During Nursing school, we had one semester and clinical rotation in mental health (more familiarly known as \”Psych.\”). I was assigned an in-patient mental health facility in downtown Chicago, where we spent a couple days a week talking to patients and nurses, and figuring out the floor. This was honestly the rotation where I was most uncomfortable (although it would probably be up there with pediatrics). I once caught a patient trying to sneak a plastic knife out of the dining area. Another day, I found myself so confused at interviewing a very pleasant young man who was in the facility for suicidal ideation because he just seemed so, well, \”normal.\” I also had a strangely amusing, yet slightly disturbing, conversation with an older gentleman about why he was drinking water with black pepper in it; \”it\’s to balance out all the sodium I had yesterday.\” (I later found out he suffers from schizophrenia.)
But one particular incident stands out. During one of those days, a young Korean woman, probably around my age and a student at a local law-school, was admitted to our floor. She was very quiet and withdrawn, but had been admitted for a \”psychotic break,\” having been found pacing wildly, words pouring from her mouth in flurries of unfiltered thought. Her parents visited her in the unit one day, her father wide-eyed and frustrated, as no one could explain to him adequately what was going on. At some point during this visit, she pulled her parents over to me, saying that I speak Korean, and left, as they looked to me for something, anything to explain what had happened to their daughter.
Now, my Korean is elementary on a good day. Medical terminology is still beyond me. I awkwardly introduced myself, probably gibbering something about just being a student, and let them know I would talk to one of the nurses about their questions and their general confusion. I was horrified, not just with my lack of language skills, but also because I did not plan to do anything with mental health in my future nursing career outside of incidental cases of patients with a history of illness, and I was incredibly uncomfortable with the whole situation (not a super-great explanation, I know, but there you go.)
Has anything changed between then and now?
I\’ve now been in nursing for about 9 years. In that time I\’ve worked in the hospital for a few years, then mainly in outpatient oncology. Between both professional and personal experiences, my attitude toward and understanding of mental health has changed profoundly. If anyone asked me who should be a part of their regular care team, I would not only list off a primary care provider and a dentist, I would put \”mental health professional\” at the top of that list as well. I almost wish they would be assigned at birth, since mental health is so crucial to maintaining one\’s own personal health and wellness.
BUT…
I\’ve always thought of mental health as something OTHER people go into, not myself. Sure, I help to coach my patients and friends to find someone, and look for resources for them with gusto. I see a licensed therapist regularly. My husband and I also regularly see someone for marriage counseling as well. These have been incredibly valuable and enriching experiences. But as much as I appreciate our therapists\’ expertise and ability, I myself have never dabbled in it directly. And although I still don\’t think of mental health or psych nursing as a specialty I would go into, I have begun to realize as someone who wants to work with people in the church to work on their health and wellness, this is something I need to be actively educating myself on and finding ways to grow in. There\’s also the fact that there have been several instances in my life where I have found myself unsure, anxious, afraid, and confused as I have tried to be there for others suffering from different kinds of mental illness. I want to be better than I was. I want to be better than I am.
All of that being said, based on the experience I have had, if anyone asked me for my advice in dealing with their own mental health issues or wanted to get on top of this area of their wellness, (I know you\’re not asking me, but if you\’re interested enough, stick around!) here\’s what I would say:
1. Find someone ASAP, before trouble comes.
My husband and I have had a lot of conversations with married couples who anticipated having children in the near future. We are almost guaranteed to tell them to find a marriage counselor as soon as possible. In general, I would recommend finding someone as soon as you know you\’re going into a transition period. There is a great illustration from Conan O\’Brien, a late night television host, who says that having children is like testing a car for loose screws. Once every however-many cars, a manufacturing facility will pull a car from the line and shake it every which way to see if it holds up. Much like this car, having kids will test you to see if any screws are loose in your relationship. But in general, not just in marriage and childbearing, all manner of transitions can cause upheaval, even the positive ones. New jobs, job loss, change in location, a new diagnosis, etc., all of these can lead to emotional and mental health status changes.
We have also recommended finding someone sooner than later because we recognized that finding a counselor who fits your lifestyle and personality takes time. Shortly before my first son was born, we went to a few sessions with a counselor, and although we tried it out for a few weeks, both my husband and I realized we just weren\’t clicking with our counselor all that well. When our son was born, we never went back, but we also stopped looking for someone for some time because life just kept getting busier. We finally went to see someone about a year later because I was struggling to pull myself together and felt my soul shriveling into a raisin. Our first session with this new counselor was only a few days after we found out I was pregnant with our second child. And it worked out SO well. Our first session made such an impression, we kept trying it out. It was honestly so fun that we still continue to see him to this day. And even now, almost 2 years after our first appointment with him, we are constantly finding ways we can improve and grow and work on our relationship.
Like any relationship, a counselor-counselee relationship takes time and work. Sometimes, it just doesn\’t fit or work out, and looking for someone else is ok! But know that it won\’t always be satisfying or comfortable. So try someone out, and if it doesn\’t work, licensed counselors, therapists, psychologists, and psychiatrists are trained with a certain level of professionalism, and are usually able to handle a patient moving on. For example, when I first started personal counseling, I loved meeting the person I found from the get-go. However, scheduling conflicts led to difficulty figuring out appointment times, and eventually we parted ways. She was able to help me transition to someone new by sending over her notes (after a few signed consent forms), and she very professionally helped me transition over well. (There will always be exceptions to this, but don\’t let that stop you!)
2. Mental Health counseling is not a substitute for community.
A few years ago, I met with a patient who was just… going through a lot. She had a treatable breast cancer, but had a history of multiple mental health issues and was on several different medications to help with anxiety and depression. She was actively seeing a counselor and psychiatrist. However, one of the things that struck me as I spoke with her about how she was doing was how much it would benefit her to find a community. I encouraged her to find something, whether that was group therapy or a faith community, so that she would find herself surrounded by supportive people. (It\’s in moments like these that I see the potential the Church has to be a healthy, supportive, and loving environment to people in need. We aren\’t always good at it, so Lord help us, since we need it!)
Coming from a Christian perspective, I understand a lot of it might sound like proselytizing, which I guess sometimes it might be because I think Jesus is pretty awesome, but there was a lot more involved. There is something about feeling alone and isolated that affects not only how you feel emotionally and psychologically, but also how you feel and respond physically. A meta-analysis study done at Brigham Young University in 2015 concluded that chronic loneliness increases mortality, and is associated with poorer health (CITATION HERE). Loneliness matters. It reinforces the fact that we were created for community, even the most introverted of us.
Therapy is meant to help us work on our emotional and mental health. However, it is not meant to be the only community one experiences. If anything, good, quality therapy helps us to expand our ability to have good, quality relationships with others. So along with a good therapist that you click with, find a community that you click with. That might mean looking for something not-so-obvious. For example, for a short era of time, my husband and I, along with a few members of our church, would join a Gundam model building group once a month at a local hobby shop. Not only was it therapeutic to build something with our hands, we met some wonderful people there.
Unfortunately, one of the things I am not qualified to address (yet) is finding mental health services for those who lack either time and/or money to take care of this aspect of their health. SO… for those of you reading this, do you have experience in this area? Where could one go if they lacked the time and money? AND, what are some good books and resources on faith and mental health that have helped you on your journey?
Citations (is this how you\’re supposed to do this?!)
Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015 Mar;10(2):227-37. doi: 10.1177/1745691614568352. PMID: 25910392.