In Response to “Why It’s So Hard to Get Mental Health Care” from the Patriot Act with Hasan Minhaj
cw: suicide, mental illness
I love Hasan Minhaj, and this is a really good episode. He explores multiple barriers to getting treatment for mental health, but focuses largely on one of the biggest: insurance coverage. In the work that I do for the Southwest Wisconsin Behavioral Health Partnership, one of the things we are constantly talking about is how to get rid of barriers to treatment. Because if you are struggling with depression, and you try to reach out for help and get denied over and over again, eventually you stop trying. And people are literally dying from this. Everything we do, we are constantly considering how to make the resources as accessible as possible.
There are a few things that are outside of our control, but nonetheless we are working towards changing. I appreciate that he mentioned the lack of psychiatrists in rural areas, that is a huge issue that many people living in urban areas are unaware of- sometimes the barrier is just a lack of available treatment, the help that you need does not exist in close enough proximity to you.
The other one is insurance. It is wild to me how insurance companies see mental illness as “more subjective”. Like they can just come in and tell people that their mental illness isn’t bad enough that they NEED a certain level of treatment. Aside from being unfair, this logic is fundamentally flawed. Because people with mental illnesses rarely are totally honest about where they are at in their minds, both to their doctors but also to themselves. And having a company tell you that the life saving treatment you are receiving isn’t really necessary, so therefore they will stop their coverage, is a punch in the gut if I ever heard one.
After I tried to kill myself, I did an Intensive Outpatient Program that saved my life. It consisted of group therapy for several hours a day, and I can tell you multiple people in my group had to leave the program early because their insurance decided they were no longer going to cover it and they could not afford to pay out of pocket. These were people who were just as suicidal as me, and struggling to function day to day as much as I was. But they were told the skills we were learning that eventually saved my life, weren’t “medically necessary” for them. I think about those people a lot, and if they are still alive now. I was friends with one of them, and I wonder if he is still out there trying to survive. I hope that he is. But talking to him on his last day, I can’t tell you how demoralizing it is to be told that your illness isn’t serious enough or your LIFE isn’t worth enough to an insurance company that they will pay for a treatment that could save your life. It’s bullshit. And we need change now, we need these laws enforced now.
original post on November 14, 2019 in response to Season 5 Episode 1 of the Patriot Act with Hasan Minhaj
Further Comments on “An Invisible Illness” Meme (pictured)
cw: suicide, self harm
I wanted to share this because I think that many of us often forget that suicide is the result of what is commonly an invisible illness. It’s invisible because its in our brains, but it is also invisible because we become so damn good at hiding it. The reasons for hiding it may vary, but are all connected to stigma surrounding mental illness. We know how to put on that bright face and go out and do the things we know we’re supposed to do.
I’ve heard things like “Oh she has so many friends, she can’t really be depressed”, or “I don’t get why she’s acting depressed when she does so well in school, what could be so bad about getting straight As?” or “If she’s so depressed, why is she involved in all of those extra-curricular activities?” said about me or about others in front of me. And to someone who may not be fully able to conceptualize mental illness, I can see why they would have this perception. Because most people believe depression is sadness. So if the person doesn’t seem all that sad to them, or if they have a lot of good things going for them in life, it is hard to believe that they are “just really sad” to the point that their lives are at risk.
So let me be clear now: saying these things is harmful to those who may be at risk. Because depression is not sadness. Sadness is sadness. Depression is so much more than that. It is crushing loneliness even when you are surrounded by friends. It is having these negative thoughts that are tearing you down inside constantly buzzing through your head at every moment of the day. It is loathing your own reflection. It is wanting to die all of the time and not knowing why you would feel this way. It is fighting the urge to self-harm long enough until you are alone and no one will see you do it. It is crying from a deep pain that turns to sobbing that becomes a panic attack. It is losing the ability to stand on your walk home at night and collapsing. It is reliving every little mistake you’ve made since you were ten and berating yourself for it over and over every time you try to sleep. It is acting in selfish and manipulative ways and feeling like you are in the backseat and someone else is driving and you are powerless to stop it and hate yourself for it. etc
I got good grades in high school, was captain of a sports team, and had a lot of friends. I was also suicidal. One does not exclude the other. I learned from a very young age how to go to the bathroom at school to have my “freak-outs” (later identified as panic/anxiety attacks) during class so no one else would be there to hear me. Then when I was ready, I knew exactly how to splash cold water on my face, give myself some air, and look in the mirror and practice my smile, and go back out like nothing had happened. This was a survival skill I learned early on- because no one wants to be friends with the kid who’s always sad and crying. Or who “just wants attention.” One day, after I came back out, I was so good at faking it someone actually remarked “wow looks like someone is happy today” as I skipped past. My stomach twisted and I felt one of the other symptoms of depression- guilt. I felt guilty about everything, most of which was not my fault, but I felt guilty about pretending to be happy when I wanted to die inside. Guilty if I appear sad, guilty if I fake happiness. Just always guilty.
All of this is to say: if someone is brave enough to tell you they are struggling, take them at their word. You may not have known, or could have never predicted it, but believe them anyway. Because it could save a life. Make yourself known as a safe person to those who appear to be doing well in case they are really not. Talk about suicide and mental illness in a non-judgmental way so people might feel comfortable enough to reach out.
