Over the last few months, for the first time in my life, I have been begging for help — not the help of a friend or family member to get me through a tough time, I mean real psychological help. As I’ve been shut out from meaningful care in every direction I’ve looked, I have been left to advocate for myself in fixing the serious, deep psychological issues I face. This has not only stalled my current healing process but woken me up to the broken nature of our county’s and country’s mental health care industry.
I was diagnosed with borderline personality disorder (BPD) as a teen, which some consider too young an age for such a diagnosis — something I plan to have re-diagnosed in the coming months. Living with BPD makes the stress of daily life more difficult due to distorted thinking that causes unstable emotions and relationships. When in the throes of overwhelming emotions, I am unable to think straight or react in a healthy way to triggers and other instances that cause me to act out or say things that are hurtful, filling me with shame and worthlessness in the end. I also struggle with recurring depression, anxiety and seasonal affective disorder among other negative personality traits such as rage, suicidal ideation and dismissive communication that isolates me from others.
I have a deep-seated fear of abandonment and what’s known as a “disorganized attachment style” that has made it nearly impossible for me to establish a true connection with any person for longer than a couple years. I have avoided reconciling or doing the work that could help heal these traits my whole life, believing I was stronger than my problems or that I could simply suppress them — bottle them up until they go away and/or drink myself into countless stupors to mask my feelings. More recently, while navigating through the early stages of a journey in sobriety, I’ve dealt with an especially difficult end to a meaningful personal relationship, professional burnout and the passing of dates and anniversaries that are extremely emotional for me.
During this time, I’ve been participating in intense rounds of therapy, in which I’ve repeatedly had to process serious childhood trauma. My lack of emotional regulation has thrown me into a deep feeling of loneliness that has spiraled me into a darkness I haven’t known before. I thought I had been depressed before, but this time has been an entire new level of emptiness and self-doubt.
As I’ve sought help with these issues, I’ve come to realize one undeniable fact: Our mental health care system is hopelessly overwhelmed. Let’s start from the beginning: Having finally overcome childhood trauma related to seeking help from mental health professionals and with medication management that made it difficult to start asking, I finally scheduled an appointment with my doctor and let it all out: I can’t focus, I can’t sleep, I can’t eat, I feel like giving up on work and life. I need help.
We started on a low dosage of an ADHD medication to assist in my focus, which helped initially. Without looking at me or asking a single question in the 10 minutes I was in his office, the doctor told me, “I can tell you’re experiencing depression, so let’s start you on an SSRI,” which refers to a selective serotonin reuptake inhibitor, a specific type of antidepressant. I declined that offer and insisted that I be referred to a psychologist for evaluation and diagnosis as well as a psychiatrist for accurate medication management. I was told I would hear back in a few days.
A week went by before I called to check on things. “They have the referral but something is holding it up, it looks like insurance maybe. Give it another week.” After three weeks, I went to a follow-up appointment with my primary care physician to see how the new meds were working out. We upped the dosage and added a low dosage of an antidepressant to manage my depression. I was in and out in 10 minutes.
Then four weeks after asking for real help, I had a breakdown — a serious one that included extreme visualizations of bad things. I called family members and told them I didn’t feel safe alone and that they needed to come. While they were en route, I received an email about my psych referral. “Hello, Due to no appointment availability within Atrium Behavioral Health and/or per your Atrium care provider’s referral order, your referral has been sent out to (out of network place). You can contact them at (phone number) to discuss scheduling your appointment. Have a great day!” I would eventually follow that referral only to find that nothing was available until mid-2025.
After a long conversation with my family, we decided it was best for me to go to the Atrium Behavioral Health (ABH) emergency department to hopefully establish an immediate comprehensive plan for care. During the triage-style check-in process at what immediately felt like a prison, my thoughts and words were misunderstood and misconstrued. I was deemed a safety risk, like I had done something wrong.
They took me to the back room, stripped me down to nothing, inventoried my tattoos, put me in mesh underwear and socks with grips on them, gave me some oversized scrubs and said, “You’ll have to wait here until a doctor can speak with you, but we’ll make up a bed for you.” “Here” is a quiet, poorly lit hallway with a leaky ceiling, cutesy cloud covers over some of the fluorescent lights, and attendings who watch over you but do not engage with you. The “bed” is a mat drug across the floor and placed against the wall with a sheet, blanket and pillow. If I wasn’t insane, they certainly worked hard to make me feel that I was.
I sat for hours, writhing deeper into my emotional hole with no idea of how long I may be locked in that hallway, or what the outcome might be whenever I did finally get to speak to a doctor. The experience immediately brought up trauma from a psych hospital stay I went through at 12 years old during which I was placed in an adult unit and forced to watch the David Bowie film Labyrinth on repeat for a month because the tape was jammed in the VCR while sometimes being allowed to paint pictures but always being force-fed medication.
