Mental Health

“What do you think of suicide?” he asked.

“I find it amazing,” I said, “that the mental health profession begs people who are suicidal to get help, but then betrays them.”

“How so?”

“Look. A nineteen year old who doesn’t fit in, who’s full of passion but does not know how to direct it, has been thinking about suicide for a long time. Finally things get so bad he realizes he has to do something.

“So he goes online. He sees the suicide help number. He calls it. When the recording comes on it says that calls are recorded. He slams the phone down and swears. He doesn’t want anybody recording his conversation about committing suicide.

“He’s in a panic. He looks up all the counselling services in his neighborhood, goes to their page, scrutinizes their philosophy, reads the bios of the counselors.

“Then he makes a call and a voice message comes on. He swears again but knows he has to say something. He leaves a message vague and desperate.

“A few minutes later the phone rings. ‘Oh shit!’ he thinks.

“It’s a woman. They say a few words. ‘So you’re thinking about taking your life?’ she says.

“He stammers. ‘I don’t want our conversation recorded. I need to talk.’

“‘Ok’, she says.

“The woman does some juggling of the staff’s schedule, makes an urgent call to a clinic, then calls him back. ‘Can you come in in two hours?’

“‘Yes. How much is it?’

“So he goes down. It’s a woman counselor. She promises not to record the conversation.

“They talk about his social awkwardness, the job he hates, the soul killing society he lives in. ‘No. I’ve never been abused. I had a great family life.’

“‘What do you expect from us?’ she asks.

“‘I want to see you guys one or two more times. I don’t want to come a lot and I do not want to spend a lot of money. I should be all right after that.’

“‘You are not all right now and one or two more times are not going to do it. We need five more sessions to make you stable. Can you do it?’

“‘Yes.’

“‘It’s commendable that you had the courage to seek help. You are less flustered than an hour
ago. More relaxed. So let’s make an appointment for three days from now.’

“He doesn’t like her telling him he’s screwed up. ‘OK,’ he says.

“‘But before you go I need you to promise me something.’

“‘What?’ he asks.

“‘That you will not committ suicide when you get home. If you can’t promise me that, I will call the police to take you away.’

“‘Traitor!’ he thinks. He squirms a few moments. He doesn’t like being insulted or threatened. He thinks it over. ‘I won’t kill myself at home.’

“‘You’re sure?’

“‘Yes.’ Session over.”

“But suicide help lines and local counselling offices have to protect themselves from lawsuits,” he said.

“The message machine should give people the option not to be recorded. How can I trust somebody who is recording my conversation about suicide? Who knows where the conversation will end up.

“The police thing is even scarier. I’m going to get help, then the counselor tells me she will call the police and humiliate me if I can’t promise that I won’t kill myself. It’s especially troubling when women, who are the most vocal about people getting help, and the most trusted by men to give help, put the police threat onto a client.”

“But the family of a patient would be outraged if their loved one was allowed to leave the counselling office without promising not to kill himself, then committed suicide.”

“That may be,” I said. “As far as minors go, I accept that argument. But not as far as adults go.”

“Why not?”

“Because.”

“Because why?”

“Because that 19 year old I just told you about might never see another counselor again. As grateful as he is for having the woman help him, he doesn’t want the worry about recorded phone calls, the stress of having to choose between lying that he won’t committ suicide when he gets home and being honest then humiliated when the police cart him away like some junkie or a slob living under the freeway.”

“Most people disagree with you,” he said.

“I’d say 60% of people disagree with me. There are lots of people who think that the new suicide hot line really isn’t the great healing thing it was cracked up to be. There is still the threat of police intervention. That makes people like the 19 year old even more likely not to seek help again.

“I want to keep talking about the police. Suppose somebody was betrayed by a counselor and the police are called. So he flips and gets violent and the police kill him.

“The police don’t want him going home to possibly kill himself. But because his fear of them and the humiliation that he feels for thinking he could trust the counselor overwhelm him, he gets murdered. The police would claim it was Suicide by cop, but that’s a lie.”

“You’re too extreme.”

“I don’t think so,” I said. “It’s funny that the mental health folks are outraged when a cop kills a lunatic. The mental health people demand that a counselor be required to partner with police when somebody calls the cops about a nutcase.

“But it’s the opposite in the situation I am talking about. ‘We don’t trust you so we are going to call the people who we don’t trust and who you don’t trust to drag you to the ER to wait in line with drug addicts and gang kids.’ Then the psychiatrist, who you don’t trust, will decide whether you are stable or crazy or whether you need to take medication you do not want to take.

