I recently attended a training to be a “Mental Health First Aider”. I enjoyed it and found it informative (even at 6am Pacific Time!) but there was a portion that I had to speak about. Most of the attenders were either mental health professionals or had a family member with mental illness. I was the only one who identified as having a mental illness. At one point they showed a video of someone experiencing hallucinations – speaking to people who were not there –medication bottles on the table implying he was off his medications, and a messy house implying he couldn’t take care of himself. Then it was opened up to the group for discussion: what would you do if faced with this scenario.
The ”answer” was to invite the man to talk with the two people who were concerned about him and offer to get him help. He agreed and all seemed well but then they showed an alternate ending where the man did not come and talk but one of the persons called for help anyway. This is where I spoke up.
Let me make myself clear, if faced with someone who is a danger to himself and others, call 911. However, do not call because someone is talking to people who aren’t there. Do not call if someone chooses not to take medication. Do not call if the house is messy. The police will not do anything unless someone is in danger. You cannot be confined against your will just because you make someone uncomfortable or they think you “should” be taking your meds. I’m not saying ignore the situation! Call 988. Connect the person with resources. Be a friend but know the limitations and risks of calling 911.
There was conversation about “wellness checks”. This sounds so great in theory. The police come and talk to the person and the person gets the help they need. If they need to be hospitalized they have a nice bed and caring professionals taking care of them. They’re given medications that make the voices stop and the person is able to have a meaningful life. Oh, how I wish that was true.
Here’s another scenario. The police show up on the doorstep and the person hallucinating doesn’t know what’s going on. Maybe it goes well or maybe the person becomes argumentative – lots of ways that can go wrong! The person gets taken to the hospital where they wait 12+ hours for a bed to open up. I once went in at 11am and got a bed at 3am. During that time, they’re scared and confused but the social workers and counselors are so overworked they don’t have time to comfort them. They finally get taken to the ward and put in a room. It’s clean but sterile and still no one comforting, just business as usual. Medications are messed up because the regular psychiatrist and the hospital psychiatrist disagree on treatment plans if they communicate at all. The “patient” goes to group therapy with people they don’t know or understand. They’re unhappy and resentful at guess who? The person that started this nightmare.
But you only wanted to help and don’t understand why the person isn’t on meds. Well, I’ve got news for you: medications aren’t magical! Even if we find a combination that helps, it can take weeks or months to find the right meds that can make a difference and good luck finding one without all the lovely side effects: lethargy, weight gain, tardive dyskenisia (muscle spasms and facial contortions) or flat affect. We don’t feel things. We don’t understand things. Even the right meds come at a cost.
So, when faced with someone with a severe mental illness don’t ignore them. Reach out to be a friend, a support. Just don’t dump them on the police because you don’t know what to do. Realize if you do, you’ll undermine trust. If the person is a danger to themselves or others, you call 911 but know that’s not a magic fix and there may consequences. Suicidal ideation is real but if every time you talk about it you get locked up, it’s not going to stop the thoughts from happening but it’s going to stop you from telling someone and then it can be too late.