The Lack of Social Capital: (Chapter. 2)

Written by Andi Bazaar, Co-wrote by Timothée-freimann Schofield | Sept 24, 2022

"We can stop shaming people who deal with or speak up about their mental issues, no person in a suicidal state or struggling with any mental health issue should have to feel silenced or shamed."

I want to be very clear, this is not a resource problem but this is a system problem.

It is hurtful, frustrating and itself triggering to have organizations and leaders address this issue by pointing those who are struggling to resources or worse, having us take a survey making it clear how hurt and burnt out we are — only to point us to self-help resources.

I have been to therapy, I have spent years developing skills, expertise and insight. I have been evaluated by professionals and found that medications aren’t the solution for me. I don’t have anxiety or depression, I have simply endured years of trauma and abuse.

There is no quick and easy fix to that, I don't need to be more “resilient.” — I don't need to just reframe my thinking.

I have spent my entire life finding ways to stay to true to myself and thrive despite all that I have been through, I know how to take care of myself. What I need is the time and space to take care of myself.

• I need to be able to sleep 7-8 hours a night.
• I need to be able to workout for at least 15 minutes 6 days a week.
• I need to have at least 1 day off a week to grocery shop, meal prep, process my emotions, spend time with my wife and kids also surround myself with the love plus energy of my relatives in nature.
• I need to be in a system and organization that is not actively hurting me.
• I need to be treated like I am more than just a warm body with medical knowledge.

Nothing about burnout surveys, resource lists, awareness campaigns or the behind the scenes “check-ins,” that I am sure will happen after talking about this is going to give me that.

• I am still going to be expected to work 12-14 hours a day 6-12 days in a row most months this year, do service work for my program and speak-up also give away my insight to try to make the environment I am in more bearable for people like me.
• I am still going to be told I lack professionalism for talking about these issues honestly and publicly.
• I am still going to have leaders spend more energy threatening me and my future than they are going to to spend really listening to me and trying to make things better.
• I am still going to be forced to generate revenue for, and execute the wishes of, systems and organizations that are failing to meet the needs of the people in my communities of the people like me.
• I am still going to be forced to listen to empty land acknowledgments highlighting the profits and power being generated from the lands taken out from under the feet of my cousins.
• I am going to continue to struggle with suicidal thoughts because I refuse to submit, I refuse to accept this as how things have to be. I refuse to have my spirt broken. As a result at times, I will feel hopeless and frustrated as I keep fighting, resisting also reliving my trauma.
• I am fortunate in that I have the love, support, skills and resources I need to survive this. I have a robust safety plan, I have the ability and willingness to walk away if things get too dire. I have the experience I need to know my limits.

But again let me be clear — what I am struggling with, what several of my colleagues are struggling with has nothing to do with resources. It has nothing to do with our capacity to be great physicians.

We certainly do not have enough mental health resources in our health care system, it takes months for me to get my patients the support they need and there are limited outlets that feel safe to physicians plus work with our work schedules.

However the underlying issue is that we have created, perpetuated and inflicted upon one another a toxic, health-degrading system that fails to protect and support our mental health. That keeps us from being able to take care of ourselves.

"We can stop shaming people who deal with or speak up about their mental issues, no person in a suicidal state or struggling with any mental health issue should have to feel silenced or shamed."

• Suicide is a leading cause of death in the United States with 45,979 deaths in 2020, this is about one death every 11 minutes.
• In 2020 an estimated 12.2 million American adults seriously thought about suicide, 3.2 million planned a suicide attempt and 1.2 million attempted suicide.
• In 2020, suicide was among the top 9 leading causes of death for people ages 10-64. Suicide was the second leading cause of death for people ages 10-14 and 25-34.

As a someone who has experienced chronic suicidality since age 10, I want to offer some insights that mainstream prevention orgs don't often share.

Suicidal ideation does not mean a person needs to be immediately hospitalized against their will, a significant portion of the population experiences suicidal ideation and never acts on it. I'd argue that it's a "normal" response to many difficult life situations.

Suicidality isn't always episodic, that means that for some people the desire to die never goes away. We wake up, think about it and carry on with our day. I've seen this called "grey suicidality" online and it's fairly common. Again, not an emergency!

Reporting someone for being suicidal can get them kicked out of college and fired from jobs, it can even cause them to lose custody of their kids. Mandatory reporting policies are dangerous and are aimed at protecting businesses and organizations from liability "not helping people."

There are many ways to handle mental health crises that don't involve cops or involuntary psychiatric care, access to childcare, meals, emergency funds and affordable medical care can go a long way. Being in a community where people can talk openly about suicidality is huge.

The United Nations has called involuntary psychiatric care a form of torture but it's still regularly practiced on suicidal patients in the US, involuntary 72-hour ("5150") holds are the norm for people deemed a threat to themselves. During this time, consent goes out the window.

5150 holds are one of the only legal circumstances in the USA where people can be forced to undergo medical treatments and ingest food or liquids against their will. (The other circumstances include treatment of minors, intellectually disabled adults and incarcerated people.)

Suicide risk following involuntary psychiatric hospitalization skyrockets, while 5150 holds may prevent a person from dying in one moment of crisis they don't protect people long term.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710249/

#988Lifeline openly engages in nonconsensual active rescue despite its harms and lack of effectiveness, callers seeking phone support can end up being escorted by police to a psychiatric hospital against their will sometimes at gunpoint if the officers deem the person dangerous.

It is possible for us to develop our skills as physicians, take care of our patients and keep the health care system running 24/7 without these systems harming us and keeping us from being healthy. We can do better and we must do better.

A SPECIAL THANKS TO:

• Dr Oliver Schofield, MD (Consulting)
• Dr Seth Gryffen, MD (Consulting)
• Timothée Freimann schofield (Co-wrote/Photographed)
• Henrie Louis Friedrich (Analyst)
• Shot at GQ’s Studios by José Schenkkan and Benjamin Schenkkan Joseph
• In collaboration with “Clayton-euridicé Schofield” / Clayton Euridicé Schofield