Okay,
let’s be frank. When a person has a mental illness, it’s
automatically assumed that he cannot be trusted. For some reason, it
is as though one of the actual symptoms of mental illness is
dishonesty.
However,
contrary to popular belief, this is not a symptom listed under every
diagnosis in the most recent edition of the Diagnostic Statistical
Manual (DSM V), America’s reference for diagnosing mental
illness. Neither is it listed as a symptom under every diagnosis in
the most recent International Statistical Classification of
Diseases and Related Health Problems (ICD-10), and yet, as a
society we have determined that if someone is mentally ill, he cannot
be trusted. He Lies.
Why
is that?
Perhaps
it’s because there are several illnesses (psychotic illnesses)
that involve psychosis and delusions, where a person experiences an
alternate reality. Maybe it’s because as a society we cannot
wrap our brain around the fact that just because someone thinks
differently than we do, doesn’t necessarily make him a liar.
Linguistically
speaking, in writing case notes (documenting information after a
doctor or counselor visit) the professional must document what was
discussed. When I began working in an office with clinical case
notes, I was appalled at the language used in case notes. There are
some questions that clinicians ask people with schizophrenia or
schizoform illnesses, involving whether or not the person is hearing,
seeing, feeling, smelling or tasting things which others do not.
Of
people who are severely depressed, clinicians ask if the person is
suicidal or homicidal. If patients states that they aren’t,
it’s recorded in case note that the clients “deny”
such thoughts. Deny — implies that really the client is lying.
Regardless
of how much we deny it, language affects our thoughts and behaviors.
If a clinician or doctor writes case notes for 10 people a day,
stating each time that the client “denies,” symptoms,
little by little he create an image within his head that clients
essentially lie to him, regularly. I’m not trying to paint all
professionals in this light, but I sure have met my fair share.
We’re
all familiar with the story of the boy who cried wolf. How do you
treat people who lie? You begin to lose trust in them and begin to
ignore them. Unfortunately, there are people in the profession of
helping people with mental illness who pave the way for society to
follow their lead, ignoring the opinions of those with mental
illness.
You
may think my blanket statement is an extremist one; I wish it were.
But chances are, if you are one of those who think it’s an
extremist statement, you have never experienced your valid opinion
being brushed aside by someone in authority.
Let
me share with you just one of the many examples I’ve
experienced.
After
three days of not sleeping, I called the crisis line to connect with
my doctor. I just needed to know what medication I could take so that
my brain could rebalance itself. I was in control, but cognitively, I
was aware of how continued sleep loss would erode my ability to make
sound decisions.
I
called the crisis line at 2 a.m., but the crisis line was down. The
call rang through to someone else within the corporation who wanted
to know how on earth I got their number. I explained I’d called
the 800 number; I got screamed at and hung up on.
I
called the crisis line again and was connected to another person
associated with my health care service, who as you can imagine was
not happy that I call at two in the morning. This person, too, was
extremely agitated and hung up on me.
In
the eight years that I’d used the crisis line, I’d never
had problems, so I proactively verified that I was calling the right
number, and called the crisis line a third time where once again it
routed me to a random angry person asking me how I got the number.
Finally, in desperation, I called the ER. They asked me to come in,
which I dutifully did.
After
telling them what had happened, they reassured me that the crisis
line does not have problems and admitted me for being awake for three
days and “delusional.” What would it have taken to call
the crisis line?
The
following day, my doctor came to me asking why I was in the hospital.
I told him the situation and that I’d just needed a medication
adjustment to sleep so that I would be able to reset my brain
chemicals. When I told him about my crisis line experience, he
laughed, nodding his head. He told me they’d never had problems
with the crisis line. I asked him to check the crisis line “just
in case.” He walked away, smiling and nodding his head. What
would it have taken to call the crisis line?
The
next day the same thing happened. Later that day my social worker
came to visit me. I’d never impressed with the level of care
that she provided, but I told her that about the crisis line’s
dysfunction. She also kind of smiled, nodding her head and left. What
would it have taken to call the crisis line?
I
am very familiar with the smiling head nod. I’ve seen regularly
since I was diagnosed 15 years ago. It’s the nod that says to
someone, “Yeah; right.” To me that nod also means,
something along the lines of, “I’m just going to smile
and act like I’m listening long enough to leave.”
I
got the same smiling head nod when I told the inpatient doctor that I
was in a master’s program at the local university. Smile. Head
nod. I told him that I was serious. In fact, my professor was so
impressed with my work ethic and critical thinking that she hired me
as her graduate research assistant.
My
inpatient doctor responded, “Oh, right Sarah,” Smile.
Head nod. As he walked away, I caught up with him, giving him my
business card. He went to shove it in his pocket, but I asked him to
look at it. There was a long exhale. He stared down at the white
piece of paper in his hand. With wide eyes, he said, “You’re
in school? Where?”
Sadly,
frequently people who are aware of my diagnosis, and who knew me when
I was sick, have much the same response, regardless of my nearly
four-year remission. I don’t know why. I was never the boy who
cried wolf. I don’t believe I ever purposefully lied about
anything happening in my life, and yet people aware of my diagnosis
often brush me off as though my opinion and observation are invalid
and without value.
Maybe
if people could stop and listen to those around them, regardless of
circumstance, we might just be able to prevent something referred to
as “learned helplessness.” Unfortunately, many people
with a mental health diagnosis stop taking initiative, taking care of
their symptoms, because they feel that regardless of their efforts,
nothing will change. Regardless of their efforts, no one listens.
Maybe if we start listening to one another, maybe we can lift one
another above learned helplessness, empowering people to make a
change.
Going
back to the crisis line, my third and final day in the hospital, the
doctor came to see me and told me that he’d figured out
why things were so slow. Evidently my social worker actually called
the crisis line and discovered it wasn’t working. At last,
someone took me seriously, or at least serious enough to check —
just in case. My opinion of her changed in an instant. She listened.
“It’s
a good thing she caught that,” my doctor continued. He wasn’t
being ironic. He was just stating what he believed was a fact. “Can
you imagine?” He shook his head. “What would have
happened if someone called it in crisis?”
Sarah Price Hancock, a graduate of San Diego State University's rehabilitation
counseling Masters of Science program with a certificate psychiatric
rehabilitation.
Having embarked on her own journey with a mental health diagnosis, she is
passionate about psychiatric recovery. She enjoys working as a lector
for universities, training upcoming mental health professionals.
Sarah also enjoys sharing insights with peers working to strengthen
their "recovery toolbox." With proper support, Sarah
knows psychiatric recovery isn’t just possible — it’s
probable.
Born and raised in San Diego, California, Sarah served a Spanish-speaking
and ASL mission for the LDS Church in the Texas Dallas Mission. She
was graduated from Ricks College and BYU. Sarah currently resides in
San Diego and inherited four amazing children when she married the
man of her dreams in 2011. She loves writing, public speaking,
ceramics, jewelry-making and kite-flying — not necessarily in
that order.