The First Time You Go to the ER with Suicidal Thoughts
You are 19 years old, on your computer at home, and you have been depressed for weeks, maybe even months. It has gotten really bad lately, and you are talking to your best friend online. You have been really laying it all down about how depressed you have been and how all you want to do is sleep, you wish you could stop existing, and you wish everything could just end.
Suddenly, you hear a knock on the door of your apartment and it startles you. You have been isolating yourself for days, so this is a surprise. When you look out of the peep-hole, you are bewildered to see a male police officer standing outside the door. Shaken and not knowing what else to do, you answer the door.
He knows your name. How does he know your name? When he asks to come in, you are reluctant to let him come in, but you know you don’t have a choice … do you? So you let him in. Then he asks to see your room. When he looks inside your room, he scans the interior, most likely getting full view of the scattered articles of unwashed clothing, dirty dishes, week old pizza boxes, and of course, the multiple anti depressants on the bedside table. Of course, he immediately asks about the pills. “What are the pills for? Have you taken any of the pills today? How many of the pills have you taken today? How are you feeling right now? Do you want to hurt yourself or harm someone else right now?”
He asks if he can take you for a ride in his police car, and you are reluctant to go, but again, you are not offered a choice and you are also not sure whether or not you have one, so off you go. About ten minutes later, you are arriving at the hospital. At this point, all you know is that someone called a hotline and the hotline notified the police that you are a danger to yourself. Nothing else is explained.
You are taken into the hospital emergency area by the police, and left in a small, white room with one hard, non-cushioned chair to sit in and wait for a triage nurse. Someone immediately comes in to ask you to remove your clothes and hand over all of your belongings, including your phone. They give you what they refer to as “blues” which just looks like a plain blue hospital outfit and they exit. They even take your underwear and bra.
It takes hours for the nurse to come and you are so agitated and emotional at this point that you feel like you would have been better off at home. When the nurse finally arrives, you try to ask him what is going on through your tears and hyperventilating and all he says is that you are a danger to yourself and he would be interviewing you to determine whether or not you will be admitted for a stay in the hospital. Of course, you immediately panic. You have never heard of being hospitalized for depression. All of this is extremely overwhelming, and why was it taking so long?
The nurse begins to question you rapidly. “What did you tell your friend when you spoke to him earlier tonight on the internet? Do you wish to harm yourself right now? Do you want to harm other people? Are you hearing voices or seeing things that aren’t there? Do you know, in what specific way you would harm yourself? Have you had, or do you currently have, a plan set in place to harm yourself?”
Eventually you let slip that one time while you were walking to work you had a fleeting thought while you were crossing a bridge, wondering what it may be like to jump off that bridge. The nurse pauses and writes down what you said. You immediately regret telling him. The nurse tells you he has everything he needs; the psychiatrist will be in to see you shortly.
It is hours more until the psychiatrist comes. You have two panic attacks before you can see the psychiatrist because this is all brand new and overwhelming to you, and on top of that you can’t reach your family or friends. You are still locked in the cold, small white room with the hard chair. At one point, you panic and try to ask someone for help. You think they could help you to calm down. You try to go up to the window and ask for help, but they blatantly ignore you, and eventually they just shout “no.”
The psychiatrist finally enters the room a couple of hours later, and asks if you have had anything to eat. She is much gentler than anyone you have interacted with thus far. You tell her no, so she gets you a dry turkey sandwich wrapped in plastic wrap but that’s okay you’ll take anything at this point. While you eat your sandwich, the psychiatrist proceeds to tell you that you will be admitted to the hospital for a stay. There is no telling how long or short this stay will be. That will be up to the doctors and therapists on the unit. She wishes you the best of luck and exits your cold, white room with one hard chair.
You end up staying in your cold, white room with one hard chair for the next 24 hours until a bed is available on the mental health unit. During this time, you drift in and out of consciousness, trying to sleep, being startled awake by the occasional nurse passing through, collecting blood samples and making sure you are still alright.
When your room on the unit is finally ready (the next night at 7PM) a security guard is sent with a wheelchair to retrieve you from your cold, white room with one hard chair.
Once you are on the unit, you are checked in and shown to your room. The room is modest. It has a bathroom, which is nice, but the door doesn’t close or lock, for safety purposes. The bed is moderately comfortable, but is really just a mattress on the floor since you are a fall-risk due to a seizure history and you aren’t allowed to have sheets, since you are considered a “suicide risk.”
After being shown to your room, nurses begin to come in one by one and introduce themselves, along with your treatment team. These people are much gentler and seem to know how to make you feel safe. You immediately feel a sense of calm. You are introduced to the activity calendar, which contains a schedule of groups for the week, and you are given a folder of introductory packets about the mental health unit along with some of your rights as a patient. Wouldn’t it have been nice if they had given you some of this information when you were in the ER? This could have prevented the 24 hour-long storm of emotions that you had to go through because of the confusion.
For the next week, you are treated daily by a social worker, psychiatrist, recreational therapist, and you are welcomed into group therapy sessions. You are even given access to pet therapy, which is a new concept to you. You are given access to books, but no personal electronics. There is a public phone on the unit to call your family within the allotted hours, and visiting hours are 1 hour per day.
You realize, even though the process of getting from the ER to the actual unit was more of a struggle than it should have been, this type of stay could be potentially life-saving for someone who is suicidal or mentally ill.
Finally, when it is time to go home, your family travels to your city to pick you up from the hospital. You have dealt with depression and therapy before, but your family was shocked to hear that you had been hospitalized. You are nervous to see them, but they seem supportive. Your family consults with financial supports before you leave, and you are checked out of the hospital.
About a month after you get home from the hospital, you find that a bill has been sent from your insurance company stating that your stay was “not medically necessary.” This strikes you as odd, because you did not have a choice in leaving the hospital. You were held there under “mental hygiene arrest.” Of course, you appeal this bill with the help of your mother, and eventually the insurance company rejects this appeal. The final unpaid portion of the bill is $11,000. You hear about an organization called “Charity Care” that helps people pay their hospital bills when they are in need and eventually they help pay off the entire bill. This is a huge relief.
All-in-all this experience is rewarding. However, you believe something needs to be done about the mental healthcare system. Your ER visit made matters worse for you, and added to your stress to say the very least. You should not have had to wait for 24 hours for access to care, and you know even though your initial process wasn’t great, there are people out there who don’t have access to mental healthcare at all. That needs to change. The insurance process also needs to change. This may be getting worse rather than better. You know there are many great advocates working to better our mental healthcare, but it is also not a priority in our government. Your experience has inspired you to find treatment and advocate for others to better the system.
Gearsbeck, C. (2018). The First Time You Go to the ER with Suicidal Thoughts. Psych Central. Retrieved on April 7, 2020, from https://psychcentral.com/lib/the-first-time-you-go-to-the-er-with-suicidal-thoughts/