Asking For Help: Talk About the Way You’ve Been Treated

American Association of Suicidology
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Suicidal thinking isn’t always caused by mental illness, but it can be a fast ticket to a diagnosis, possible commitment to a psychiatric ward and even a police record in some cases — and such things can stay with you. So much of the silence around this experience is tied to concerns about how it could affect the rest of our lives. Our educations. Our careers.

It’s pretty clear that after a suicidal experience, each of us comes to terms with it in our own way. It helps to know what protections we have while working things out – Can a university really kick out a student after an attempt, for example? – and what more might be needed.

But because our experiences are so individual and often so silent, we have little idea how many of us have faced the same uncomfortable, even unfair, reactions. Sharing information about how you’ve been treated can help all of us. Here is a good recent example by Melody Moezzi, a lawyer, author and attempt survivor.

And here’s an example of Susan’s spirited writing on these issues, a paper on the divide between people in our society who hide their diagnosis or experience and those who can’t or refuse to. “The determination by experts that a person has a ‘mental illness,’ sometimes after fifteen minutes of evaluation in a hospital emergency room, unites into one category millions of people with extraordinarily divergent personal experiences who might otherwise never think to identify with each other,” she writes. If these groups did recognize that shared experience, she suggests, they would “create a political force unlike any that has previously existed.”

Rights are rarely emphasized in traditional mental health messaging, but as more people step forward to share their stories, it makes sense to be clear about how we want to be treated as well.

Often, we don’t even know what we deserve. An example: When you come to an emergency room in crisis, only a handful of states across the U.S. give you a document explaining what to expect in this often bewildering time. This is what you would receive in Texas (click the first link). New York and Massachusetts offer similar guides.

Of the national mental health organizations, only NAMI appears to offer a legal resources section on its website, including links to the Bazelon Center for Mental Health Law and the National Disability Rights Network. The NAMI site also explains one way you can have a say at the state level on rights protection. (The author of that article has been an outspoken survivor.)

The American Civil Liberties Union, which once was more active on mental health, published a clear and useful guide in 1996, “The Rights of People with Mental Disabilities,” which needs updating.

Here are a few highlights from the ACLU guide, which explains – and sharply questions – some of the most sensitive issues around experiences that often follow a suicide attempt:

“It is possible to write narrow standards for defining dangerousness to self or others . . . but only if commitment is based on actual conduct, not speculation as to what a person might do in the future on the basis of a diagnosis or other demographic characteristics.”

“Although most state statutes contain an imminent harm requirement, they do not provide a precise definition of the term, leaving it to clinicians and the courts to decide whether the proper period is a matter of hours, days, or even weeks.”

“The doctrine of informed consent applies to every competent adult. The existence of a mental disability, by itself, does not disqualify an otherwise competent person from exercising this right.”

“Most states have not extended the Fifth Amendment privilege against self-incrimination to civil commitment proceedings … because the purpose of confinement is treatment not punishment.”

” . . . otherwise confidential doctor-patient communications are generally admissible in commitment proceedings.”

“… the general rule is that psychiatric patients do not have a constitutional right of access to their medical records . . . ”

These are just a few of what might be described as the “Wait, what?” moments one has when peeking into mental health law.

In this week’s post wen ask for your help. Please share it widely, because you never know who’s “been there.”

Susan Stefan is one of the most well-known mental health lawyers in the U.S., and she’s written books about discrimination against people with “psychiatric disabilities,” with an emphasis on personal stories. She’s now writing a book about laws and policies around the world related to people who are suicidal, and she wants to hear your experiences. What works? What doesn’t? What makes things worse?

You can help her by taking this short, anonymous survey. And if you’re willing to do an in-depth interview, as we have, please contact Susan at stefansusan (at) gmail (dot) com. If the survey link has any hiccups, please let her, or us, know.

Your answers to the survey could help bring more of these issues into the open.

Finally, here are some thoughts from a newly posted interview at Talkingaboutsuicide.com with Melodee Jarvis. She works with a new San Francisco-based project, the Center for Dignity, Recovery and Empowerment, that uses the personal stories of attempt survivors and others to tell the public about the weight that stigma and discrimination bring:

“Speaking as an advocate for a minute: People with lived experience of mental health challenges face societal discrimination, often in overt and devastating ways,” Melodee wrote. “Our quality of life suffers tremendously, in part because so many others can’t see us as anything other than nuisances at best, menaces at worst. People see us as a danger to them, a danger to ourselves, a blight on the social landscape. People who otherwise have progressive views about human rights issues still can think we should be locked up for our own good, and for the good of everyone else. . . . “

“At my new job, one of my tasks is to confront stigma, to confront these acts of prejudice and discrimination with the hope of countering them with positive messages of dignity, recovery, and resiliency. Suicide attempt survivors are, as a group, at a higher risk of dying by suicide than any other. I believe that (and studies have shown that) it’s likely that the stigma that we face, stigma related both to our lived experience as suicide attempt survivors and often having been through the mental health system in some capacity, that this stigma contributes to the likelihood of us attempting again. And when we attempt again, we often die. So in this sense, stigma reduction is about saving lives. So, yes, this is a civil rights issue. Even more to the point: It’s an issue of life and death.”

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

2 COMMENTS

  1. One major flaw with the survey is that it assumes that everyone has made at least one suicide attempt. There is no option to select “0” or to specify a certain level of ideation or parasuicide. Legal commitment standards generally accept less than an attempt for involuntary admission.

  2. It is well documented that many people experience involuntary psychiatric treatment as an assault. Some describe it as similar to rape where the assault strikes to the core of your body, mind and soul. As with sexual assaults, our mental health system needs to respect the very basic human requirement at such times that ―No means ―No. It is also well documented that many suicidal people are struggling with complex personal histories of trauma. For these people, involuntary psychiatric treatment further traumatizes them, often worsening or indeed sometimes triggering suicidal feelings. More generally, if we understand suicidality as a crisis of the self –i.e. rather than the consequence of some ―mental illness (see below) –then it simply does not make sense to further attack an already fragile sense of self. It is hard to imagine anything less helpful for the suicidal person than to be assaulted by those you seek help from at a time of such crisis.

    Read more http://www.communitylaw.org.au/mhlc/cb_pages/images/MHLC-Forum-Paper%20David%20Webb.pdf

    Psychiatric inpatients are at extreme risk for suicide in the period immediately following discharge, but high-quality aftercare may be protective, new research suggests.

    But none of the other research I could find points to the added trauma of the inpatient psychiatric experience on this higher rate.

    I think all to often when a suicidal person is exposed to abuse called “help” by psychiatry it confirms to person the world is just mean and cruel anyway and no one cares.

    Or inner thinking like this,

    “I went and asked for help and all I got was an intake strip search, a week of walking around with no shoe laces and brain disabling drugs I didn’t want forced on me with threats and coercion, if that’s ‘help’ than its hopeless, I really am better off dead…”

    I guess the problem is if being suicidal lead to other people being caring and being nice and helpful the number of people claiming suicidal thinking would go up 1000%.

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