Thursday, May 10, 2018

"How were you able to ask for help?"

Last week, I hit the road with a box full of copies of Christ on the Psych Ward to kick off a summer of talking with people of faith about mental health, mental illness, and spirituality. I did four speaking events in a week, with a total of about 100 people in attendance. I'm feeling immensely grateful for the ability to do this and for the wonderful conversations I had with folks in D.C., Rochester NY, and Scranton PA.

I should probably get the car washed. 

One question I was asked several times by several different people has stuck with me, and I wanted to put down a few quick thoughts about it. After sharing some of my story about finally seeing help for my mental health struggles in 2011, a number of people asked me how I was able to reach out and ask for help when so many people can't bring themselves to do so.

First of all, let me say this: if you have lost someone in your life due to mental illness, as I have, you know that it's an awful, awful thing. And no answer or explanation can make it less awful. So please, know that none of what I will write about here is meant to create shame or guilt around this topic. There's so much we don't know, don't understand, and don't control about suicidal behavior. In writing and talking about it, I hope to push back against shame, stigma, and silence, and help more people get help. But when someone is hurting so badly, it just hurts. And the words I have to offer are limited.

Second, and related, I want to write about this question -- "How were you able to ask for help?" -- in a way that avoids making me into the hero of this story. I wasn't able to ask for help because of some strength or moral superiority that others don't have. I'm a better person than I once was for having asked for help, but it wasn't because I'm a better person that I could ask for help. So please know that.

With that said, there are three things that helped me ask for help, and one thing that made it harder for me to ask for help.

The three things that helped were: people in my life who talked about their mental health struggles with me; people who checked in on me when I was having a difficult time; and access to care.

The thing that made it harder was: toxic constructions of masculinity.

So, let me share just a little bit about each of these.

First, people in my life talked about their mental health struggles with me. This started with my family. My father and mother both put work in to break through the generational pressure of family secrets and to talk to me about the histories of mental illness, addiction, and compulsion in their families. At the time they decided to do this, it probably made me uncomfortable, and I probably didn't know what to do with it. But when I hit a real crisis point in 2011, I had some groundwork laid, some vocabulary, some dim understanding, that mental health struggles existed in my family and that the awful experience I was having might be, not an isolated incident, but a part of a larger whole. That helped me reach out for help.

Second, people checked in on me when I was having a difficult time. Friends noticed that something was up, and they asked about it. I didn't always know what to say to them. Sometimes, I flat out denied anything was going on. But the cumulative impact of people asking if I was OK did make an impact, and it did help me ask for help. That's really important for people to know: even if it seems like you're not getting anywhere by checking in on someone, it helps. I wasn't always ready to respond, but when I eventually did reach out, I was enabled to do so by the support that had already been shown to me.

Third, I had access to care. I wasn't as aware of this at the time as I am now, but I had a level of access to mental health care that is often denied to people in this country. I had a ride to a hospital. I had people around me who not only knew how to get me to the hospital but knew what I needed to tell the ER staff so that I could get the help I needed. I had economic resources and buffers (though even with them, I ended up in massive debt). I had a generally positive view of health care, that hospitals were a thing that were there for me and there to help me. For many people in this country, barriers to care mean barriers to asking for help. If I'm going to encourage people to share their stories, push back against stigma, and ask for help, I also need to be working to change unjust structures and assure that when people do ask for help, they can get it. Otherwise, encouraging people to ask for help isn't helpful; it's even a little bit cruel.

And one of the structures that needs to change in order to ensure better access to care is the toxic way we construct masculinity. I write in my book about seeing my father cry when he came to visit me in the hospital, and how difficult that was for me to witness. Even in a family that had worked hard to talk about mental health and mental illness, I still picked up on the subconscious message that men shouldn't cry. And that we should be careful about how long we hug other men. As I say in the book, it was easier for me to think of God in feminine images than it was for me to see a subversion of traditional masculinity. If we continue to teach boys and young men that crying is bad, that talking about feelings is bad, that violence is the only acceptable way for men to express emotion -- then how are boys and men going to reach out for help?

After I got out of the hospital, I joined a Dialectical Behavior Therapy group. The psychologist who ran the group interviewed me at the beginning of the process, and expressed surprise that I was there:

"I don't usually have men in my groups," she said.

"Oh, that's interesting," I said. "Why is that, do you think?"

"I know why it is," she said. "The men who need these groups usually end up in jail."

I didn't end up in jail. Many people who need help do. But since going into the hospital, I have learned a lot about the way that my gender, and my understanding of my gender, impacts my mental health, and creates barriers for talking about emotions and struggles in an honest way that leads to more health and more wholeness.

Why was I able to ask for help? Ultimately, I don't know. It was an experience of grace; and yet, again, I don't think the difference between me and those who can't or won't or don't ask for help is that I have grace and they don't. There is always a grace, however hidden, available to those who are hurting so badly. I believe that very deeply. But I also believe there are ways for us to be means of grace for each other in a way that leads to more health and wholeness.

So, if we want to be means of grace for each other, if we want to help more people get more help, here's four things to do:

1) Talk honestly about our mental health struggles

2) Check in on the people we are connected with when they seem to be struggling
3) Advocate for just and equitable access to mental health care
4) Teach and model healthier understandings of gender/masculinity 

AND. Our faith communities can be places where we do all four of these things.

I hope that helps.

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If you or someone you know is in a crisis, you can call the National Suicide Prevention Lifeline: 1-800-273-8255. You can find out more about the Lifeline at their website and on the website of the American Foundation for Suicide Prevention. The Lifeline now also has an online chat option. I keep an updated list of mental health resources, particularly for people of faith, on the Christ on the Psych Ward website.