Trigger warning: This Spotlight post deals with mental illness, suicidal ideation, self harm, and hospitalization in a psychiatric facility.
I like to think that I’m usually polite. I use sir and ma’am, I smile and greet people as they walk by. But on my 18th birthday, everything in me wanted to lose it when anyone told me happy birthday. I wanted to snap back “I am not happy. Today is not happy. This is not happy!”.
You see, I turned 18 years old in a psych ward. One day every little thing I did had to be approved by one of my parents, and the next morning I woke up with a bucket of a new type of R&R (responsibility and reality) dumped on my shoulders. You know those “you’ll be an adult soon, get it together” lectures that every teenager gets as they’re turning 18? Those are quite interesting in a psych ward, but you can not get away from them. Anywhere. You can’t leave. They follow you, constantly. Sometimes it’s patients, sometimes it’s staff, but they never leave.
For the record, I was also sick and suicidal on my birthday, but I did not snap at anyone all day. I had a few panic attacks where I essentially snapped at myself, but still, I managed to smile and be polite and I think that’s reason for me to deserve a trophy. Just saying. I’m basically an Olympic gold medalist in politeness.
However, turning 18 in a psych ward gave me a unique perspective on how the mental health system in this country is structured. Quite honestly, I think that it sets teenagers and young adults up for failure in a few ways. I turned 18 on a Child and Adolescent Acute unit, and the day after my birthday I was moved to the Adult Psychiatric unit. These units were in the same building, literally just through a set of double doors. I continued to freak out for most of the day after my birthday as well, because I was scared or the change and everything I’d heard about adult psych wards. Providers put far too much pressure on teenagers with the frequent statements of “You need to do this now, or else…” “You don’t want to have this as an adult…”. If you can handle an adolescent psych ward, you can handle an adult psych ward. At least on the adult units, most of the patients are more mature than the adolescents. Most of them. Not all of them. But that’s true in society as well, so that’s a mute point, even if it may be a different type of immature than the average type you find in society. My first roommate on a psych ward was a sixteen year old psychopathic patient. I have yet to have a worse roommate in any facility, and trust me, I’ve been to a lot of them,
However, as far as that facility was concerned, one day I was a child, and 24 hours later I had magically turned into a full-grown adult. Thankfully, I was fortunate enough to keep my doctor and case managers, who were both absolute angels. I’d known my doctor for months through another facility, and she did a lot to try to make that transition as smooth as possible. However, my doctor was one of very few exceptions. I can count on one hand the amount of people in that building I truly trusted, and I was beyond fortunate that one of them was my psychiatrist, because she is the only psychiatrist I’ve ever trusted. That woman is an angel. But psychiatrists like her should be the rule, not the exception. Patients should feel safe talking to their providers. Facilities are there to provide tools to deal with stress, not add ways of increasing it.
Turning 18 was a transition for which I was horribly ill-prepared. Turning 18 in a psych ward was even worse. While there’s obviously a legal aspect of turning 18 that happens to every individual, most of the time that doesn’t include having a new place to sleep at night, and not feeling safe in that place. Most of the time that doesn’t include having a lawyer come up to you unannounced two days after your birthday to ask if they can speak to your family. Most of the time it isn’t as drastic. The thing is, turning 18 shouldn’t feel drastic at all. Turning 18 should be a celebration, an invitation to freedom, a one-way ticket to the ride of your life. For me, it felt like a death sentence. Everything was changing and out of my control. Life was a terrifying concept. I was being blamed for things that I couldn’t change. I was stuck between two frightening options, neither of which should have existed.
If it weren’t for my psychiatrist being so amazing, turning 18 would’ve killed me. My insurance had stopped paying, and administration was ready to discharge me, even though I wasn’t safe. Once again, the healthcare system really only cares about the money, and that’s not okay. That transition was not done in my best interest, and I am so lucky to have had a doctor who was acting in my best interest, because without her, I wouldn’t be writing this today.
So, I write this on behalf of the patients who aren’t as fortunate as I was. Turning 18 in the current mental health system is dangerous, and something needs to be done.
To the providers who truly care about your patients, thank you. Thank you for trying your best, sometimes even risking your jobs, to protect your patient and do what is right.
To the patients like myself, keep fighting, please. We have the power to make a difference. You’ll get through this. Trust me, if I can do it, so can you.
To everyone, please, consider what your patient needs. Listen to them when they try to advocate for themselves. We can fix this broken system. So, why not start now?