Mental Health Stigma Suicide

(Non-Pandemic Post) Racism in Mental HealthCare.

This has been digging at me for awhile. I collaborate with several therapists and prescribers of African American (also Jamaican and Haitian) descent.

There is one in particular who practices close to where I am located, and who is simply phenomenal. I refer practically everyone to her. She’s seasoned, she doesn’t get phased by high acuity, and she can take on complex families and cases, and she is always open to collaborate.

I’ve had more than one client come back to me after a couple sessions with her (often white parents of a white kid) who ask for another referral as they “don’t feel it’s the right fit.”

You can imagine my facial expression right now. It’s the one that smells and calls out bullshit.

I always pry to the Nth degree…exactly what is not the right fit? Yeah but exactly what didn’t go well for you/your child…I need to know precisely the issue because I don’t want the same issue to happen with the next person I refer you to. They usually smile because people tend to smile when they get uncomfortable. They squirm in their chairs, and make super vague statements about what went wrong.

I push until it is awkward to push any further.

I’ve then spoken to the therapist and we hash it out. We are comfortable enough with one another that she can say if she feels it is related to race or not and I agree or disagree. Most often I agree.

There was one case that the family just didn’t want to do therapy work. It was almost palpable relief to us both in that dialogue that there was one white family who wasn’t racist, just lazy. We laughed about it.

As I said, she is seasoned. I value her input and I value her clinical opinion. I don’t think I can put into words the enormous respect I have for her clinically. It’s hard to find good therapists. Especially forty years into a career when they can be burned out or a little crazy and not as invested in their clients. But she invests everything in her clients. I definitely have a top ten therapist list of who I would refer my own family members to. She’s on there. Probably at the very top.

To hear her question herself and her skills because of ignorant people who discontinue treatment abruptly because they are racist creates this anger and hurt that again is hard to put into words.

I’ve read “Me & White Supremacy” by Layla F Saad which helped me explore my own internalized racism and white privilege because I have Black clients who have made me do better and be better. Hearing experiences of African American women who have been abused and marginalized and ignored creates a space that cannot be ignored by any white person I would hope.

I’ve fired a client after they fired that therapist. One client admitted to me it was because of race. One client admitted to me it was because they didn’t feel they could benefit from treatment from a Black woman. I told them they likely then couldn’t benefit from treatment with a lesbian. So I’d provide them a referral and they could leave.

No one else has ever admitted to me that it was due to race. Though I have asked outright. I told her recently that I fired that person and she remembered them even though it was a few years ago. I didn’t tell her at the time. I didn’t know if it was right or wrong or what.

The older and more experience I gain the less tolerance I have for racism, hate, homophobia, bullshit.

It eats at me that a skilled clinician questions their skills because white people are ignorant.

I can’t apologize for other’s behaviors but I can ask white people to do better. Check your privilege at the door because there are plenty of brilliant Women of African American Descent who know so much more than you and who can support you and just do their jobs as clinicians. Skin color should not qualify a person to be or not be your therapist. That’s ridiculous.

I’ve lost clients because I’m out about being Queer. But I don’t wear it on my skin. I have it easier.

To all the clinicians of minority status whom I work with please know I’m challenging clients in my office. I’m not letting it go if they discontinue treatment abruptly and if they admit to discontinuing treatment due to the color of your skin I’m discharging them from care.

And Dear white people. Do Better.

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Why I’m Pro-Cop.

I didn’t realize until I reached adulthood that people could be anti-cop. I didn’t know about racial profiling, and I didn’t know about the murders of defenseless African American teenage boys. And yes. That is white privilege.

I didn’t know that there are police officers who treat psychiatric patients like criminals or worse like animals. And I didn’t know that there were police officers who questioned women’s rape stories as stories and not as fact.

I also didn’t know the large number of people who identify themselves as “anti-cop”. But I do now. I have a smidge of understanding now having witnessed horrific behavior by police officers in the emergency department and on an inpatient psychiatric unit. I know  a psychiatric patient who died because a police officer tased them to death, and I know that killed me inside a little.

