“Hey mom, I just can’t do it anymore! . . . It’s over! . . . He’s out and I’m a mess!”
“Can I crash with you while I sort myself out?”
That desperate call came to my friend Leah, about one year ago.
“Another one bites the dust!” she thought. Never liked him anyway, wondered why it took her so long. “Yes, of course”, emerged from her lips as she welcomed her boomerang 40-year-old offspring home to her childhood basement retreat from the battlefront of an ill-fated, problem-plagued relationship that took 20 years to crash and burn.
But her fantasies about her beautiful, educated and intelligent adult child, rebounding quickly disappeared much faster than she ever expected when she began to notice a descent into the dark, cold, shaft which took her daughter unexpectedly into the deeps, into the bowels of depression.
Her sunny disposition turned sad, her social involvements became fewer and she slept far more than ever before. She stopped eating much, then stopped eating all together. She quit taking calls and gave up responding to texts and emails. She ceased to communicate, declined opportunities to join Leah and her guests for meals, and no longer took interest in others. Her days turned to nights. Her gaze became blank and distant. Sometimes her troubled angry eyes focussed on Leah with an unfamiliar strange and inexplicable steady stare that caused considerable concern, because Leah could not read with any confidence, the meaning of the thoughts and feelings which drove it.
Leah had read about grief and knew it was to be expected after a long-term relationship dies an ugly death. She thought that the safety of her home, removal from the pressure of work and expenses, and her love for her adult child would take care of it. Soon her kiddo would be back in the game she presumed. She was, unfortunately, quite wrong.
Four months in, her middle-age daughter was no better, and seemed to be getting worse. Restless nights, agitated behaviour and comments about people watching her, cameras in the house and expressions of irrational occurrences in the neighbourhood began to alarm Leah and others who cared about her daughter.
It was pretty damn crazy!
Five months in, Leah suggested her daughter get some medical help but she refused to see her doctor, said she needed no medication and simply needed a bit more time to find her way. Before leaving on a lengthy trip, my friend convinced her daughter to go to an Ottawa hospital emergency department to get checked out, so she could rest easy leaving her alone. Finding her dead on the basement floor was a fleeting but frightening thought that had crossed her mind more than once.
They arrived at a bustling, overcrowded emergency department of an Ottawa hospital around 2 pm, set up camp for the day and waited well into the evening. By 8 pm they were informed that the fatigued psychiatrists had gone for the day. They chose to stay on in order to maintain priority in the line, and sat all night in hard straight chairs, watching the feverish pitch that our health care professionals must perform at. The night brought masses of patients with all kinds of medical problems into the hospital, seeking the best of the best to keep them afloat. Dawn broke with the staff still swimming upstream against the rapids.
It was pretty damn crazy!
By 11 am, the obviously ill daughter had been checked out, and prescribed some medication. Leah was told to take her home, as she had promised not to harm herself. When Leah asked if she could be referred to a psychiatrist in the community, the emergency physician replied, “There aren’t any to refer her to”.
Leah left on her travels counting on kind friends and neighbours to keep tabs on her daughter, video chatting often and connecting by text and email. Her mood ascended rapidly into healthier levels of the mind, and after several,months seemed reasonably renewed. She was eating and sleeping, walking the dogs at the Bruce Pit, and going to meet-ups to connect with some new friends.
But it did not take long before she seemed to be reverting, slip-sliding ever so slowly back down the sewers of the common cold of mental health afflictions known as depression.
“Are you still taking your meds?” Leah queried.
“No”, came the answer. “My prescription ran out.”
“Do you have a repeat?” she asked.
“Do you have a doctor’s appointment?” she followed up once more.
“Can I drive you to your physician’s office? To the out-patients department at the hospital? To the emergency department again?”
Leah tried so many times. But the answer was always the same.
“No.”
The mood and behaviour, often bizarre, abnormal, paranoid, delusional and disturbingly psychotic, became a daily presentation from this beloved adult progeny.
