Medical Doctors Need Better Mental Health Education

*Trigger warning: Mild wrist-cutting.

Note: Though masochism plays an important role in this story, I won’t analyze it too deeply here, because it’s beside the point of this article. I’ll save that for other essays, like this one.

…

This is a recounting of the disrespectful and ignorant way I was treated by supposed medical professionals on a night a few years ago when I self-harmed. In sharing this story, I want to address the abysmal way in which mental patients are often treated in medical contexts. It’s a critical issue that’s often ignored.

…

Part 1: What Happened

Not even five years after my first suicide attempt, I graduated high school and moved to Los Angeles to attend the University of Southern California.

USC had been my dream school for many months, and I had worked tirelessly on my application. The university was in beautiful California, in the land of celebrities and sunshine and buildings that climbed all the way up to the sky, just like I planned to do.

Eight months later, I was dragging myself down to the campus police station at three in the morning, my wrist bleeding.

…

By the time I hurt myself in my dorm room, I had been miserable for the better part of a year at USC. My roommates insisted on keeping our apartment a loud, disgusting trash heap; my classes caused me so much anxiety that just the thought of studying started my heart palpitating; I’d fallen in love with a man who had rejected me apathetically after many frustrating months of failing to win him over. After being pushed beyond what I could mentally withstand, I finally opened up my wrist, as I always did when life became unbearable and I could see no way out.

…

The police officer at the Department of Public Safety called the EMTs when she saw fresh blood under my sleeve. I was detained voluntarily at the station until the ambulances arrived. For whatever reason, my cuts were hardly glanced at by the EMTs before they covered me with a blanket, strapped my arms by my sides, and loaded me into a lift at the back of a fire truck. I was raised into the giant vehicle, its sirens blaring, while seven or eight of the largest men I have ever seen watched on, bundled up in their fire uniforms.

Once I was in the truck, I was tilted onto my back by one of the EMTs, who pulled on my sleeve to look at my cuts, which were the physical expression of my intolerable mental suffering.

His response was, “That’s it?”

…

Once we arrived at the hospital, the doctor barely paid attention to me.  He stuck around just long enough to ask in a voice that suggested I might have been five years old, “Well what did you do that for?”

…

Part 2: Analysis

In an ideal world, everyone knows how to help someone who hurts themselves. In that world, self-harm doesn’t create panic. And that’s because, in an ideal world, self-harm is recognized not only as a problem in and of itself, but also as an indicator of even worse mental problems.

However, we don’t live in an ideal world, and my cuts that night were misinterpreted and overblown by the medical professionals who were supposed to be taking care of me. It started with the police officer who called 911 from the Department of Public Safety. There was nothing but panic written on her face as she reported me as if I were having an emergency, even though my cuts were shallow and horizontal, and my demeanor was clearly exhausted, not impulsive or suicidal. By treating my molehill like a mountain, the officer added unnecessary stress to my already deteriorating mental state. Her actions also made me feel guilty, like I had done something morally wrong.

When the EMTs arrived, they restrained me, which made me feel like an even bigger basket case. It was clear that they thought I was a crazed threat who was likely to try to hurt someone, instead of what I really was: a small, worn-out teenager who just didn’t want to be alone anymore.

Still, I was strapped to a chair and rendered immobile. In seemingly no time at all, my desire to express my emotional pain alone in my dorm room had turned into a public scene with flashing lights and lots of strangers paying attention to me. I felt like the headliner in a circus.

Self-consciousness added itself to the list of massive unpleasantries metastasizing in my head. I would have happily stepped into an ambulance and let them bandage me, but they never gave me that option.

To quite literally add insult to injury, they also degraded my mental suffering. By saying, That’s it? in response to seeing my cuts, the EMT implied that my physical injuries were my only issue.

However, my emotions weren’t even a blip on the EMT’s radar. Here was someone who responded to emergencies on the dangerous streets surrounding USC. He probably had experience treating stabbings and gunshot wounds, as well as other gruesome injuries. By comparison, my cuts probably looked like nothing to him. I’m sure he thought that a couple of tiny scrapes on an otherwise physically healthy young girl’s wrist didn’t merit calling the emergency hotline and rushing half a dozen fire fighters halfway across downtown LA.

While I agree that they overreacted, he missed the point completely.

Not only did he fail to consider my psychiatric symptoms, which clearly needed tending to, he was also extremely inconsiderate about my suffering. That’s it? translates to Your pain doesn’t count because you’re not hurt badly enough, which means You don’t deserve medical attention. In other words, I was wasting their time.

As soon as the words left his mouth, I felt humiliated, guilty, and most of all, hopeless. My depression was unbearable, but according to a medical professional, it still wasn’t bad enough to deserve treatment.

At the hospital, I was only asked about my problems in the context of my wrist. No one thought to unearth my mental history; no one cared to find out about my previous stays at psychiatric institutions; it’s doubtful that the hospital even had a specific questionnaire for their depressed patients.

The medical staff obviously had little or no experience with people who need mental help. The doctor spoke to me in a condescending tone that no psychiatric professional would ever think to use with a masochistic patient. When he asked me why I hurt myself, there was nothing professional in his voice. He wasn’t trying to find out what had lead me into such a miserable state, let alone make any progress toward improving my toxic life circumstances.  I could tell he honestly just couldn’t begin to comprehend why a person would cut herself.

Because the caretakers who treated me that night had so little training in mental illness, I didn’t receive the help I needed to prevent me from ending up in the hospital again. I was discharged the next morning without so much as a referral for a talk therapist, let alone the medications I needed to treat my mental health problems. Instead, I was essentially just told I would be okay and sent back to the environment that had made me want to hurt myself in the first place. I had nothing to show for my awful night of “healthcare” but a thousand-dollar medical bill and a piece of gauze taped over the cuts on my wrist.