Jesse: Jim, Michelle, if you were involuntarily hospitalized, who would be your first phone call?
Michelle: Okay, number one, this is Committable. Number two…
(laughter)
Michelle: I mean, honestly, the reality is I don't know because in that situation, I'm not okay and I'm not going to be thinking straight and I'm going to be panicking. And I've often thought to myself, genuinely the only telephone number I still have memorized is my parents and they will be utterly useless. They will actually be worse than useless. They will do active damage. I keep trying to memorize more numbers, and it's not happening.
Jim: I panicked when you said we're going to introduce the show slightly differently.
(laughter)
Jim: Being confronted with, who would you call an involuntary commitment situation? I don't, like, I can't even imagine.
Michelle: There is an immediate need for comfort. Like there's this immediate, it's almost irrelevant who will do the most benefit, and it's more like who will make me feel the illusion of any semblance of safety and comfort in this moment. Even if they won't be able to actually accomplish anything. Like, who will calm me down?
Jesse: And I think that is a big part of why it is so coercively powerful when, in these types of situations, a clinician says, If you sign this voluntary, You'll probably get out sooner.
Michelle: And that paper, like, that paper would symbolize that as well. Like, that would be a trained professional, that I would see as a trained professional, saying, here is this lifeline of comfort for you. Like, if you sign this, everything's gonna be okay. And I would go, Great. My sole purpose right now is to feel like everything's gonna be okay. Thank you for giving me what is clearly the ticket to feeling that way, even though it's actually completely fucking you over. Jim: Just to remind people that one thing that you're probably not gonna be reminded of is that, you know, there should be a phone number posted somewhere, and if it's not it should be available somewhere where there is going to be an organization that's going to have advocates and lawyers and others who you should be able to call. And who can send someone over and advocate on your behalf. I mean, how effective they're gonna be able to be is kind of up in the air, but they're going to be presumably in your corner. So, you know, the kind of advocates and things that have shown up on the show. They're people you can call.
Michelle: Can I have the Disability Law Center number just like tattooed on me?
Jesse: You can, and the Disability Law Center is a great resource for people in Massachusetts to be aware of because it is the State Protection and Advocacy Organization. But within the first few days of an involuntary hospitalization I believe the organization more set up to respond to that would be the Mental Health Legal Advisors Committee. Unless what you're looking for is the organization that will be assisting you in your legal defense at a commitment hearing, in which case that would be the Committee for Public Counsel Services. But all of those would just be for Massachusetts.
Jim: That's just Massachusetts?!
Michelle: Yeah, we are just in Massachusetts.
Jim: All right, 49 more to go.
(laughter)
Jesse: So the complexity of this question, how frighteningly overwhelming it can be, that is the mindset that I want us to be thinking about as we go into the episode, which is about to start right now.
(intro music from Reasonable by Christopher G. Brown)
Jesse: This is Committable, a podcast about involuntary commitments. I'm Jesse Mangan, and I'm here with Committable producers Michelle Stockman.
Michelle: Hello!
Jesse: And Jim McQuaid.
Jim: Goddammit, can I just add, Michelle's first one, when she said hello, I felt like there was an element of like, look how easy it is, Jim!
Michelle: Correct.
Jim: Excellent.
(laughter)
Jim: I am so good at this.
Michelle: You’re crushing it.
Jesse: So for this episode, we are going to be hearing the story of someone who was involuntarily hospitalized in Ohio. And we're going to learn about the impact that process can have on a person asking for help.
Jim: So this is someone who reached out to you, had been committed, and...
Jesse: Right, this is a conversation about what happened to Kaylyn.
Kaylyn: My name is Kaylyn. I am a, um, well, I was a mental health tech at a local pediatric hospital and I worked on their inpatient psychiatric floor.
Jesse: You were a mental health tech, but you went into that with some personal experience. Do you want to talk about that personal experience? And say whatever you're comfortable sharing.
Kaylyn: Yeah. So I had been hired in the middle of February to work as a mental health tech. And then at the end of February I had gotten pink slipped, which in Ohio, that's the involuntary commitment paper, right? So, I got discharged March 1st, and then two weeks after that I started my orientation. So it was very, very fresh.