And that was pretty damn crazy!
In the vernacular, common man’s verbage, she could be and was likely described by many in her network as demented, bonkers, cuckoo, or bananas. Or maybe some who witnessed the symptoms of her illness might think her loony, batty, wacky or unglued. And still, likely others referred to her behind her back as off the wall, out to lunch or even nutty. Our society still feels comfortable somehow to use these words, these descriptors of real people who are sick, to try to explain an illness so insidious, so unrelentingly devastating, so scary that even the hosts of this monstrous controller do not have just the right words to give it a proper name.
There is stigma attached to this illness in our culture, Leah knows the ignorance and she and her daughter know the pain. Our society definitely needs the ‘conversation’ and a great deal more research, education, funding, medical interventions and social change.
The story of Leah’s daughter includes three more attempts to get treatment for her illness within a year. It talks about an understanding Justice of the Peace who assessed her need for medical assistance against her will, telling a worried mother that despite all the right forms and approvals, “They will just let her out”. It talks about two compassionate police officers telling my anxious friend that despite all the right forms and approvals, “They will just let her out”. It speaks of the overworked doctors and workers in hospital emergency units, telling a caregiver that despite all the right forms and approvals, “They’ll just let her out”. And through it all, they are unable to tell a mother, the one friend and family member who loves and is responsible for a very sick individual, absolutely nothing!
And the reasons are pretty darnn crazy!
They say it’s the law. They say it’s human rights. They say it is privacy.
We know ‘that mental illnesses are brain disorders — real biological diseases — no matter what’, according to a special 2019 Time publication by on mental health. Our culture says that humans who experience a mental illness that puts them out of touch with reality must make their own choices. These very ill people must decide to seek or accept help by themselves.These human brains which are no more capable than my dog or a 95-year-old senior with advanced dementia to decide to make healthy, sensible, rational decisions about themselves or others, are expected to do that of which they are totally incapable: to think rationally, with clear thoughts, so they might competently decide what is best for them in treating their illness, and to select the option that will heal those very, very, very sick minds.
If anyone is demented, idiotic and unhinged it must be the leaders who set the rules in place for others with such illnesses. Have any of them actually experienced a psychotic break? Have any of them asked our experienced health care professionals about the capacity of a delusional paranoid, psychotic individual for rational thought? Have any of them any personal experience in their families or networks which provided them insight and knowledge upon which they decide what is just, what is fair and what might be the right legislation for our brothers and sisters who live a period of time in their lives, with such a mental illness?
I am 100 per cent confident that if they knew fully of what they speak, consumers of service attempting to help a loved one, so extremely ill with symptoms such as paranoia, delusions or psychosis would legislate something different than what is so frustratingly currently in place.
For what is in place, in practice, is pretty damned crazy!
Leah’s daughter had a second go with ‘mother-initiated’ help at local clinics and doctors offices. Two clinics were closed tightly on Labour Day weekend, a third would not service an adult not registered as a patient and a doctor who might do a home visit was non existent in the city of Ottawa despite all possible efforts to find one. Like an irritating scratchy broken record, all resource contacts told Leah she must bring her daughter to the emergency department of a local hospital. All unwilling 150 pounds of her!
A third major effort was an ‘Intervention’ where a group of competent adults in Leah’s network who care about her daughter, assembled with the goal of influencing her to get medical help. Each spoke calmly to her of their concerns, each wrote up their impressions of her behaviour and expressed thoughts, and each supported sympathetic police, holding appropriate legal forms, in escorting her to a different hospital emergency department. They were hoping like Hades that a medical someone might actually be able to treat her successfully, despite that unwillingness, driven by her mental dysfunction, causing her to reject all loving efforts to assist.
The second hospital had been suggested and endorsed by some friends who had experience in the healthcare system. It was smooth, streamlined and efficient. It was quieter, calmer, supportive for sure. Yet, somehow by the treatment Leah got from a few, she wanted to remind them that her daughter’s mother was not the enemy!