“If you haven’t lost your cool on the trip with the cops to the emergency room, you can give the psychiatrist a line of gibberish and thank him profusely for his service. But when you get home you’re a wreck. You don’t trust anybody.

“You need to talk to somebody about your betrayal, but what will someone think?

“They might say it’s a good thing the cops took you away. Now what? ‘I just wanted to talk to somebody’.”

“What are you saying?”

“I’m saying lots of things.”

“Tell me.”

“One thing is to leave the police out of it. I wonder how many guys lost their cool when a counselor who they thought they could trust called the cops on them. Calling the cops was a trigger for the person thinking of committing suicide.

“Now he is dead because of the police or on a list of officially deranged people or locked up for resisting arrest. The words from the public service message keep haunting him. Get help.

“We hear that the mental health profession does not want people with bad mental health to be stigmatized. There is a photograph of a positive looking woman who has depression but is celebrated for being ‘a mom’, a professional and an all around wonderful woman who happens to have depression.

“The same thing should be said of people with chronic suicide ideation. This is Steve. He has had thoughts of suicide almost every day since 1991. He gets help when he needs it. There are a lot of wonderful, competent, loving men like Steve who know their suicide thoughts will never go away, but who desperately want to embrace the world. Make arrangements with a counselor to get yourself help when you need it – no shame, no blame – and most importantly – no police.”

“Wow.”

“I’m not finished. The mental health professionals do not want to look bad if one of their clients committs suicide. That is their greatest concern.

“The counselors do not have the maturity to say ‘It’s not our place to tell you not committ suicide. We can tell you that you have a warped brain and that you need to admit to yourself, if not to us, that you have a warped brain. We can counsel you to the best of our ability'”

“That’s it?”

“Almost. People with chronic suicide ideation can leave $1000 with a counselor. Such desperate people will know that they have somewhere to go and someone to trust explicitly the next time and the next time and the next time that they are terrified of their suicidal thoughts.”

Over the edge

Sunburnt and stinking
Man walks perimeter of park
All day every day
Saying nothing
Walking with no one
Looking at nobody.

You know given a normal mind –
Walking alone
Talking with no one
Looking at nobody –
How you might lose yours.

Friday, May 18

Dear Jim,

Hace buen tiempo as they say in Spanish.

I’m sitting outside at my favorite coffee shop. There’s no wind. It’s not hot. There aren’t too many people.

I just read the New York Times. I enjoyed it. There was a good report about the City of New York’s efforts to find apartments for its’ 60,000 homeless, and the opposition that the city receives. The opposition especially does not want shelters for men in its’ neighborhoods.

I can’t blame them, but most of the homeless are men, at least here in Sacto. What is America going to do? Our city council just approved a 16-20 bed facility for terminally ill homeless people. That is a great idea.

Also in the NYT were letters in response to an article about a college student who committed suicide. Of course the university gets blamed for the death.

People say that professors should say something to a student who has started to behave strangely. But what is a professor supposed to do?

He would say that he isn’t a mental health professional, that he would be stepping out of his domain. He might also say his students’ problems are none of his business. If a courageous and empathetic professor approached a student who seemed to be on the edge, the student might curse him, or sue him for being nosy.

We complain about the invasion of privacy by the government and business, but we want universities to keep tabs on their students’ mental health.

It would scare me as a college student if I knew that the software that reads my papers for class sends a report to the dean when I write: I am lonely.; They should throw the scum in jail.; I get plastered every weekend. It’s a gas.; If somebody breaks into your apartment you should be allowed to kill him.; There’s nothing wrong with spanking your child.

The more we try to monitor people’s mental health, the more mentally unhealthy we become. Who can I trust if any negative, angry, lust-filled, profane statement might be interpreted by the authorities to mean that I need help – forced prescribed drugs or required counselling?

It’s a double whammy for people who are on the edge. You don’t want to tell your family and friends you are suicidal because you don’t want to burden them.

Yet you can’t trust the mental health profession. It keeps an electronic record of all your appointments and what you revealed about yourself. That’s scary because all your information can be sent to insurance companies, hospitals, and police departments with the click of a button.

So We’re here to help, but Our neighbors are watching you. And We report all suspicious persons to the police. And Smile. You’re on camera.

I think I said this before – no wonder people don’t seek help. We are trained to be afraid. If we were not a police state there would be good mental health. There would be more trust – of yourself and of others.

Remember last year when I wrote to you about the new building for the natural foods co-op? I told you it made me feel good because of the natural light, healthy electric light, and a great view of the sky from the outdoor eating area upstairs. What I was saying was that it was good for my mental health. I really needed the shot-in-the-arm.