But back to my recent event. A man who said he had been held in the hallway for three days continuously begged for any health care professional to talk to him, tapping on the glass divider of the nurses’ station situated in the middle of the ED. “You’re gonna get another day if you don’t calm down,” they told him, adding that the best thing he could do was go to sleep.
There was no way I would be sleeping in this hallway. Described as a place where “you can’t hurt yourself,” the hallway felt more like a prison or the stereotypical asylum you may have seen depicted in movies. The hallway was painful. I even tried to plan an escape.
So many mental health advocates focus on the stigma that surrounds mental health disorders, but nobody discusses the more tangible issues that arise when a person finally overcomes that stigma and shares that they feel unsafe in their mind. There is no safety in being locked in what feels like a forgotten hallway where you no longer have choice, voice or independence.
I paced the hallway repeatedly, 75 steps from end to end. I got up on my toes to peer out the single window pane that wasn’t covered in tinted tape to remind myself that the outside world was real. I had only been in for three hours at that point.
Finally, after convincing myself it wouldn’t happen at all, a doctor came in looking for me. “So, what’s going on?” he asked. I laid it all out again. He didn’t ask another question related to the care I was seeking, just gave me the options. “We can keep you overnight, and since it’s after midnight that would mean for an additional 36 hours; we could find a bed for you in our Davidson facility and hospitalize you; or you could go home. Our time together is almost up.” Another 10-minute interaction.
I went home, desperate not to spend another minute in that hallway. Before leaving, however, I asked about an option that he hadn’t referenced: a partial hospitalization program, something that could help me find daily treatment while still having the independence to address my many responsibilities at work. He offered to refer me to a program ABH offers and said I should hear back that same day or the next about setting up the intake process. Once I was finally discharged, free from the confines of that dungeon, days continued to go by with no word about the program.
I called only to be told to call back the next day, only to then be told to call back the next week. I wanted to cry. I did cry. Please, help me. I finally got the call I had been waiting for telling me I was scheduled for intake in early October. Finally.
Through this experience, I’ve also come across another mental health care process that needs immediate reform: scheduling a psychological evaluation to diagnose mental and personality disorders, which would ensure I receive the correct type of therapy for long-term change. After receiving my intake date, I made no less than 86 phone calls to private practices and hospital systems over the next two days all around the state. “You need an in-network referral … We don’t have anything available this year … We don’t actually do that kind of testing here even though it is advertised through the resource you checked …”
Out of pure luck, one nonprofit in the area had recently hired a new psychiatric nurse practitioner, which opened up one single available appointment in the coming weeks. I gladly took it. I now have everything scheduled that I feel I need to continue the work I am doing on myself. Getting here was a nightmare trial of impersonal rudeness, unanswered phone calls, brush-offs, lies, misunderstandings, carelessness and a number of other experiences that all in their own way added to my existing feelings of worthlessness.
(UPDATE: After this story was sent to be published in print, the author was informed by the nonprofit where the evaluation and testing were scheduled that the psychology practitioner is no longer working at their facility and that the appointment was canceled with no other dates available.)
I am not a special case. In fact, I am quite privileged in the sense that I have a place to live, a strong support system, a job, and self-awareness that led me to finally seek help, not to mention all the systemic privilege that comes with being a cisgender white man in America. Despite that privilege, it was everything I could do not to give up at any given turn, as I had to keep reminding myself that this isn’t the life I want to live anymore.
Another privilege I have is this platform, which I have now been motivated to use in the hopes that I can help someone else who feels hopeless get the help they deserve — to remind others that they are not crazy, that their feelings are valid, that the world is a hard place to live in when you’re fighting with yourself.
I also realize that something needs to change. I don’t know how that change is made, but that’s not my job. The administrators of our health care system must make this change. To start, the powers that be must build more capacity — more appointments available for people experiencing a mental health crisis to provide more personalized care outside of being institutionalized at the drop of a hat.
There must be an expansion of services offered, which can only come from an increase in public funding. There must be an entire overhaul of the physical space you are confined to when seeking this help. In that nightmare of a hallway alone there could be impactful changes made: The walls could be painted a therapeutic color instead of the lunch-bag brown that they are. There could be a room with the lights on for those who don’t want to sit in the dark at night.
There could be a room for engagement where a counselor is available to simply converse. There could be a doctor assigned specifically to address the people waiting in the hallway. Hell, offering more than one TV with different viewing options would create a more enjoyable experience for those waiting.
The entire experience must be changed. You should not feel like a prisoner for wanting or needing help. You should not be made to feel like an animal. You should not feel like you have done something wrong for wanting to better yourself. We must do so much more to help the people who are struggling.