I know countless stories from my clients of negative interactions with police officers in their professional and personal lives.

I know that I am not a Person of Color and will never know the fear that community has ingrained in them from a young age because of racial bias and racial murders and I also recognize that is privilege. I don’t have a solution for that in this moment. But I think it’s important I acknowledge it.

I know I was shocked the first few times I had clients make disparaging remarks against police officers in front of me, and it was work for me to keep my mouth shut and not challenge those beliefs because that’s not my job or role. Instead I try to understand their narratives and journeys and how they came to this space of distrust and fear.

But I also know that there are a lot of police officers. According to stats on a government website there are roughly 750,000 officers at any given time in our country. That’s a lot of individuals. Within any large number of people carrying guns there are going to be bad people. People who make bad decisions. And mistakes.

But I’m not trying to convince you to be pro-cop. I’m just going to explain why I am. Because it’s something I’ve struggled with; trying to reconcile my own experiences positive and negative, and the negative experiences- including murders and wrongful deaths- of others.

When I was eight a police officer lived on my street and played football every day with all the kids. His parents still live there and we have now known him and his family for over thirty years. When I was growing up a girl around my age had a father who was a police officer- he was at one point my basket-ball coach. When I was sixteen I got into a car accident (I was driving and going straight and a car turning left rammed in the drivers side of my car).

The responding officer was my DARE officer when I was in fifth grade. He saw the cut on my head, saw that I was terrified, in shock, and alone. I basically fell into his arms sobbing and looking back I can see that the other driver realized he was screwed.

I have seen detectives come in to detect shit (Shout out Bad Boys II;) while working in the ED and inpatient. I have been in the room with them when they see the body of an abused child for the first time and seen the horror and weight of it on them as they leave. I’ve worked with law enforcement around sexual assault and rape cases and seen them work their ass off to get enough evidence to prosecute the perpetrator and not rest until they know they’ve done everything they possibly could do for justice.

I’ve worked with officers who are just as infuriated and injured as I am when we don’t see justice done to perpetrators.

I’ve seen officers go above and beyond to protect and serve children and victims.

As I said, I’ve seen the bad side. I’ve experienced the bad individual police officers. But I’ve seen the good too. I’ve seen the fighters who fight for those who are weaker, for those who are considered “less than” in our society, and those are who I respect and those are who continue to solidify my outlook on police officers.

Law enforcement officers have, in my opinion, the hardest job available. They are underpaid, understaffed, hated in some cases, and yet they continue to press forward. There is corruption, there is greed, there are horrible outcomes including wrongful deaths that should not be excused or ignored.

But as a society we depend on law enforcement to serve and protect. And in my own personal experiences the serving and protecting I’ve witnessed gets me in the gut. Because it is authentic and honest and something I truly admire.

To reconcile the death of a psychiatric patient who was wrongfully targeted and tased with my experiences with other law enforcement has been the most difficult for me. Because that person did not deserve to die in that manner. But for me, hope springs eternal and I chose to incorporate a DBT skill to stop wracking my brain about it. It’s called radical acceptance.

I decided I am going to radically accept the world the way it is in this moment for me, and that means there is a grey area. There are good cops and bad cops quite literally. And I refuse to let the wrongful actions of some overshadow the brave and solid work of so many others.

Last thing. I know that every one has different personal narratives and you may strongly disagree with everything I’m saying and that is your right and privilege. Like I said, I’m not trying to change your mind, I’m just making peace with my own.

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Disney and Three Year Old Boys

We were watching Snow White with the boys. They insisted after seeing a Princess Book of mine and seeing a princess they hadn’t seen on the tv before. They wouldn’t leave me alone about it. I had a lot of feelings about Snow White.

She’s fourteen! That’s disturbing to me. I didn’t want my sons seeing a fourteen year old dealing with a Prince and marriage. Cue me shaking my head and massaging my temples. Fourteen! But they were insistent. They being Declan. He’s obsessed with the Princesses. We will come back to that later.

