invisionary: "When I give food to the poor, they call me a saint.  When I ask why the poor have no food they call me a communist." (Communist _support)
[personal profile] invisionary
Are you safe?

These words have a very specific meaning in our household. If I ask this question to someone I am looking for a clear answer without any evasiveness. I am evaluating someone’s psychiatric health and whether or not they are in crisis.

It doesn’t matter who they are and my response is the same regardless. It could be a random stranger, an acquaintance, a recent friend, a dear friend, a family member, one of my kids, or even my spouse. Once this question is on the table the protocol is the same. It has to be. Everyone who knows me knows they can count on me to handle a potential crisis the same way every time.

Ideally the response I will get to the “Are you safe?” question is Yes, I am. In order to affirm that I need to know that the person is not in imminent danger of harming themselves or anyone else. If they think they are in danger of that I will work with them to a very limited degree, recognizing that I am an aspiring clinician, but without formal training, and that there are many situations where this is actually a strength and not a weakness. Yet I am no replacement for trained and licensed professionals. If someone is in genuine crisis I will act. I will get mobile crisis on the scene or I will call 911. If those aren’t necessary or appropriate I will drive someone to a local psych hospital. I’ve done this before.

This routine is for my own protection as well as for others. I’ve had to tell people who have presented with gestures that I will take their gestures seriously. I will arrange for help if necessary, making it clear to them that I don’t have the mental energy to spend on people crying wolf. If it’s bad and you need help I will answer – I will drop what I’m doing for anyone that needs it because it’s a moral obligation I feel everyone should do. A mental health crisis is a life-threatening emergency and should be treated with the same respect as any other. For that reason it’s about as rude to demand that kind of attention from someone for something that can wait to see a doctor during regular office hours, or even for urgent care.

Consistency is a key element of this protocol. There are many professions in which the protocols are the same because you need to be able to count on the person next to you acting the same way every time, despite not knowing anything about them, because time is of the essence and a life is at stake. I am only operating at a triage level. Either someone is safe or they are not. If they are safe, good – stop here but keep an eye on things in case that changes (and give them some love – obviously they’re hurting if it got bad enough that I felt the need to ask in the first place!).

If they are not, I determine what the best way to get them to safety is. If they are not local to me, I find someone who is local to them to intervene – if I know someone local to them personally who can help, I consult them. If not, I get their local authorities involved. If I am local, and it is safe for me to do so and I am able, I personally escort them to a local psychiatric facility and advocate for them (I know my local psych hospitals fairly well, some through personal experience). If it’s not safe, I stay the hell away and get someone more properly trained involved. There’s some judgment involved here and I can be wrong. I also have to bear in mind factors like whether a person has access to health insurance – if it’s a matter of life and death I will of course intervene, but I won’t be escorting them to the private hospital that only accepts people with good insurance.

Where friends are concerned I would rather find myself losing friendships and sleeping better at night knowing they are alive and well and hating my guts, as opposed to a less alive alternative. I have lost friendships over calling people out on suicidal talk that wasn’t actually serious. I am fully prepared to lose more in the event that I have to call mobile crisis to arrange an escort to a psychiatric ER for someone in genuine crisis. I wouldn’t like it if it were done to me, but I hope that when I come down from whatever brain misbehavior I’m going through that I will recognize that whoever made the decision was acting in my best interests, and doing exactly what I would have done.

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invisionary: "When I give food to the poor, they call me a saint.  When I ask why the poor have no food they call me a communist." (Default)
Invisible Revolutionary

December 2011

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