I just learned that the daughter of a very good friend of mine had to be forcibly hospitalized after experiencing some form of psychosis. At this point, I don’t know too many of the details, but from what I understand she had to call the police to have her taken away. Certainly not the way that you want to get help for a friend or family member. Sometimes, however, symptoms can become serious enough and can crop up without warning and you have little choice but to seek whatever immediate help is available to you. This is an extremely difficult choice for anyone but you have to know that, in wellness, the person who you are forced to commit are usually able to see the reasons why you have taken the steps that you did.
My own father once called the police on me and I was taken, voluntarily at first, to the hospital where I was to stay for a few hours. When the hospital didn’t allow me to leave, I was eventually forced into 4-point restraints and held there like that for the next 12 hours. The following morning they refused to give me the cab voucher that the police had assured me that I would receive, so I was on the other side of the city in winter, without proper winter wear, left to figure out my situation on my own. I can’t even remember if I had a coat with me. I had been drinking at home alone when they found me and I don’t think I had thought to bring a jacket.
Based on my personal experiences with my family and the struggles that we experienced together with getting me to see a psychiatrist I wrote this post that contains a set of numbered steps that you can take with your doctor and loved one to get them into the office. Things are usually a lot easier once you can just get passed the step of getting to that first visit.
I know that my friend has spent some time reading my blog and so I dedicate this post to her and her daughter. I want to start by saying that she didn’t do anything wrong by calling the police. It is very important that you call for aid when your family or loved one is in crisis.
In the future, however, I would probably recommend to my friend that she reach out to a mobile crisis unit in Toronto that specializes in mental health care vs the police. I say this for a number of reasons. First and foremost, the mobile crisis units are specially trained to deal with people in active mental health emergencies. The police receive training in this area as well, but are much less equipped when mental illness is a factor, which is why the city of Toronto is actually working to implement psychiatric nurses into the police service, by making them available to attend certain calls. Regardless, if you live in a metropolitan area, I would Google available mobile crisis units and have that number by the phone should the need arise.
To my friend, I would tell her to call the Gerstein Centre the next time she is facing an emergency.
This is their emergency crisis line:
If you have a friend or loved one who struggles with mental health issues, and especially if you affected by mental illness, I would also familiarize yourself with the mental health emergency care in your immediate area. This is important because, should you ever be taken to a care centre by police car or ambulance, you want to know what hospital offers what services, what kind of staff they have on hand, what are their facilities like, etc.
To my friend, I would tell her that she should avoid going to St. Joseph’s, if at all possible, even though it is the closest in proximity. They recently lost their last remaining on staff psychiatrist and so the care that anyone dealing with a mental health crisis would be more general.
This brings me back to my experience of being put into restraints. Had I been speaking with a mental health professional, they probably could’ve rationalized with my rather manic brain that I should calm down and that eventually I would be allowed to go home, where the other nurses just some me as a problem and dealt with me as such.
Regular nurses have a very difficult job and I am not at all trying to downplay how important they are and how well equipped they are at dealing with patients in a regular state of mind. Very specialized care is absolutely required when someone is profoundly depressed, manic, or in psychosis and you want to be certain that you are receiving it from someone with a good deal of relevant experience and training.
To my friend, I would suggest either CAMH or St. Michael’s. CAMH is an obvious choice because they specialize in mental health and addiction exclusively, and I would say the same thing to anyone who has a friend or loved one experiencing a mental health crisis. I say St. Michael’s because they were recommended to me by my social worker as a viable option with psychiatrists on staff, however, I was just on their website and didn’t see a “psychiatry department”.. so I really don’t know. My social worker is in a position where she is taking people in and out of hospital all the time, and so if she says that she recommends St. Michael’s, then I take her word on it.
After emergency care has ended and you are faced with trying to get things back to normal, I would work very quickly to get supports in place that will be there the next time that crisis may arise. To my friend, I would suggest that she take her daughter to P.A.R.C. at 1499 Queen Street. It is where I was set up with my social worker, who I now see for one hour every week. We were matched through their case management program.
I often feel that I am “not ill enough” to require a social worker to come to my house every week, but without those visits, there is really very little that would break up the monotony of my life. Together, we are working on new ways that I can add variety to my existence, reasons to get outside, and etc. She asks about the important things that are signals to my mental health, like self-care and social interaction. She has become invaluable to me. Even on the days when I don’t feel ill enough to deserve her.
They say you are a member as soon as you walk through the doors at P.A.R.C. There is no cost associated with any of their services and lots of opportunities to volunteer, if you ever want to give back.
While at P.A.R.C., I was introduced to another program called W.R.A.P., which stands for Wellness, Recovery, Action, Plan. I would recommend that my friend create a W.R.A.P. with her daughter, as soon as she is able. I would also highly recommended that you create a W.R.A.P. if you are the one who is dealing with mental illness.
W.R.A.P. was created in 1997 by a group of individuals who were looking for ways to overcome their own mental health issues. The point is that you create the plan in times of wellness so that it is available for you in times of crisis.
You have to identify the markers of when you are well, outline the things that are helpful to you for recovery, mark red flags that make illustrate you are entering crisis, and list what you need from your friends and family who have access to your plan for when you are existing in phases of when you are both well and in illness.
In my plan, I am mostly focused on what should occur in an instance of emergency, like in the scenario when my dad called the police to check on my wellbeing.
I discuss who would be my power of attorney, who should be privy to what information, who is the medical liaison between the doctors and my parents, what medical facilities I would like to be taken to in an emergency, who I would want to see and who I want to stay away, etc, etc.
You can create a W.R.A.P. for anything. The women who taught the program to me uses the W.R.A.P. system for everything. Her family lives overseas and so, for example, if she is having to take a plane to go for a visit, she will create a plan for herself to manage herself and symptoms during the course of her trip.
I personalized W.R.A.P.’s for everyone on my list who was to receive a copy, which included my boyfriend, my social worker, my doctor’s, my psychiatrist, my lawyer, and my dad.
You have to be prepared for people to not necessarily be happy with all of the plans that you have made for yourself, as was the case with my dad. He was unhappy that I wanted to have my medical information to go through a medical liaison and that I would not allow him to receive updates directly from my doctor.
My reasoning for this was personal and ultimately unimportant. The point is that it was the way I wanted it to be and my dad was unimpressed. You have to be a little bit selfish when you are looking out for yourself in times when you are not well. You have to put yourself in that mindset. You have to imagine yourself at your absolute worst and try to foresee how you want the people around you to manage your care. I love my dad very much, but after incidents like the one where the one where he nearly had me needlessly committed, I feel he is a much better support vs a decision maker.
I have one final recommendation to my friend and her daughter, as well as anyone else who lives in Toronto who may experience auditory hallucinations, and that is the Toronto Hearing Voices Cafe, which is a group of people who meet at the All that Jazz Cafe at 72 Howard Park, once monthly, to discuss hearing voices.
The Toronto Star did a story about the group that is available here, their facebook group is here, and their website is available here. I have personally not attended a group meeting at All That Jazz, but my social worker has and said that the group was very inviting and that she gained a great deal of insight into experience of having hallucinations.
That’s all for today. I hope that you will take advantage of some of the links that I have included in this post, whether you or a family member is in crisis now or if you in fear that you may be entering into crisis at some point in the future. There is a lot of good information here that I am sure you can make good use of.