Here’s the thing. I treat a lot of fourteen year olds. They are just babies. And I know that when we only lived to age forty then fourteen was kind of old. But we live to one hundred now. So fourteen is wicked young. Also Snow White is white. Really white. I try and get them to watch Tiana and Mulan and Moana…which they do…because for God’s sake can we get some color in there?! Apparently only white women were pretty and marrying princes in the past.

Anyway, I let them watch it. The Queen is freaky. I forgot how freaky. And Snow White was young. Freakishly young to me. Twenty years younger than myself actually.

So I’m thinking we are ruining the boys and then at the end when they get married, Declan says, “I Sleeping Beauty. I marry a prince.” I said, “You’re the prince and you are going to marry Sleeping Beauty?” sorta puzzled. He adamantly shook his head, and laid back into the couch as he calmly said, “I Sleeping Beauty Mama. I marry the Prince.”

First off Dec, we were watching Snow White. He apparently thinks Sleeping Beauty is better. Second, I got bigger problems than an underage bride. My wife and I looked at each other, then I pounced on him and tickled his belly and he giggled and laughed, and I said, “Baby, whoever you are and whoever you marry, I love you. I love you no matter what.”

Then we laughed and played. What’s interesting is Jackson knew he was not Sleeping Beauty and in fact just watched the interaction with Declan and I. Which is uncharacteristically quiet of him.

Then I’m thinking, whatever and whoever they are I cannot imaging living without them. The number of Queer individuals I treat who are cut off from their parents because of their Queerness is heartbreaking and as a Mom I will never understand or condone it.

I thought I sorta rocked that moment as a Mom. Because seriously in twin Mama mode we are just trying to survive. Gay/straight/boy/girl/queer doesn’t matter. Let’s just make it to the other side of twin childhood in one piece.

But then I’m googling Disney Princess ages and Jasmine is 15?! WTF?! I thought they were at least eighteen. Wow. Disney epic fail!

What is my point? Love and accept your kids. No Matter What.

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How my twins and my whiteness got me out of two tickets.

I’m not saying this with pride. But on days like today, when they brought me to tears and I brought them to tears. Well I need to think about something other than them flooding my kitchen with the damn faucet when I was in the laundry room for maybe two minutes. And how Declan wrenched my freaking back because he didn’t listen to me, climbed too high at the playground, and then let go and fell and I caught him in one arm…all 37 lbs of him. Yeah that freaking hurt. It was a bad long day for all of us. So this blog post is not about that, it’s about something bigger and deeper.

The first ticket they got me out of…I was using my cell phone…on speaker phone about three or four years ago, when I was pregnant with them. Very pregnant. I had a big Jeep Grand Cherokee. The cop pulled me over literally as I was pulling out of the parking lot from work. I had some one on speaker and was switching it over to bluetooth and bam. Red lights.

I explained I was switching to bluetooth but I literally just got into the car. He asked for my registration. I looked at him and explained, “I have to get out of the car to get it. It’s too far, and I can’t reach the glove compartment because I’m pregnant.” This was not a lie. I actually couldn’t reach it over the belly. I leaned over to demonstrate.

The cop looked disgusted. Because who wants to make a pregnant lady get out of her car in the 90 degree heat, behind the psych hospital, and make me walk to the other side to find my registration. He knew it was going to be a shitshow. He asked me if I worked at the psych hospital, I said I do, I’m a nurse practitioner. He facepalmed. Because he knew that my co-workers would likely either be watching or coming outside and then berate him for making the pregnant lady waddle around extra in the heat. He likely brought patient’s to us. He knew my co-workers are mouthy.

He asked me to show him the bluetooth working, which I did. Then he said, “Just go.” but not a nice Just go. An I’m disgusted with this whole situation type of “just go”. I drove away.

