On Mental Healthcare in America
- not f. scott
- Sep 8, 2019
- 6 min read
Updated: Sep 9, 2020
*Trigger Warning: Contains references to self-harm and suicidal ideation. See end notes for resources.*
Are we all mentally unwell? I look around at the various communities I have connected with in my life and believe this could be true. When work and upward progression are the focus, fuel, and structure upon which our existence and societal worth relies it is difficult not to be at least a little anxious, a little depressed…
Depending on where you’re from (and I mean this on multiple levels of personal origin), life can be consumed entirely by a career you don’t really want, amongst crowds you don’t really relate to, in environments you can’t really afford. To rest is perceived as lazy, to spend is perceived as careless, and to struggle means you’re just not good enough to succeed. At least, that’s certainly how it seems sometimes.
Today, with the weight of social media, our world has become wholly preoccupied in calculating our life’s appearance to others and criticizing how others’ lives appear to us. And then we throw mental health into the mix.
I have a mental illness, though a number of confidantes have felt certified enough to tell me I don’t have one. Family and friends, that is. Very few know that I was on medication for it. Even fewer know the gory details of my experience.
I keep the specifics private for several reasons, but perhaps the most glaring one is that I’m tired of being told that I’m wrong, that the therapist I could once afford was also wrong, that the psychiatrist was just trying to make money.
Unfortunately, with our flawed mental health system, these thoughts aren’t so far fetched. I went through three psychiatrists before I found one who sort of worked. The process has and continues to be a horror story. I was taken on and off medications that are dangerous to be used so flippantly. Appointments were cancelled last minute (the doctor’s doing, not mine). I was forgotten about. I was thoroughly talked down to: “If you’re ‘so depressed’, how did you make it through grad school?”
When a psychiatrist looks at you like you’re a little girl saying your paper cut needs stitches, you lose one of the precious few reservoirs of hope you have left.
I was almost hospitalized.
But after all the dismissing and disbelief I’d encountered up until that point, the key word to me was almost. No one would believe my struggle with almost. Almost, to me, meant I was either a coward or overdramatic.
I remember one day leaving a half-insured, horribly expensive, 10-minute psychiatrist appointment feeling completely ashamed. My narrative had been corrected upon demonstration. “Oh, those aren’t cuts, honey, those are scratches.”
Though I was terrified of these scratches - more-so, what I had been trying to do with them - the mentally ill part of me only thought, “Why didn’t you go deeper?”
I can’t really say for sure what it is that brought me to today in one piece, but it truly saddens me that it was not for the help of the mental health professionals I spent $1000s of dollars I didn’t have on. I do think it was beneficial to have a mental health counselor to talk things over with, but my literal change of mind seems to stem from a serendipitous strand of good luck. Namely, I was able to remove myself from the circumstances aggravating my condition and relocate to an environment much more suitable for me.
Though I am no expert on building functional mental healthcare systems, I think I’ve earned the right to say that this one doesn’t work. By assigning cookie-cutter descriptions to widely variant issues we have created a widespread sense of psychiatric expertise based solely on immediate, visual evidence. We squeeze patients into 10-minute slots, but how can any mental health professional possibly grasp the extent of what is going on in that time span? And with an insurance bill well into the $500s month to month, why does so little of it cover mental health at all? A healthy mind is unaffordable. It is ludicrous that insurance companies treat this like an additional premium.
What’s more, with the infamous referral system that rules so much of American healthcare, many patients have to pay multiple fees to multiple professionals in order to get the proper treatment they need. In my experience, I had to spend around $100 a week to visit a therapist first (or Licensed Mental Health Counselor - LMHC) who then diagnosed me and requested that I see a psychiatrist in addition to her weekly sessions; note, an LMHC is not authorized to prescribe medication, but does offer the various talk therapy sessions many psychiatrists do not provide.
And despite the fact that psychiatrists and psychiatric nurses are entitled to this highly catalytic, medicinal doctordom, generally, they never speak with the LMHC. For me at least, my LMHC’s referral to a psychiatrist sparked neither recognition nor discussion between the two, and after he fell through due to an exorbitant $650 self-pay rate I couldn’t afford when my insurance failed, I was on my own to find a new psychiatrist for myself. Though my LMHC was kind about it, she concluded that she had exhausted her resources. There wasn’t a single other psychiatrist she considered trustworthy and sympathetic enough to recommend.
Finding this second psychiatrist (who did accept my insurance) was daunting, but doable. Discovering that this put my life in the hands of the most unprofessional man I have encountered to date was catastrophic. I won’t get into that nightmare. Nor will I get into the horrors of scheduling mandatory, bimonthly “medication management” appointments around limited psychiatric office hours without souring relations with my own employer. Spoiler alert: it got ugly.
By the end of it all, though, what I’ve learned is that nothing about mental health treatment is easy or straightforward, or for many of us, supported. On top of that, no one in the upper tiers of mental health seem to grasp that mental illnesses, like people, have individuality. That we require sympathy, not condescension, to be understood.
So to anyone, both professional and casual, who has retaliated to the disclosure of a mental illness with something like, “You don’t act depressed enough to be depressed,” think about what you’re saying. The human brain is as unique as its bearer. Two people can wear the same diagnosis and look completely different. My struggle presents quietly and with reserve because that is how I present myself. It is a part of me. Those who present the same illness any differently aren’t any “more” or “less.” Mental health will never be as simple as that. You have to look beyond the surface.
I’m writing this, perhaps, because a part of me still craves validation. Because not so deep down, I still want undeniable confirmation that the chemical imbalance in my brain is serious and real despite its appeared differences from Abnormal Psychology or 13 Reasons Why or that person your boyfriend knew in high school's Instagram.
But, I’m mostly writing this for you, my fellow survivor. If you or a loved one have lived through something similar, I hope I’ve given you some solace. I hope you don’t feel as alone and unheard as I did. I hope you have not been conditioned to think that pain only exists if it looks a certain way, and if you have, I hope you find the right support soon. It is out there somewhere. In spite of it all, I still carry optimism in this.
And to anyone who has any sway in this far too important field, please evaluate the impact of your interactions. The human mind is not a business transaction. Stop treating it like one.
*For those of you struggling, here are some affordable (ie; free) resources that have helped me through some of my hardest times. Please note, that I am only speaking for one person (myself) who has sought mental health treatment in the NYC area. I cannot and do not speak for everyone. This commentary is solely meant to reflect on my personal experience, provide solidarity to those who need it, and demand change from those who can enact it. Don't lose hope! It 100% can get better for all of us.*
(This is a super helpful, free mood-tracking app for your phone - it was instrumental in giving me perspective on what things upset and improved my mood, and allowed me to decide what to avoid and what to incorporate more into my day-to-day.)
(This sounds silly, but studies actually show that looking at tender, fuzzy creatures does wonders to alleviating anxiety - if you're petless like me, here's some of my fave furry friends to visit from time to time.)
(Need I say more?)
And as always, if you are at the point where you are seriously terrified of yourself, help is ALWAYS right here, 24/7:
Comments