Two young residents asked Leah if her daughter had been violent? Had she been threatening to hurt herself?? Or had she threatened to hurt anyone else? The list grew longer and nothing really seemed to be quite right to describe her most recently behaviour but Leah knew better than to presume with any accuracy at all, the future actions of a mind so disturbed and incapable of reason.The young doctors agreed that Leah’s daughter was very ill and needed medical help. Leah tried to explain that she had brought her daughter to this hospital for treatment because she was sick, not because she had been violent or committed a criminal act.
But still they informed Leah they could not keep her for more than 72 hours or treat her without her answering one of their six questions affirmatively.
It was the law, they said. Human rights, they said. Nonsensical, Leah said.
Pretty damn crazy for sure!
Leah stayed in the emergency area long into the night and returned each morning to visit and learn whether or not her daughter was going to be admitted and treated for her illness, so she could be mentally capable of an independent future. While the front line staff were amazing, the psychiatrist was unable to talk to Leah or say how her daughter was doing. She could not even tell Leah whether her loved one would be staying or let out.
“I am unable to speak to you. I want you to leave” was what the psychiatrist did say.
Leah felt unsupported in her efforts to care for her daughter at that time during this crisis in her life. In hindsight, Leah wondered why the health care professional could not have said something like, "Thank you for coming. Family is so important. We cannot tell you much. Be assured we will do our best to help your daughter. Why not go home and rest?”
But it is the law, they say. It is human rights, they say. It is privacy, they say.
Pretty damn crazy, I say!
Leah had dealt with the system, forever helping many others, had put in a lot of time researching and talking to professionals in the city and consulted a counsellor on strategy to secure treatment for her darling girl. When Leah got it all together, involved the right players, said the right words and checked the right boxes, her daughter was finally admitted to an Ottawa hospital for medical treatment.
‘There is a God’, I remember Leah exclaiming. ‘Thank you to the health care team at the second Ottawa hospital that my daughter found treatment at after exhausting efforts to help her climb out of her dark and deep hole”, she added.
She cannot say how much she respected and appreciated the staff on that treatment unit. Everyone there was exceptional. And the best thing of all is that her daughter made exceptional progress. She accepted her situation in time and became compliant with treatment. Her mood lifted, her mind returned to a normal rational state of reality and her behaviour appeared more typical of the wonderful charming and sweet young woman Leah knew as her healthy adult child.
Now that Leah’s daughter is on the road to recovery, she is capable of making her own decisions. She is capable of calling the shots. Now she functions once more on her own as a rational adult, is her own Power of Attorney, and can advise her physicians about any involvement in her care that she would like from her mother.
That is the law, they say. That is human rights, they say. That is privacy, they say.
And that is pretty damn good, I say!
But when an adult is suffering a mental illness that sucks all ability out of them to think as a rational adult and prevents anyone from engaging with them in a reasoned, sane discussion, they are akin to very small children or to very old person in advanced stages of dementia.They cannot be expected to conduct their lives while experiencing insanity as if they were not insane any more than we could expect a person living with quadriplegia to get up out of a wheelchair, stand in line, take hold of a pen and paper and sign themselves into the hospital for medical intervention.
That would be crazy, we’d say. That would be absurd, we’d say. That would be nuts for sure, we’d say.
And yet, we do it to those experiencing serious mental illness symptoms such as psychosis, delusions and paranoia, regularly denying these ill people access to treatment because of our laws and practices. Their caregivers, families and supporters often burn out trying to help them. Many of those sufferers end up on the streets among the unbefriended homeless population. And they live that dreadful, hellish existence because they go untreated. They go untreated because they have no capacity to choose treatment. They go untreated because no one can talk about them or discuss with anyone what is happening to them or what might be happening to them down the road .
That is the law, they say. That is human rights, they say. That is privacy, they say!
Now that, methinks, is pretty damn crazy!