A longtime friend lost his battle with chronic illness and depression to suicide. It’s very sad, but what deeply troubles me even more is that there are so few resources available to people who struggle with depression. Some of you will say but yes, there are plenty of resources if you look for them. That may be true if you have the financial means to pay for it. But in reality, affordable mental health care is almost impossible to find.
This was from a conversation I had with a friend recently. There is a lot of truth to what he says too. Our mental health system has declined significantly over the last number of years when it comes to dealing with crisis and long term care. And this lack of services has without question contributed to unnecessary suffering. But is it the lack of ability to pay for the services available the reason a person kills themselves? I don’t think so.
Just ask Robin Williams, Curt Cobain, Hunter S. Thompson, or Tony Scott just to name a few.
Do you think that these people didn’t have the means to obtain help? Out of the thousands of suicides each year, could the majority of them been saved if mental health services and been readily available? Is it really that simple? Can suicide be prevented by providing affordable and accessible care?
People don’t kill themselves because they can’t get help. People kill themselves because they are miserably unhappy.
That being said, the state of mental health care in this country is woefully inadequate. A number of years ago there developed a trend to ‘privatize’ psychiatric services. Governments believed that without state sponsored facility care would be picked up by local, private providers. They decided that each community could take care of their own. In reality though, what that did was greatly decrease needed resources particularly acute crisis response. A 60 minute episode recently did a story on this very thing. I won’t quote numbers, but the upshot of it was that the number of psychiatric beds in the US had decreased by 50% or more. That’s hundreds of thousands of inpatient beds. According to an interview with an Emergency Room Doctor, Hospital Emergency Rooms have been overwhelmed with people in severe emotional distress.
Wait a minute. You can go to an Emergency Room for psych care?
Yes, mental episodes can be an emergency, and the doctors can keep you safe. Safe for a little while that is. Without inpatient facilities many people who seek out help in ER’s are either turned away, or released still in crisis because there’s nowhere else for them to go. Undoubtedly, all too many of these people end up taking their own life.
But for every person seeking help, how many are there that are suffering in silence?
I’ve physically and intentionally hurt myself so many times. There have been multiple attempts at suicide; and a couple of them damn near successful. I have spent months in complete, abject misery and despair. During manic episodes I have endangered not only myself, but many of those around me. I sometimes have wondered if the extreme risk taking behaviors are really a subconscious attempt to kill yourself. And each and every time I was so unhappy and struggling so hard I was in some form of mental health treatment.
And I still wanted to die.
My friend went on to say that ‘he had personally experienced the problems with inadequate mental health services’. He was trying to manage his depression without drugs, and could not find any provider that could help him with this. The doctors he could find were out of network for his insurance, and he couldn’t afford the high co-pays.
This isn’t a lack of available care; it’s just that he doesn’t like the care he has available.
I don’t know the whole story of course, but the implication is that his depression is manageable with medication, but his choice is to learn to deal with it ‘naturally’. I wonder what would happen if his depression got so bad he decided he couldn’t live with it anymore. Would he take medications then? Would he be able to get them? I strongly suspect that he’s never truly been in that darkest of places. Otherwise, he would know.
No one else can make the pain stop.
Okay, I’m going to play both sides of the fence. Our mental health system is broken. The streets are full of people who are homeless and wandering around with untreated illnesses. The available services are completely overwhelmed, and unable to offer much more than very basic help. There just too many needing help, and too few to provide it. Years ago I experienced this when I was going to a county provided mental health clinic. They basically threw drugs at me; there was very little time of actually therapy. The waiting room at this facility was always packed with scores of people needing help and getting very little of it. And I’m completely convinced that there have been lives lost that could have been saved with proper care and intervention.
I’ve been unbelievably fortunate that my current therapist continued to see me when I was unemployed and unable to pay anything. There are a number of support groups in my area, and they have proven to be a fantastic resource. Even before I accepted that I had a chronic, potentially life threatening illness I always have sought out help.
Having this help has undoubtedly saved my life on more than one occasion.
Flip, flop; flip flop. I know, I’m talking out of both sides of my mouth here. But there is a point to all of this. While we desperately need more mental health resources, suicides can and do happen to people who have the finest care available. Because in the end, suicides doesn’t always happen because of a lack of care.
Suicide happens because of a lack of hope.