But now I hate it. Like one of my friends said, “It’s so yuppie.” Now they want to sell hard liquor, just like all the stores they think they are different from.

We keep talking organic in America, but we are so full of fear and alienation and anality that we are light years away from an organic state of mind. However we might get an organic police state.

You will have a view of the mountains and eat organic beans and rice when you are in jail for something you didn’t do. The mountains and organic food will help your healing process.

I feel like I am in jail. Crazy people feel trapped. We are exiled in our own country.

Sorry to bitch Jim.

Love,

Dave

Friday, November 17

Dear Jim,

How are you? I´ve been weak since last Saturday. I stayed home for two days, then yesterday I got a helluva headache at work. It was so bad that when a customer asked me a difficult question, I went to get somebody else to answer it. I would have gotten sick if I had tried to help her.

My headache was an allergy headache. I took the wrong kind of painkiller after lunch. I wish I had taken something different. I almost didn´t make it until the end of the day.

You got a lot of headaches in high school. They had something to do with your glasses or needing glasses. When you returned from Seattle in your twenties, you got lots of headaches. I remember you refused to take aspirin.

All of us kids get lots of headaches. Sis I only gets them during allergy season. I used to get a lot of headaches like the one I had yesterday. One of the reasons I don´t get as many now is because I do not eat as much bread, cereal, soy milk, and pastries. I have more energy too.

Remember how your hands used to turn purple in the cold? I think that kept you out of Vietnam. I had really cold feet and hands for a long time, especially my feet, but in the last few weeks with the start of the cool season, they haven´t been as cold.

I think it has to do with eating more salt. I read a review of a book on salt in September. The review said that many people today do not eat enough salt, and that even more people eat too much sugar. It said that salt is essential and people should eat more. I knew I wasn´t eating properly, that I had to cut down on sugar, eat more protein, and increase the variety of foods I ate. So I went out and bought some classy salt.

Wow. It tasted great and I felt better. I felt lighter.

When the book about salt arrived for me at the library, I read it intensely. A lot of it was too hard to understand. But when I read the list of symptoms of possible salt deficiency, I felt good when I saw ¨cold appendages¨.

I´ll see how it goes the rest of the winter. I wonder if your hands were cold and purple because of a salt deficiency. I laugh thinking about your story of asking the guy in the mountains to go into your pocket to take out the car keys and open the door for you because your hands were so cold you could not feel.

I talked with dad today. He sounded really good and he felt really good. It is interesting to hear him struggle to be articulate. He´ll ask me what I ´ve been doing. I´ll say, ¨I just got back from the store. I wanted to go before it rains.¨ He will hesitate then say firmly, ¨You never know when a big storm will blow in.¨

I feel sorry for him. He also reminds me of myself and my struggle with speech.

I have been telling myself and others for years that I do not have enough people to talk with and that I desperately need to talk. When I go to work it is difficult to talk because, like I told you, most people are not interested in talking with me.

My talk at work is like the speech of a desperate man. I struggle to speak and sometimes I make no sense. I feel like I am an old man lost in the world he is no longer part of and that does not want to recognize him.

The other day I was working on a project with a guy. As we were finishing, a woman walks in and hears me sigh then say OK as I walked over to do something. She said, ¨People say ´OK´ a lot around here. Always talking to themselves.¨

Then two more people came into the room. She said, ¨I hear ´Allright´ a lot too.¨ I said ¨I say ´allright´ a lot.¨ Somebody laughed. ¨Yeah you do.¨ Then I gestured with my arm and fist – ¨Allright! Right on!¨ – and everybody laughed.

We bantered about more expressions from the 60´s and 70´s. I said, ¨My generation is easy to make fun of – ´Far out man!´¨

I don´t laugh much at work, but I did that day. I cut loose too – but that can be dangerous at work.

The problem at work is I need the people there to provide me with the conversation I do not have outside of work. It´s like people would rather give money to a successful man than a homeless man, so people would rather talk with somebody with a lot of friends than somebody with hardly any friends.

I´m worried about my mental health. I do not know what to do to have people to talk with like you and I used to talk, and the guy I used to play music with talked, and the way my friend who I met on the quad at Sac State talked, and the way I talked with some of my girl friends.

They say you´ve gotta grab the bull by the horns. Everything I have tried to do to embrace the world and meet people hasn´t worked.

I remember you telling me about a Scandanavian woman you met. She told you that friends in her country had long intimate conversations. You contrasted that with the horseshit relationships people have here.

I don´t move quickly. It would take a lot of time to make intimate friends, but I´m running out of time. Help me to think of something, and to have the courage to do it.

Love,

Dave