Degrees of Urgency

It’s Fall 2021. As I type this, I’m walking up the hill, headed to my dorm. I need to pick up some stuff to bring back to the studio for tomorrow’s class. The fear that I won’t be able to carry it all to class tomorrow morning makes me feel like I’m suffocating. When I’m busy it’s easy to forget that I’m always anxious. I want more free time, but as soon as I have it I realize I’m incredibly high strung. Once I’m done with my current anxiety-fueled task, I’ll sit back and think of ways to distract myself. If I’m not careful, there’s always a chance the night will end in tears.

On another night like this, I had RISD’s mental health crisis line open on my laptop and my phone in my hand. Fed up with feeling a familiar mental poison chug through my veins and finding it hard to breathe under the weight of being alive, I called them. I didn’t know what to expect. I waited for a while, gave someone my information, and waited again until I was transferred to a very nice sounding woman. I talked for a while, probably too long. Over the course of the call, though, I began to realize that she was primarily asking whether I might cause myself any physical harm.

She sounded concerned, so I assured her with my heavy, tired voice that I’d already decided not to do anything serious, and that my mind wasn’t going to change anytime soon. I tried to slowly back out of the conversation, not wanting to seem rude or ungrateful as I realized that she wasn’t going to be of much help in the way I needed. Then she stepped in, asking if I’d be ok if she hung up. I hesitated. After having spilled my guts, I’d feel a lot different, but I wouldn’t be dead. That seemed to be her main concern—her job too, I guess. I eventually managed to hang up of my own accord, feeling stupid and alone.

Once my embarrassment had faded, I started thinking about the big picture, asking myself, why was this phone call all I was given? Or, more specifically, where’s the middle ground between routine mental health appointments and the emergency room? This isn’t so much a RISD issue, it’s a problem with how we conceptualize mental health in general. For non-lethal physical pain you can go to urgent care, but there isn’t really an equivalent for mental health. Imagine describing to your doctor an unbearable stomach pain and hearing in response: Well, we don’t know if you’re dying for sure, so come back when you’re at death’s door!

But even those at “death’s door”—experiencing urgent mental health emergencies—aren’t treated too kindly. The stories of abuse I’ve heard from patients give me goosebumps. People in their weakest and most vulnerable states—delusions, psychosis, suicidal ideation—begging for help. At best being turned away, or else having everything taken from them through legal policies that strip them of their rights. The mentally ill have been continuously denied autonomy over their bodies and property, supposedly because they’re a danger to themselves and those around them. In reality, you’re far more likely to be harmed for being mentally ill than to hurt someone else in a fit of illness.

In many ways, being mentally ill is prohibited by society. It’s expensive; it can be dangerous to disclose; it’s stigmatized. Yet so is reaching out for help. You’re not allowed to be sick, but you’ll be disparaged for trying to fix it. It’s not uncommon to hear people talk about entering therapy as something shameful or weak, but the symptoms people show without that support are similarly unacceptable. The most socially accepted solution for many people is either to simply do nothing or self-medicate.

I’d be lying if I said that I don’t contribute to this stigma. I’ve often felt like I couldn’t or shouldn’t reach out for mental health unless absolutely necessary. To me, necessary means once the mental strain starts expressing itself physically as pain. I also get extremely anxious about the possibility of inconveniencing anyone, whether it be a mental health professional or a sympathetic teacher or friend. Partly out of the awkwardness of being vulnerable and miserable, partly because I don’t want to put that kind of pressure on people who aren’t trained to deal with it. Even though I would advise others to always ask for help, I’d rather suffer than reach out for help I feel like I could get by without.

All this said, RISD Counseling and Psychological Services hasn’t been an overall disappointment. My experience with the crisis line was underwhelming, but my first meeting with a counselor was delightful. She handled my case with care and set up a medication evaluation. The doctor I met with made me feel more comfortable than any other I’ve ever been to. Though things soon became tricky again. I was given a list of potential therapists RISD would cover, all of whom had waiting lists. Reaching out seemed so difficult, and I was too busy to start such a daunting process—I just can’t go to college and find a therapist at the same time.

This is a depressing reality that I and many others live with. But it’s nowhere near as depressing as the conditions that people with less luck face in similar situations. I’m lucky that medication works for me—for many it doesn’t; I’m lucky that I didn’t bounce from prescription to prescription, trying to find something that works; I’m lucky to have doctors who listen to me and don’t think I’m making up my symptoms; I’m lucky that college has given me a level of personal freedom that’s made it easier for me to work on my mental health uninterrupted; I’m lucky I have the money to pay for my prescription. It’s terrifying to realize how much your access to proper help relies on how well things beyond your control end up. And even with all my luck, if I were still living with my family, no amount of therapy and medication could ease the chokehold of a toxic homelife. Many people’s mental health issues can’t be properly treated without first removing or improving the conditions that caused or exacerbated the problem in the first place. At that point, medication is like slapping a band-aid on an open wound.

For now, however, medication is helping. My anxiety is more manageable. Still, I don’t want to trick myself into thinking this will solve everything. The severe declines—the way my body freezes up, the months-long roller coasters of feeling like I got better, only to plummet back down again—it all feels so routine and inevitable. I can’t imagine life without these symptoms. I don’t know what that would be like.

So back to the big picture. I’m no therapist. I don’t know what changes need to be made exactly, all I know is needs are not being met. I wish I could curl into a ball, hyperventilate, call a number and feel like I’m talking to a person who’s concerned about my quality of life, not just the fact that I have one. I want to feel human, I want to feel like someone has time for me, I want to feel like we’re both being real. Maybe what I’m looking for exists, but I haven’t found it yet. Maybe I’m not trying hard enough. In all honesty I try to leave my room only when necessary for the most part. I’m often too tired to do anything other than homework outside of classes.

I’m sorry I don’t have something more definite or conclusive to offer, like a thorough mental health advocacy plan. Even now I feel the need to be apologetic! What I know I want to say is this: I don’t think people realize that a huge step in suicide prevention is not just listening, it’s being there, connecting, actually helping. And no one should be “not suicidal enough” to qualify for help.