Jesse: What drew you to want to work in that sort of setting?
Kaylyn: I have always been interested in mental health and in college I was going to be a counselor, and then I decided, no, I don't want to do that, I'm going to be a psych NP. So now I'm in nursing school, but I've just always had an interest in mental health. And I've gotten more of an interest in psychiatry as I'm doing some medical stuff with nursing.
Jesse: What happened that led to you being pink slipped before you started work?
Kaylyn: So I was getting TMS treatment for treatment resistant depression, and I had been doing really well, like the treatment was working. And my husband was going out of town one weekend, and I knew he was going and it was fine, but then my roommate told me last minute, like hey I'm going to be out of town this weekend too. So my brain just instantly went, whoa, you could do this, this and that, and then, like, be done. And that really freaked me out and I didn't want to do that. So I had mentioned to the TMS tech, my intention was to ask them how I should approach my therapist with that, but the result was my psychiatrist being called, PD being called and me being sent to the emergency room. And then I think by the time I was with police, like I was no longer a reliable person, so it didn't matter. It was, well, you're a psych patient now, so whatever you say we're taking with a grain of salt because your psychiatrist said this, and that's what's true. But I had never spoken to my psychiatrist during the whole ordeal, which is my favorite part.
Jesse: So you have this conversation, this process is initiated, then what happens? Do police come to your home?
Kaylyn: No, I was still at the TMS clinic. So the tech had asked me to go sit in the office and wait. So she had, like, attempted to safety plan with me, but I did not realize that's what was happening. Like she was asking me, could you go stay with a friend? Could you go stay at your parents? And I was like, no, I don't need a babysitter. I just need to talk to my therapist. And then she called my psychiatrist. And then about 20 minutes later, police are coming into the room and nobody, like, I had no idea that that was going to happen.
Jesse: What happens then? Do the police understand the situation?
Kaylyn: I don't think that these police really understood the situation. The one officer accused me of attention seeking, because when they started asking me, did you say this, did you have these thoughts? And obviously I'm going to deny everything. Cause I don't want to go to the hospital. So I was like, no, no, no. And they're like, oh, so you're attention seeking? And I was like, Does it look like I want this attention? Does it look like I'm enjoying this? Yeah, and then they went through all my stuff. You're supposed to be able to have the least public, the most private way possible to be sent to the hospital, right? But the police car was on the side of a busy road. a couple blocks down from where I live and they had to pat me down, and throw me in the back of the police car. And they told me, and this is the other thing that I found about psychiatry and counseling is there's an illusion of choice, but a lot of times there's not really. Like they told me, look, you have a choice to come with us on your own, or we're going to have to take you involuntarily and forcibly. That's not a choice. Like you just told me, I can walk with you or you're going to put handcuffs on me.
Jesse: There seems to not really be awareness of the authority in that situation, the power imbalance. Like if someone comes up to me and says, I'm about to take your freedoms away, I'll do whatever I can to try and avoid that. It's not a fair or reasonable situation. There isn't really a choice. As long as that legal authority exists, I'm in self preservation mode.
Kaylyn: That's exactly what happened. When I got to the hospital I told them, look, if this is the alternative, I will do whatever. I will sign whatever you want me to. I'll call however often I need to for safety checks. Like just, going to the hospital is the worst thing that you could do for me. I had, um, extreme paranoia at one point about like, I just was convinced everybody was trying to send me to the mental hospital and I had just, like, gotten over that. And then this happened and I was like, oh, maybe it wasn't so irrational of a thought?
Jim: One thing in particular that really jumped out, you know, this is just a theme that pops up again and again, is that the moment you're a, you know, a mental patient or a “crazy person”, which happens well before you end up at the hospital, right? I mean, the moment the police show up, you've been predefined as, you know, “crazy” or whatever, but regardless of what the particular label is, you're no longer a reliable person. And I just thought that was a really powerful phrase that just captures so many people's experiences.
Jesse: Yeah, there are so many similarities to other stories we've heard, like Cassidy's story in season two.