Flashforward to Thursday. Yes the day after I wrote the horrible blog post about my horrible week leading up to Wednesday. Thursday morning I got pulled over for speeding. He said, “You were going 50.” I said, “Yes, I know I was, my bad, but I mean it’s a 40 zone…” meanwhile the boys are saying “Hi, Hi, Hi….” on and on until the officer says “Hi” back. He was youngish and smiling at me. It takes me awhile to register, but I think he was flirting which is weird because he clearly saw my twins in the backseat. I’m not used to being flirted with as a Mom.

He replied, “Actually it’s a 35 zone.” I said, “Well shit. My bad.” Because I did actually think it was a 40 zone. Then the boys get louder, and Declan says, “I scared Mama,” and I’m telling him it’s going to be okay, and then I look at the smiling police officer and do my best to look apologetic, and he asks me if I’ve gotten tickets before, and I say No. In my head I think ‘because I’m a nurse and I was pregnant’ but whatever. He lets me go, and tells me to have a “very nice day,” with a huge smile and a wave to my boys.

Now I’m thinking am I being punk’d? Because who gets out of a ticket with a smiling police officer? Then I think, well I’m a white woman with two toddlers in the backseat, in a nice car, wearing nice clothes, and then I’m like Fuck. White. Privilege.

I didn’t want a ticket. And is this only the second one I’ve gotten out of in my life? No. Unfortunately not. But the point is I’ve gotten out of them. And had I been Black or Hispanic or a man would I have gotten out of them? Hell no. I know I wouldn’t have. Had any of these officers known I am married to a woman…would I have gotten out of them? Who knows. I generally don’t wear my wedding ring to work so both times there was no obvious sign I was married.

I don’t know how to change this. Because, well for one thing I don’t want the damn ticket. But neither does any one else regardless of race or gender. It didn’t feel like a win as I drove away. It felt like a, shit, I suck so bad for using white privilege in this moment without even being aware I was using it. But that’s the point right? That’s why people who are not white get so pissed at white people for not even acknowledging that we have privilege and that we use it. It didn’t even hit me fully until I was pulling up to daycare. Where thankfully my two white boys are the minority.

I got out of the car the same time as a Black family, and that’s when it hit me. I thought what if it had been them who got pulled over? A Black Father and his daughter. Would he have gotten out of the ticket with a scared toddler making a scene in the backseat and a winning smile in the front? Probably not.

I’m not going to pretend I could possibly understand what it would feel like to a Black man to be pulled over by the police. Or a Black woman. I can’t. I can imagine it is fear and vulnerability though. The fear and vulnerability I’ve felt when I’ve been with my wife in conservative areas. The fear and vulnerability I’ve felt as a woman when I’ve suddenly realized I’m in an elevator full of men. I felt fear when I got pulled over. But not fear for my life. Fear of a ticket. A piece of paper, money, the hassle.

I can’t imagine being pulled over and fearing for my life. But I know that is the reality for many.

Like I said, I don’t have the answers, but I know this is a problem.

I always call out heterosexuals for not using their heterosexual privilege to advance LGBT rights. Well I’m not about to not call out myself when I’m using white privilege to my advantage without using it to advance the rights of all Persons of Color. This is a conversation that the hate in our country has sparked: finally. If there is anything good that comes out of the asshats in DC it’s the conversations around race, sexuality, gender identity, and that yes white privilege does exist.

As I said, I don’t have all the answers, but I will not remain silent or put my head in the sand and not acknowledge the problem. And that I too am a part of it. These are hard times and hard truths. But, perhaps Prince Edward says it best to Heath Ledger in A Knight’s Tale, “But you also tilt when you should withdraw…and that is knightly too.”

I know now is not the time to withdraw but tilting puts the knight at risk. It is a true fighter though, someone who weighs the options, knows they may fail, but tilts anyway. This piece was uncomfortable to write for me. Because it makes me examine my faults. No one likes to do that. But until we do nothing will change. So here I am, laid bare, tilting when perhaps I should withdraw.

I also know I need to switch to bluetooth before putting the car in motion and apparently I need to be more aware of speed limit changes on back roads. My bad.

p.s. the picture- of course they had to hold hands and walk down the brick path at the playground today after he wrenched my back, and look all cute and stuff. They know how to play me.