Mental illness: Demystifying the boogeyman
The Herald Journal - 1/30/2018
My mother had just gotten off the phone. She looked shaken.
“What’s wrong?” I asked.
“Your cousin has been hospitalized.”
“Why? What’s wrong with her?”
“She had a nervous breakdown.”
“I don’t know. But she went to the mental hospital in Provo.”
As a boy, the words “nervous breakdown” didn’t compute. My cousin didn’t seem crazy, and I couldn’t fathom her needing a mental hospital. I had heard about the state mental hospital. It was where insane and unhinged people were sent. But nobody I’d known had ever gone there, until now.
The ominous nature of this news was made more so by the fact that I was told we couldn’t talk about it to anybody outside of our immediate family. Why? Apparently, because it could tarnish our reputation. Good families don’t have mental illness and word could get around. This topic was never again discussed openly among ourselves, and absolutely never brought up with my cousin or her family.
In 1978, my wife and I lived a few blocks from that same ominous mental hospital, still shrouded in mystery. I was in graduate school in marriage and family therapy, admittedly a mental health field. However, marriage and family therapy focused on the sane side of life. We didn’t deal with “those people” — people who needed major tranquilizers, who had to be locked up for their own safety or the safety of others. Despite what I’d learned about mental illness in my undergraduate courses, the state mental hospital was little more than a snake pit in my mind.
Fast-forward to 1981. I’m now a doctoral student in psychology at Utah State University working at the Counseling Center when, for the first time, one of my patients was suicidal and needed hospitalization for his own safety. By then I’d had enough graduate courses in abnormal psychology that the concept of mental illness was no longer mysterious. But I still had no experience with real patients in actual mental health facilities, and my patient was relying on me to keep him safe, which meant I had to figure out how to get him admitted.
I steeled myself and made a call to the on-call psychiatrist. My nervousness was undoubtedly laid bare over the telephone line. He asked me a lot of questions about my patient, most of which I couldn’t answer, which seemed to annoy him and made me even more uptight. But somehow, possibly due to my pleading tone of voice, my patient was accepted for admission. I accompanied him to the old Logan LDS Hospital at 200 North and 300 East. The building was aged and looked like a fortress, which fit in with my conception. We found the mental health unit and a nurse emerged from the locked door to receive my patient. Having discharged my duty, I was happy to leave without stepping inside.
Fast forward again to 1983. I had just completed a year-long internship in Kansas and was the greenest psychologist at Logan’s Bear River Mental Health Center. My new caseload was full of people with mental illness: schizophrenia, manic-depression, obsessive compulsive disorder, addiction, depression, anxiety and marital and family issues. It was expected that if any of my patients required hospitalization, I would go to Logan Regional Hospital’s Behavioral Health Unit, and work with the staff on behalf of my patient, which I did. Additionally, I was assigned to accompany some of the more severely disordered/disabled BRMH patients on weekly outings.
Having been forcibly exposed to chronic mental illness, what I found was people — enjoyable, fun-loving, interesting, intelligent, caring, hurting people. They were more like me than different.
They wanted what I wanted. They struggled with problems I didn’t, but I struggled with problems they didn’t. Several things made my job enjoyable bordering on delightful. I had a great supervisor, Skip Winger, who talked me through tough cases and helped de-mystify my clients. And those weekly outings helped me see the playful, humorous, child-like, joyous side that existed in the most severe clients. We could definitely relate.
Any remnants of my original fears about mental illness were removed when I was hired by Logan Regional Hospital to provide psychological services to the behavioral health unit. This exposed me to clients at the height of their problems — suicidal, manic, psychotic, aggressive, anxious and catatonic. Now I was on the inside of those locked doors, treating whatever came through them, with the able help of nurses, psychiatrists, social workers and community clinicians. I became very comfortable with what went on within those doors, and was grateful for the tools we had at our disposal such as medications, group and individual therapy, recreation therapy and skilled psych techs who managed the patients day-to-day with care, patience and humor. We had opportunities to make a difference when people’s lives were being rocked by trauma, divorce, abuse or emotional flare-ups. It was challenging and invigorating.
Once again what I found was that, even in patients’ most trying moments, there was much to admire. They could show incredible insight and courage while facing daunting problems. They could also treat other patients with great sensitivity, concern and respect. It’s true that there were times when limits had to be enforced or someone would even have to be restrained. There were also heartbreaks. Twice I administered CPR while working in the BHU, to no avail. But I always looked forward to going to work, interacting with my patients, working with my colleagues and enjoying my friends.
I look back with some amusement at the boyhood fears I had of mental hospitals. The boogeyman of mental illness has long since disappeared for me. A deep respect for those facing problems has replaced it. Still, I’m empathetic when I see the jitters others exhibit about mental illness. Not everyone has opportunity to get close enough to people with mental illness to shrink the boogeyman. But many of us can begin, in part because we have friends, neighbors or family, whom we love, who have mental/emotional challenges.
In my next article I’ll attempt to address how to be supportive when someone is struggling with mental illness. I’ll try to address whether it’s OK to ask how they’re doing, whether it’s helpful or hurtful to get the details, and what to do if they start crying or seem upset. I’ll also try to address what to do if you feel someone is using a mental illness to try to manipulate or control you, get attention, or obtain special favors. We’ll also address when it’s time to get professionals involved or seek professional advice yourself.