Michelle: I mean, I think she possibly even used some of the same phrasing as Cassidy, which was essentially, you know, both of them being put in a situation where they're trying to just tell someone, you have to believe me, this is the worst thing that you could do to me right now. Here are all of the other things that I am willing to do. All of the other, like, ridiculous measures that I am willing to go through to convince you that I'm going to be okay for this limited window of time. But whatever you do, just don't do the one thing that is absolutely the worst thing that you could do for me and having that not be, you know, acknowledged or listened to, or adhered to. And it always reminds me of these times that we talk in every state about these, like, least restrictive things of, oh, let's make sure that we've exhausted all of these other possibilities before we go to this worst case scenario. And these are just two perfect examples of people who are saying, like, yeah, can we please just run through other options that we know are possible right now before you go to this one that I know is going to be worse. Like, I promise you I can find a way to cooperate with you in one of those 7, 999 other options.
Jesse: Yeah, these systems are not designed for adaptability. Typically once it starts you are just caught in the process until it's done with you. And so, Kaylyn had gone to a scheduled appointment that ended up with her being taken by police To a hospital. So what happens then?
Kaylyn: They put me in an ED room with the lights turned off and the curtains drawn, because if you're a psych patient you need no stimulation, right? There's a one-to-one with me and they tried to get me to give them my clothes and I would not, so they just gave me a hospital gown. And then they do like blood tests and vitals and an EKG, but nobody had ever told me that that's what they were doing. Like, they just come into the room and like to do things to me and I was like, Oh, okay. And at this point I'm just like, I need to be as cooperative as possible because I don't want this to go any further. So, yeah, it was very much just like you're a patient, we just have to get in here and do our things so we can transfer you to a psych ward.
Jesse: Did you feel like someone was actually trying to listen to you and hear what you needed during that process?
Kaylyn: No, the ED physician actually came in with the pink slip and read it to me, and he was like, how am I not supposed to admit you? Your psychiatrist wrote this. And I said, okay, he never talked to me first off, like, this is the situation right now. And then he said he would think about it. And he came back a couple hours later and he said, honestly, I'm an ED physician, I don't feel comfortable overriding your psychiatrist. And there are no psychiatrists in that hospital, I know that. I think there's maybe one psych NP, but she didn't evaluate me, she came in and told me that they were looking for placement.
Jesse: So the process is happening and you're just sort of caught in it. What happens next once they do decide that they're looking for placement? How long are you in the ED? And then what happens?
Kaylyn: I think I was in the ED for about 12 hours and then they had EMS come take me. And I overheard at the nurse's station, my nurse saying that I was hysterical, which I was not, I was just very anxious. And I told him when the EMS came in, I was like, for the record, I'm not hysterical, I'm just anxious and sad. And so I had like an hour ambulance ride to the hospital that they put me at, and I got there in like the middle of the night and they kind of threw me in a room, had me take off my clothes and then they were like, okay, what's going on? And I was like, I don't know. I was just trying to talk to my therapist, then the police came and now I'm in the hospital an hour away from where I live. And I was like, I want to speak to a psychiatrist right now. And at the time they were like, there's no psychiatrist here. And now I know they're on call, but that, you know, you wouldn't have gotten that opportunity at midnight. So either way, I was destined to stay the night there. And it was a Thursday, so the next day on Friday, like the doctor never saw me, it was an NP and her psych exam was very short. I was in a continuing state of like panic attack, coming down, panic attack, coming down. So I was, I probably appeared very unstable, but it was just, I was literally living my worst fear, right? With nobody around me, I didn't tell anyone. I told one friend, but other than that nobody knew but my husband. So like, I couldn't call my dad and be like, Hey dad, get me out of here. You know what I mean? There was no support. So I was just very freaked out and you know, I go into this interview still kind of like trying not to cry, but very much crying and the NP says, do you want to do this at a different time? And then she offers me an Ativan, and I swear, the amount of times I was offered an Ativan at that hospital? Insane. Anytime you're upset, do you want an Ativan? It's not, do you want to process it? It’s not, do you want to talk about what's going on? It's, do you want some meds?
Jesse: So, you arrive at the hospital, the psych facility, on a Thursday. And I'm assuming it's a 48? Or 72 hour hold?
Kaylyn: Yep.
Jesse: 72, okay.
