a time before x-rays or anesthetic, prescribing environmental supports to fix what is so deeply internal. Suggesting tactics to help the mind, heart, and soul find peace or feel more alive. We are all doing the best we can.

I departed from the girl, friend, and caregiver, with them smiling and the girl referring to herself as “giddy now.” I hope that she will be okay. I hope her arms will heal. I never know the impact of my work – and this kind of experience where I feel good about the conversation we’ve had and the work we’ve done are my favorite scenarios. Not all of them are like this – sometimes I walk away feeling powerless, unhelpful, and unable to offer families the answers or solutions that they hope for so badly. There is no place for their child to go, or at least, not now. I am trying to be a superhero without super powers.

A girl in Wilderness Therapy created a song about hope – and that is what we cling to. My job causes me to face what is outside of my control – the nature of crisis and mental fragility. I drive out of the ER at 6:00 AM to the disappearing of the stars and the changing of the sky to the lightest gray/black. Dawn is coming. Thank goodness that the Sun is bright.

"But all the fighting in the world will not help us if we do not also hope. What I’m trying to cultivate is not blind optimism but what the philosopher Jonathan Lear calls radical hope. “What makes this hope radical,” Lear writes, “is that it is directed toward a future goodness that transcends the current ability to understand what it is.” Radical hope is not so much something you have but something you practice; it demands flexibility, openness, and what Lear describes as “imaginative excellence.” Radical hope is our best weapon against despair, even when despair seems justifiable; it makes the survival of the end of your world possible. Only radical hope could have imagined people like us into existence. And I believe that it will help us create a better, more loving future." Junot Diaz, Radical Hope, The New Yorker

*Names, of course, have been changed to protect the privacy of the individuals.