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.

Black and White

"I am losing precious days.  I am degenerating into a machine for making money.  I am learning nothing in this trivial world of men.  I must break away and get out into the mountains to learn the news."  John Muir

I drew a picture of autumn in my Human Behavior class, just like I used to do back when I was in undergrad: make paint drawings on my computer.  Only this time, I also talk in class and contribute, because I actually have thoughts to share and questions to ask.  My professor was talking about race and explaining the process of children coming to an understanding of it, but she spoke like an outsider, as if she was raceless rather than white.  My class has zero diversity, in terms of color: we are all white.  But why didn't the conversation open up to what that means to people?  Did you always know you were white?  I didn't really even know why race was even an issue until I was older.  I had grown up in such a homogenous community, I didn't even really understand why prejudice existed.  People were people.  Isn't this why Stuff White People Like was developed?  Because some white people think they have no culture?  Then I go on that site and every new thing he adds, I think, "I love that!".

I used to think, when I was little, that if people would just stop referring to each other in terms of color, all those issues would go away!  What was wrong with people?!  And why were there two political parties?  Wasn't there just one correct answer to every problem?  Shouldn't these people be finding that answer?  Why would you support the wrong answer?

I also thought that the world had actually existed in black and white at one time, from watching black and white movies.  I remember staring out the window at all the grass and trees, asking my mom, "So when was color invented?".  I also thought God wrote the Bible and dropped it down from the sky and that the rest of the world lived in chains because my teachers kept telling me to be thankful for the freedom that I had.  I pictured everyone else in the world living in black and white still, in prison, and starving.  And I also thought I was a pretty smart kid.

I'm glad I don't think those things anymore, but the learning never stops.  One of the most frustrating things, in my social work classes, is to hear classmates ask questions such as, "Why is immigration so hard?  I mean, my grandparents came over here and worked."  There is just so much I want to respond to that I have to focus on containing myself and remember that we are not on the same page.... maybe even not in the same book.  I will limit myself to one reasonable comment given without an inkle of outrage... hopefully.

But am I learning nothing in this trivial world of men?  Sometimes, I do want to flee to the mountains and get away from having to converse with those whose ideas don't expand my mind in ways I'd like.  But there is always something to learn, even if it's how to hold my tongue and refrain from exploding over the myriad of challenges faced by all kinds of immigrants and how.....

I will finish my drawing of the woods.

Breaking the Rules

Sometimes class feels filled with tedious questions about protocol, whereas, in one of my more adventure-related classes this was typed on one of the slides:

No rules works all the time.

Too much planning stresses me out.  I asked my brother for directions to where he and my family were on the Cape one time and he said, "Follow signs for The Cape."  When I drive somewhere, I just need to know the routes or the general direction - not every left or right turn.  Sometimes it feels like people are saying, "So, what if there's no street sign at the intersection, but there hasn't been a sign that says we need to turn right for the same route?  Do we still go straight?"  YES!  KEEP GOING!

If there's a detour, should we follow it?
If we turn down a street, and there's a dead end, should we try to keep going?
What if the light is not turning green, but it's night time, and no other cars are around?  Should we go?
What if I'm holding a coffee and eating a sandwich, is it okay to take my hands off the wheel for a second?
If the speed limit is 65, would I get a ticket if I go 67?  What if everyone is doing 80?

Sometimes there is an obvious answer - YES FOLLOW THE DETOUR - and other times there is not.  This is where ethics comes in and some conversations involving ethical decisions are more interesting than others.  What if your client's girlfriend is standing outside with a gun, and the police say they can't do anything unless something happens, do you let them leave?  One of my professors did.

This same professor said that one of her big breakthroughs was when she realized that the clients she was working with had lives.  When I sit in class, I can imagine one can get so caught up in organizing that they the bigger picture.

Meanwhile, back in Adventure Therapy class, I lost $2.10.  An auction was being run by my professor.  What were we bidding on?  A $1.00 bill.  The winner takes all, but the second and third place people still have to pay.  What?  Right.  Best game ever to play if you're a professor.  You could go home with a little extra at the end of the class.

He started with a $1.00.  For the first round, three people played, eventually bidding $1.00.  What happens is that when you're bidding, you get to a point where you can't afford to lose.  Or, you start thinking, "Well, I'd rather lose $.50 than $.75, if I get the $1.00."  The other problem is that, you're not exempt unless you were the fourth person bidding.  The next round was an auction of $3.00.  I was at $2.10 when I decided to stop, but the other two people kept going until $3.55.  The person who won actually lost $.50, but that's less than my $2.10.  The second place person was the biggest loser: $3.50 or something like that.

Human behavior.  What would YOU do?  Rather than sit and ask question after question, we play games.  Games quietly pull us out of our social selves and might begin to scratch away at our true selves.  Family dynamics come out as everyone is absorbed in an activity.  Suddenly your favorite uncle is pushing you out of the way to get a touchdown, your mom is changing the rules so that she doesn't lose, and your normally silent friend has proven himself the smartest in the room.  I read a quote from Plato once that said, "You can learn more about a person in an hour of play than a year of conversation."  We get so caught up in the game, we drop our cover.

Apparently my professor facilitated this same activity with a corporate group at a conference and ended up with $580 at the end.  What?  Yes.  He gave it to the service crew and they had the most awesome beerfest the last night.  Where did my money go?  To a student/friend who went to a conference over the weekend.  If only all gambled money went towards charity.

Life is about values.  We speed because we're keeping up with traffic, we go through red lights because it's night and no one is around, we text while we're driving because we care about communication.  Values are constantly being juggled and balanced: THAT'S LIFE.  It's one big grayscale, but that's what makes it so captivating... so stop talking about the rules and trying to organize everything, people....