NB: This is from three years ago. The original post is here (internal link)
Reflections on a Black December
With my violent nightmares having subsided for now, I wanted to write about how concerned I am with the rising suicide rate in America. I don’t see hope for its decline as medicine is practiced today,.
In mid-December my psychiatrist recommended that I get a sleep study. To have that test covered by insurance it was necessary to have it approved by my regular doctor who is essentially a general practitioner. This required an office visit to the GP.
When I arrived a nurse asked me a set of standard questions on a long form. When asked if I was thinking of harming anyone or harming myself, I answered in truth. I said I had given suicide a great deal of thought lately, that I had given away as many personal possessions as possible, and that I had made out my final will. She made some notes on the form.
My doctor didn’t have any questions about my suicidal thoughts, instead, he squarely focused on the task at hand, whether my condition required a sleep study. He asked me questions about my sleep, again from a form.
I never got a call back from that office regarding my mental state. No follow on at all. They ignored every warning sign I gave them.
My psychiatrist was more concerned. Besides recommending the sleep study, she asked me to call a few days after our last appointment to tell her how I was doing. Mind you, she didn’t call me, I was to call her. I have experienced more follow on calls and e-mails from my veterinarians concerning my cats than I have from my doctors about whether I might kill myself.
And although I want to be careful not to criticize the Suicide Hotline, I was disappointed in how they handled things. I wanted to talk to a suicide survivor or someone who had battled thoughts of it, but I was told each time that the phone personnel were not allowed to talk about their own personal experiences. I again felt alone in the world, even after they patiently listened to me.
Surprisingly, I was not told of any resources to access, either local or online. No telephone numbers, no meeting locations, no numbers of any health care professional. It was all just talk, although, again, I don’t mean to diminish the power of talk or having someone listen. Despite being in a desperate state, there was seemingly nowhere else to go once I hung up the phone. I called on two separate days, by the way, just to make sure the first night wasn’t a bad night for the volunteer.
Back to my psychiatrist and the state of modern medicine. Her secretary said that the doctor would be taking several weeks off during the holidays; I immediately asked for the name and number of the covering physician. She had none. Instead, I was provided with the cell phone number of her husband, who could get in touch with her in case of an emergency. No covering physician?
My Dad would have thought this inconceivable. He and his colleagues always arranged their schedules so that nights, holidays, and weekends were always covered by one of them. They rotated these days between them throughout each month. A backup doctor was always on call when my Dad was in private practice. Today, I suppose, that duty falls to the Emergency Room, where we all eventually wind up, with all of our different conditions.
Speaking of the ER, that is something I almost went to for my nightmares many years ago. I belonged to an HMO at the time called Kaiser, a large health organization. Having had a terrible spate of violent nightmares, I walked into their Psychiatric Department in Sacramento without an appointment. I needed to be seen before I completely broke down. The desk clerk refused to have anyone talk to me. In a shaky and admittedly threatening voice, I told her than unless someone helped me immediately, I was going to walk across the street to their Emergency Room and act out. She called for a nurse.
If America’s suicide rate has any chance at declining, it has to be treated with seriousness by the medical community, not just talked about how bad the problem is. People have to listen, to follow up, to provide resources. Some years ago it was said that the only way to get emergency mental health treatment was to threaten to kill someone or to threaten to kill yourself. Today, threatening yourself may not be enough. Today, in a black state at three in the morning, you may be on your own. At least get to an Emergency Room. And don’t be afraid to act out.
National Suicide Prevention Lifeline: