YESTERDAY I HAD THE KEY . . .

One day I was working as a social worker in a psychiatric hospital. The next day I was signing myself into a locked unit at another area psychiatric hospital.

The one thing I had never realized while working in the hospital (including doing admissions work) was the sheer terror and sense of loss of control that a psychiatric hospital admission causes. What an identity shift is required. A letting-go of identity and taking on an unfamiliar one.

I was at work when my doctor and I decided I should admit myself. I went home to pull some things together, but I didn’t change out of my work clothes. I think I wanted to hold on to some shred of my identity as a functioning person (even though I wasn’t really functioning very well at that point). I must have looked so odd to my soon-to-be fellow patients as I toured the unit in my dress and pumps. And it was a locked unit!

At the hospital where I worked, adult patients were in an open unit and I breezily asked (masking my fear) the admissions person as we went to the unit if it was a locked or open unit – my heart sank when she told me it was the former.

So, there I was at the hospital. Alone. It was a long and lonely first night. But I didn’t know then that in addition to working on my own problems with depression and anxiety I would be learning some valuable life lessons as well.

Lesson 1: The first morning I was at the hospital I joined the other patients for a unit meeting. Who should I see but two former clients from my first social work field placement in a day program for people with serious and persistent mental illness. They didn’t recognize me at first, but there was an immediate “a ha!” moment as I felt the great equalizer of psychiatric illness. Eventually they both recognized me, each asking me “Wait, aren’t you a social worker? What are you doing here?” And I could only reply “Yes I
am, but I am having problems too.” We were all thrown off-kilter by the role-shift.

Lesson 2: While being herded to the dining room one day, I saw across the room a woman I had gone to social work school with. She was obviously working at the hospital. I saw her a few times and we never spoke. Finally I went up to her and said hello, asking how  she was doing and suggesting that she was probably doing a little better than I was, given our current roles. I was determined to speak to her and not give in to the stigma of being ill. It felt good to take the first step by approaching her.

While that first inpatient stay was valuable in many ways, I came to feel safe in the patient role – passive and protected from myself – and it was difficult to regain the lost time. But that’s another whole topic. This stay did bring into sharp focus the fact that there are no major walls between the well and the ill. Defensive barriers notwithstanding, we are all on a great continuum in our level of functioning, our level of pain, our ability to deal with the challenges of life, with or without a mental illness.

My lessons continued after I was discharged and finally ready (I thought!) to go back to work. At one interview, touring the inpatient psychiatric unit of a local hospital, I ran into my room-mate from my hospitalization, disheveled, being led out of a “quiet room”. She said hello and I felt that I should respond – to do otherwise would be belittling to her and not honest. At virtually the same time I saw another former classmate of mine, who wondered how I knew the woman. I fumbled a bit and then said that I knew her from another program. Not graceful, but it was the best I could do in the midst of a job interview!

So, it’s illusory, any division we place between ourselves and our patients or clients. In any group of social work, psychology, or psychiatry professionals (or students), one need only look around the room to see the walking wounded. Chances are that one or more of your colleagues at any given time is feeling as desperate as I was that day that I went into the hospital. We must not prevent people (ourselves) from getting help because of some defensive construct that divides “us” professionals from “them” patients/clients.

Yesterday I had the key. Today I neither need the key nor to be within the confines of a psychiatric unit. I am working at NAMI, the National Alliance on Mental Illness. I work on a toll-free helpline, talking to family members of people with mental illness and to those with mental illness as well. I was 10 years away from clinical social work. Now I provide direct service of another kind. And I’m happy.

Tomorrow is an open book – and I hold the pen.