####WARNING: THE FOLLOWING ARTICLE COULD BE TRIGGERING FOR SOME READERS. IF YOU ARE FEELING VULNERABLE PLEASE DO NOT READ. IF YOU NEED TO TALK TO SOMEONE PLEASE CALL LIFELINE: 13 11 14 OR VISIT THEIR ONLINE COUNSELLING SERVICE AT http://www.lifeline.org.au/Find-Help/Online-Services/Online-Services #####
Over the last few weeks I have been reading about attitudes by professionals towards people living with mental health. I have to say, I am appalled, yet not shocked by the findings. The fact that literature is showing that psychiatrists, mental health nurses, psychologist and social workers have the same level of stigma as the general population is a bit disturbing. I always thought those types were the outliers, not the rule. (see here: Research Article on Attitudes Towards Mental Health)
Here’s a little tale of how these attitudes impact real people:
I need to give you, Dear Reader, some context. When reading, keep in mind that Ruby is a single mother, with no family to support her. She also lives chronic PTSD.
I have known Ruby and Sabine for around ten years. Sabine and my daughter Olivia* have been friends since they were two. They met at daycare. Sabine is a very dominating character and was talking before she was 2. Incredibly intelligent and hyper-aware of her surroundings from a young age were early warning signs that were sadly ignored. From the very beginning Sabine was not your average child. She would fly into a rage, that unless witnessed it, you wouldn’t believe it were possible. At the age of three, Sabine was capable of destroying her room and house, punching, kicking, and some pretty nasty things would come out of her mouth. I have been on the receiving end. Ruby and I would have marathon conversations on strategies to get Sabine to sleep (sometimes she would only sleep a few hours or not at all) and manage her behaviour and every time medication was put on the table, Ruby would flat out reject the idea. Most parents would beg for mercy, but not Ruby.
So finally Ruby got an appointment with a psychologist. I honestly thought that the psych would take one look at Sabine and see that this is more than a spoilt child (as she was often called), I couldn’t have been more wrong. Ruby would call me after sessions and breakdown in tears that the psychologist didn’t believe her. The psych told Ruby that there was nothing wrong with Sabine and that she was projecting onto her daughter. I finally snapped and asked if I could come along to an appointment and back her up.
I went to that appointment, nieve at what the outcomes would be. I thought, once Ruby had someone there, who has witnessed Sabine’s behaviour over a long period of time, they would see that Ruby wasn’t projecting. It didn’t quite work that way. They disregarded my opinion and basically accused me of collusion with Ruby. I’d love to see the clinical notes. No matter what we did or said, they wouldn’t believe us. Sadly, things were about to get a lot worse for Ruby and Sabine.
Ruby was diagnosed with breast cancer. It was nasty. Surgery, chemo and radiation took there toll. Surgery left Ruby, with only partical movement in one arm and chronic oedema where her lymph-nodes were extracted. The constant pain, to this day, leaves Ruby exhausted. Not to mention the added weight of having a child with special needs (even if they were unrecognised by professionals) only added to Ruby’s dispair.
When we went to have Ruby fitted for her wig, Sabine lost it. Now this is understandable, watching your mother have her head shaved is confronting for anyone (this wasn’t our first choice by the way, but there was no one to babysit Sabine at the time), but a child with undiagnosed and unsupported Aspberger’s cannot process these emotions. On reflection her behaviour is not uncommon with Aspberger’s. If only we had known, we could have managed and supported her in a constructive way. I could see the anger in her eyes. I didn’t know that “look” was a sign of Sabine struggling to understand what the is going on.
Flash-forward to 2011.
Ruby and Sabine have moved to the country and Ruby is no longer in active treatment for cancer. Sabine’s behaviours have escalated to the point where Ruby is afraid of her own child. Sabine starts stealing and taking buses all over the place. The emotional and physical bullying by Sabine is out of control. Gone are the days where I can talk her down. I could only stand on the side lines and offer support and encouragement to Ruby.
I receive a phone call from Ruby saying that Sabine has an appointment with a child psychiatrist. I didn’t have the strength to believe that this time it would be different. How happy I was to be wrong. The doctor ordered a slew of psychiatric tests, put her on medications, to manage her behaviour. The doctor took everything Ruby had to say seriously and when the tests confirmed what Ruby had said, without needing me to back her up, Ruby finally felt a small hope.
The medication’s have been a success so far in combination with other therapies. Sabine is no longer irrationally angry but for the first time in her short life, a typical cheeky kid. There is still ups and downs. I am by no way advocating medication has a cure all. It’s taken 10 years of trying everything else to get to this point. Anyone who knows me, knows that I am an advocate of holistic person-centred treatment plans, engaging in both medical and psychological models of care, but that is another post.
Ruby is now dealing with the anger of knowing that early intervention door has been slammed shut and now she must look at management. From where I am sitting, a mere observer, I can’t say that I blame Ruby. As a child on-set OCD (late intervention) case myself, I have travelled the road Sabine is about to. Being a teenager sucks enough, being a teen with a mental illness can be deadly. I only just survived myself. When Ruby called me to tell me the good news about the diagnosis, I wanted to sue the psychologist for something. Anything. Grievous Mental Harm?? If they had just listened in the first place. If they had accepted Ruby as their key insight into Sabine, maybe things wouldn’t be as severe now. If they had taken away their judgement and stigma, Sabine may not have been emotionally traumatised by her mother’s illness.
The good news is, that it is being managed relatively early and with medical advancement in both therapies and medication there may come a time where Sabine will be asymptomatic and live a content and fulfilling life. I try to remind myself that Ruby and Sabine’s struggle doesn’t have to be in vein, in that other’s wont have to suffer the same lot. It helps push my anger at the mental health systems failure towards something positive.
I haven’t really talked about the personal toll this experience has had on Ruby as it is outside the scope of the point I am trying to make. I don’t even think I have the words to describe what she has been through. She is an amazing woman and one I am so proud to call my friend. I love her beyond words.
What I hope you take from this, is that we need to change the way we think about mental illness. We need start looking passed our ego’s and knowledge (as professionals), suspend our judgement & stereotypes and start listening. If you are working in mental health (or any health domain for that matter) and you aren’t doing it to help others, you need to get out. Empathy, tolerance and acceptance without judgement are the core requirements for working with vulnerable people. I shouldn’t have to say it. It should be a derr moment.
*Names have been changed to protect the identity of the real people. This article was written with the permission of Ruby and is dedicated to her and Sabine.
IF YOU NEED TO TALK TO SOMEONE PLEASE CALL LIFELINE: 13 11 14 OR VISIT THERE ONLINE COUNSELLING SERVICE AT http://www.lifeline.org.au/Find-Help/Online-Services/Online-Services