September is Suicide Prevention Month. If you’re struggling with some of the things I’ve mentioned in this post, and you’re tech savvy, check out these free apps for support: Virtual Hope Box and Calm Harm.
original post on September 10, 2019 for Suicide Prevention month.
’13 Reasons Why’ – A Case Study on the Importance of Responsible Depictions of Suicide
A long post on the Netflix show ’13 Reasons Why’ has been a long time coming for me. Anyone who’s mentioned it in my presence knows why. But for anyone who hasn’t- buckle up, folks.
I’ve written at great length before about the importance of RESPONSIBLE depiction of suicide in the media. While it is important to talk about suicide and start the conversation about such a taboo subject, as a society we need to be especially careful when we do this in something meant to be consumed as entertainment. The main reasons are:
1. Suicide should never be romanticized. It shouldn’t be portrayed as the perfect ending to a story, the only possible ending for a story arc, or the perfect way to “get back” at the people in life who hurt us deeply. Suicide is not poetic, it is tragic beyond measure and it devastates communities.
2. Graphic depictions of suicide are dangerous. For young people struggling with suicidal thoughts, as I did from a pretty young age, one thing that holds them back is the lack of knowledge of how to actually do it. A graphic depiction of suicide can work as an instruction manual to an otherwise ignorant adolescent.
’13 Reasons Why’ engages in both of these. And while it just got renewed for a third season, multiple studies have come out about an increase in suicides among young people after this show first aired. The CEO of Netflix stands by the decision for renewal, and the creators of the show have published their defense of it in spite of academics saying there is credibility to these studies. But ’13 Reasons Why’ is an immensely popular show, so why would Netflix stop making it? And the creators may have had good intentions, so why would they believe that the reality is so off from what they wanted?
When the show came out, I was deeply disturbed by what I was reading about it. I refused to watch it for this reason. I remember a friend at the time, arguing with me about how I shouldn’t judge it without watching it first. I had seen a clip, one of those trailers for the show, that without warning flashed to a scene from the graphic depiction of suicide that occurs in the show. There were no content warnings, and the image was graphic to the point that I felt my heart drop into my stomach and my throat started to get choked up. I was floored. Seeing this clip was more than enough of it to know that I did not want to watch this show. And yet my friend at the time disagreed with this view, telling me that they had since added trigger warnings to the episode with the suicide, and insisted I should watch the show. I recount this now because I think it speaks to a major issue at play here.
For those who have never had suicidal thoughts, or lived a life touched by suicide, this very well may be a “good show”. They can find the drama and intrigue entertaining, because they have never experienced suicidality up close. They cannot understand why irresponsible depictions of suicide can be so damaging. Those of us who have had these sorts of experiences can instantly recognize it when we feel our hearts drop and our throats tighten, when we lose our breath for a second because we’ve been in almost the same position but somehow we’re alive. There is a clear disconnect here, and while the creators and producers may have had good intentions and thought they were doing something positive, it is beyond time to start listening to people with lived experience. Because this show has clearly missed the mark.
Please message me if you’d like further explanation, but I’m asking now for people to stop watching this show. Because maybe if people stop watching the show, Netflix will stop making it because it is no longer making them money. And these sorts of things that target high school audiences really need to start reevaluating how they depict suicide, because it matters. It has an impact.
original post on June 2, 2019 in response to Mashable’s “Another study points to link between ’13 Reasons Why’ and an increase in youth suicides” by Rebecca Ruiz
Separating Mental Illness from the Rhetoric surrounding Mass Shootings
As someone who advocates for mental health issues and increased access to mental healthcare, I’m almost always glad to see others doing the same. The exception is when, in the aftermath of yet another mass shooting, people use the issue of mental health as a way to distract from the huge gun problem in the US. It is very dangerous to start equating perpetrators of heinous crimes with people who suffer from a mental illness. This is a trend I see more and more after every mass shooting- “the guns aren’t the problem, its the guy with the gun. clearly it is the mental health of this guy we should be looking at” – that is becoming deeply concerning to me. It is troubling for a few reasons:
(1) In reality, people who suffer from mental illnesses are much more likely to harm themselves than they are to physically harm others. Saying that the perpetrators of mass shootings only did this because of a mental illness is not only incorrect, but harmful to those who may be afraid to ask for help. Individuals who are at risk for suicide often do not tell anyone because they are afraid of what others will think of them. They are afraid people will think they are “crazy”. If this rhetoric of labeling these incidences as “mental health issues” only continues, people will fear that asking for help for a mental illness will make others afraid of them and only make them more isolated than they already feel.
(2) If you care about having access to a semi-automatic assault rifle more than the lives of innocent children, don’t try to tell me you care about the health of others. These ideas are incongruous. Do not mask your “don’t take away my guns” with “mental illness is the real problem here”. Just own up to the fact that guns matter more to you, because right now you are reversing what little progress has been made in trying to tear down the stigma that prevents people from getting the treatment that could save their life.
(3) It might be that a shooter has a mental illness, but it also might not. Your armchair diagnosis serves no purpose here, aside from the harm addressed above. But what can be said with absolute certainty is that nearly every mass shooting has involved a semi-automatic assault rifle (the AR-15, which has been labeled by the NRA as “America’s most popular rifle”). So if you want to talk about preventing any mass shootings from occurring again, I know where you can start.
source: https://www.usatoday.com/…/ar-15-mass-shootings/339519002/
original post on February 23, 2018 in response to the mass shooting in Parkland, FL at Stoneman Douglas High School.