Kaylyn: And I didn't know this yet. I had like, my only experience was with psychology and counseling, not like medicine and psychiatry and hospitals. So there was this guy that told me, I was like, okay, well, I guess I get out on Monday. Um, no, it wasn't, it was the NP. I was like, oh, I guess I get out on Monday. Right? And she was like, well, no, cause the weekend doesn't count. So, soonest you could get out is Wednesday. And then I had someone else tell me the soonest was Tuesday. And then someone else told me, well, you signed in voluntarily, that means it's null and void, you can leave whenever you want. And it was just like, everybody would give me different answers. It was so confusing and I had no idea what they're looking for in discharge. So every time someone comes up and talks to me, I'm just like, dude, get me out of here. I don't need to be here. This is not what I need. So yeah, the doctor saw me on Monday, that was the first time I had talked to a psychiatrist and he said, honestly, your psychiatrist wrote this pink slip. He thinks you need to be here for 72 hours and he knows you best, is what they said to me. And I was like, okay, first off, I've technically been here 72 hours, because, you know, it might not count for you, but I was still existing this weekend. And, I don't know, the psychiatrist knows you best? Like I'm literally telling you about myself and telling you, like, what I'm feeling and what's happening. And you're going to go off of a piece of paper because they know me best.
Jesse: Something that really resonated with me was “It might not count for you, but I was still existing this weekend.” I have never understood why facilities are allowed to do that. If you don't have the resources to release me during the weekend, then you shouldn't be allowed to detain me during the weekend.
Jim: I keep thinking I must have lost my capacity to get really mad with this stuff, but I'm really finding myself just, like, I feel really angry and furious right now. But also it's this, like, impotent kind of anger because I don't know what to do about it. This is happening to people. There are people in this situation right this very second. There are many, many people all over the place. It's routine, it's just what they do. I don't know, it's fucking infuriating and I hate it.
Jesse: That feeling of being helpless when faced with something that you know is wrong? For me, that continues to be one of the most painful parts of being involuntarily hospitalized. But the very first thing that happened to me when I was forced into a psych facility was a nurse asking me to sign myself in as voluntary. So my next question for Kaylyn was, what happened when you first arrived at the psych facility? Did someone immediately ask you to sign yourself in?
Kaylyn: No, they pretty much just took me to a room when I got there because it was so late, which was, I don't know, when we admit patients we give them, like, they're in scrubs. They're fully clothed, but like they have me take off all my clothes and just give me a hospital gown that was open in the back. So they have me walking down the hall with a male nurse behind me and it was very uncomfortable. But anyway, so they took me to the room and then the next day I saw a social worker and she was like, here, you can sign in voluntarily. And I was like, okay, what does that mean? And she said, well, it just looks good, it looks like you want the treatment. I was like, okay, good, cool, does that get me out soon? And she's like, well, it might. So I just signed, I don't think I read anything I signed ever at that hospital.
Jesse: Did anyone at that point, or afterwards explain to you what being voluntary meant? What that status meant, what you could do to try to get out?
Kaylyn: A little bit, but not correctly, like the OT, I guess, did an interview with me and I was asking, I just asked everyone, like, how do I get discharged? What do I need to do to get discharged? And she was like, well, you signed in voluntarily, right? And I was like, yeah. And she said, well, that makes your involuntary commitment null and void. That cancels the pink slip. So in my understanding, I'm like, Oh, so I'm just a medical patient, so I could leave AMA, right? But no, I talked to a nurse later that day and she's like, no, that's not how it works. You are still here until you see the psychiatrist.
Jesse: Okay, so do you speak to a psychiatrist on Monday? What happens then?
Kaylyn: Literally nothing, I was so discouraged after that meeting and like, what's so frustrating about it is I understand the reason the pink slip was signed. I get why my psychiatrist had to sign that. But he explained to me later, like, that's not the process that should have happened. You should have been evaluated because I couldn't evaluate you, so I signed that so you could get evaluated. But nobody really evaluated me. I don't know, the NP did the first day technically, but it was like three minutes and she just asked me very standard history questions and then recorded that I was labile and crying and anxious. So yeah, the psychiatrist was very much like, yeah, we're going to keep you the length of your pink slip because that's what your psychiatrist thinks.
