I began writing this piece nearly 6 months ago. It was too painful then to complete it. Today I was ready to face it again.
Content: Mention of suicidality and hospitalization
“Are you angry?” she asks me.
Something in me breaks free. I AM angry, but not for the reasons she thinks.
I’m sitting on a telehealth call with my therapist. I’ve been working with her for over a year – since shortly after my now 22-year-old son, Blake, made his first call to the National Suicide Prevention Lifeline. We’ve been talking about how I’m dealing with Blake’s chronic suicidality and the aftermath of his recent hospitalizations. In particular, we are discussing the regular, yet now decreasing, messages I receive from people who care about me asking if things have gotten any better.
I am angry because I feel utterly abandoned – but not by friends or family. They have been wonderful. I feel abandoned by the very field I have come to love and to have put the utmost faith in. I feel abandoned by mental health.
I am a psychologist with more than thirty years of experience under my belt. I’ve worked in community clinics, and with people with some of the greatest social and emotional needs. I veered from my original path and toward specializing in Obsessive-Compulsive Disorder when it struck my own home and I realized that too few people understood the disorder or how to treat it. I have dedicated myself to educating people, making treatment more accessible, and volunteering my time for mental health causes. I have utterly, completely imbibed the mental health “Kool-Aid” because I believe people can be helped, because I am passionate about providing that help and directing others toward it, and I believe all people have a right to excellent mental health care. Ask anyone. I live, work, play, breathe, and sweat mental health advocacy.
And then my son became suicidal. And mental health abandoned me.
“I am angry,” I tell her.
“I am angry because the community I have believed so completely in has failed my son. It’s failed our family. I feel like I have lost my community.”
When Blake was in the hospital, he was told he belonged in a residential placement to address his depression and his OCD. When he interviewed for those and shared that he did not want to live and did not believe that he could get better, but agreed he would give it a try, he was declined admission. Too suicidal for a residential placement. Yet, he wasn’t suicidal enough to be in a hospital psychiatric unit. Our insurance fought with the hospital over reimbursement for days. Ultimately, the hospital agreed that he was finally not suicidal enough to be there. Yet, he had no placement to go to.
Take that in:
- Too suicidal for a residential placement
- Not suicidal enough for a psychiatric unit
And so he was sent home…
Our son was released home from his second two week stay in the hospital with an appointment with a telehealth psychiatric practice (who, when they met with him, merely told him he was too severe for them to treat) and the phone number for a mental health companion service (not covered by insurance) that charges more per single visit than many people make in a week. It was then that I was hit with the gigantic void that exists in mental health. No one checked in on us or our son to make sure he was well. Not the hospital. Not his previous therapists. No one directed us toward treatment that might be useful for him. We were left to figure it out. He was very “severe” we were told – but we were left alone, scared, and confused.
Our family is incredibly privileged. My husband had foresight and we had the ability to save a little money from each paycheck for most of the time we’ve been working. It’s turned into a nice savings. We can take the financial hit right now. I am a psychologist who is active in my professional community and I have many connections. I can call people who know people.
And even with that, the system is confusing. There may be treatment for young adults like Blake, but the point is, I’m more knowledgeable than the average mental health consumer and this is unbelievably confusing for me. The bits of treatment we have cobbled together so far are mostly not covered by insurance. The costs are staggering. I am not complaining. My son is worth it. I am able to pay for it. Many, many people would not be able to do so. And it is just not right.
Humans deserve a better mental health system than the one I am feeling abandoned by. I feel let down and disillusioned by something I’ve poured myself into and I’m still licking my wounds and taking care of what’s at home. But I hope to turn this experience into something more. Mental health can be better. It can be the care system I believed it to be. I am an ardent believer that one person can make a difference – even if it is a very small one – and, as I regain my own personal sense of strength, I will dedicate myself to making a better system. We all deserve it.
OCD In The Family 
While I’m sad this is your experience, I’m so glad you wrote this. For so long, I related to being in that terrible in-between. It left me lost and confused. So, you aren’t alone. The next question is, how do we fix it?
Hi Morgan. Thank you for sharing your thoughts. It’s good not to be alone, and, while I wish you’d never been there, it’s good to have your company. I’ve been thinking a LOT about the how to fix it. I have been thinking of some ideas about ways to make inroads (no delusions of complete repair). For one, I’d love to see a system/service/I don’t know what it is, that kind of walks people through getting care. I’m not sure exactly what it is, but it would seem so good to have a wise connection who helps people feel tethered and not lost. All my best, Angie
Yeah, it’s crazy that the system is so broken that even you can’t figure it out. It isn’t just mental health though. My father in law with a recent stroke and my step mother with opening stages of Alzheimer are both completely confused by the care (or lack of it) that they are getting. I think insurance companies make things so difficult now that it’s hard to put the pieces together. I hope, hope, hope that things improve for you and your family. It must be the scariest thing to go through. I’m glad you wrote. I’ve been wondering.
Hi Jeff. I’m so sorry you guys are going through that. And I agree with you that it’s not just mental health – our health system needs so much repair. I appreciate your well wishes. I’ve been working a lot on taking care of me and appreciating everything I can. Sending my best to you! – Angie
You and your family are in my thoughts and prayers as always Angie (this is Paul K.) Thank you for having the courage to write this post. This message needs to be shouted from the rooftops! The only way I can think of to start fixing this problem is for professionals like yourself…who REALLY want to improve things…to start working together in small teams and grow from there. Easy to say, but it’s going to take baby steps…probably millions of them. Wishing you all the best, and please remember to take care of YOU! 🙂
Thank you, Paul! I agree, those of us in mental health must take the lead. I’m willing to be a part of those baby steps. – Angie
This blog post was incredibly poignant, perhaps because it is so raw and fraught with your own experiences. I am also struck by the fact that there are some professionals whose sole occupation is to find the right placement or right fit for individuals like Blake, but that they charge $10K +/- for the service of finding the right placement.
The other thing that occurred to me when reading your post, is that in the midst of trauma/grief none of us are working at our usual capacity. Simple decisions become laborious. So, many parents/partners of suicidal loved ones are going through their own trauma in response to the situation and need other well-informed professionals to clearly guide them in the right direction because it can be too overwhelming to do it themselves.
Thank you, Sarah. Yes, you’re right. There are placement specialists and they are not accessible for many. And I absolutely was not at my best following the hospitalizations – still not quite there. We can use a guide – someone to show us where to go, how to navigate, and to check in on us to make sure we stay afloat. Blake’s previous treatment team has no idea what became of him, nor does the hospital staff. How many people get lost? How do we become a village that looks after one another, no matter what our background it means? I’m grappling with these thoughts.
Agreed! I almost wonder if there could be legislature ensuring that anyone at a certain level of care or higher has a “case manager” for first year after release, or something like that. Or even if there isn’t legislature, having therapists (like you and me) start giving feedback to all of the treatment centers we know, start chatter on listservs, present at conferences, etc. Im happy to help, am probably in a similar boat as you in that I can only commit to baby steps.
I love what you’re thinking and it is in line with what I have in mind. I will reach out to you.
Thank you for this important post, Angie, that so many of us can relate to. I don’t know what the answer is but it’s clear the system we have is not working. I feel at a loss and wouldn’t even know where to start but if there’s anything I can help out with, just say the word. These are people’s lives we’re talking about. Nothing is more worth fighting for.
Hi Janet. I do have an idea of where to begin. I will reach out to you soon!