Jesse: I have a personal animosity towards the term labile. It's such like, a broad nonsensical term of displaying a complete lack of understanding how people react to stressful situations. Kaylyn: Yeah, I have a very strong feeling about that. Like whenever I would chart on patients, I would never use labile, I would never check that box. They make it out like it's a subjective medical diagnosis, but it's really, I mean, psychiatry in a lot of ways is very subjective. And it's scary that your rights are in the hands of these people who have really high liability for letting you go, right? Or aren't psychiatrists at all, like the ED doctor, I wouldn't have had to go if he didn't sign that slip. But he was evidently not comfortable doing a mental status exam.
Jesse: So this whole process started with Kaylyn experiencing intrusive thoughts that she wanted to talk about. Then a mental health tech calls her psychiatrist, that psychiatrist signs an emergency detention order. Then police arrive, she's brought to a general hospital, held there for about 12 hours before being transported to a psych facility but by then, It's a Friday, so she's held for the weekend, and weekends don't count, so she doesn't actually get to speak to a psychiatrist until Monday. So what happens Monday?
Kaylyn: I talked my way out a little early. I talked to the social worker and I was like, listen, this is ridiculous. The big reason that my psychiatrist wrote this pink slip was because my husband was out of town, right? And I would be home alone. Well, he's home on Monday. So now I'm here in this environment that I have told you is like, extremely traumatizing for me and my husband, my support system, is at home. I could be at home safely taking my medications and following my regiment. And she, I guess she talked the team into letting me out a day early, so I got out on Tuesday.
Jesse: The idea that Tuesday was a day early, given that you got there on Thursday, is distressing. But so, you have a routine, you have a structure that works at home with medications and a support network. How much of that was disrupted in the hospital? Were you able to stay on with your medications and whatever else you needed?
Kaylyn: No, they actually didn't have my meds for the first day or two, at least. And like, I'd started getting SSRI withdrawal, right? So I asked for a Zofran. They're like, well, we can't do that, they have to order it. I did not know that at the time. So yeah, and in a way it was like, it was taking away from the treatment that I'd been receiving because I was missing TMS appointments. I missed two of them and you're supposed to go regularly for it to work. I wasn't getting all my medications and then when I did get my medications, they just handed me a little cup of pills and like, I didn't recognize a lot of it. So I asked, what's in here? And you know, they told me all my medications and then they said Trazodone, Melatonin. And I was like, I don't take that. And she was like, well, we just give it to everyone because usually people ask for it. And I was like, okay, well, I don't want it, so can you take it back? Like, I don't want sleeping pills. And I was very adamant, like, I'm not being non-compliant with my meds, I just don't need this, like I'm taking all the meds I've been prescribed. And then at one point they had upped one of my prescriptions and they didn't tell me. So when they gave me 20 milligrams instead of 10, I was like, that's not right. And they said, no, they changed it. And I was like, okay, well I'm not comfortable doing that without talking to the person who changed it first. So I was like, very much like, please don't put that I'm non-compliant, just put that I want to speak to the provider about the medication, right? So it was very, very much like you're not involved in your treatment at all. And as an employee, I can tell you that we encourage patients to be involved in their treatment. And reading my patient rights packet for my hospitalization, there's a big section about being involved in your treatment but you're not, you're not consulted. They say they do like team meetings with you, they don't. They said that I had a family meeting. My husband literally never got contacted because they wrote down my cell phone number instead of his cell phone number as the contact. And I don't know why it is that way anymore. I don't know if it's, you know, lack of staff, because that's very much an issue. Or if it's burnout, but it's like, it's not how they present themselves on paper or on their website, right?
Jesse: Yeah, patients rights often seem like one of the first things to get compromised when the system just needs to keep moving. And I think you were absolutely right to question if there's been a change in medication. Unless they're getting a court order to force that medication, there needs to be a consultation about that. There needs to be a conversation about that.
Kaylyn: And the most frustrating part about it is I got my medical records, and I read through them frequently, but there is a section where they talk about that and like, it says that they had a conversation with me about changing my meds. And like, every time there's an evaluation, it says that they consulted me about side effects, potential, like things that could happen, black box warnings, none of that ever happened. There's a lot of things charted that did not happen. And it's frustrating because I can't go and be like, Hey, this never happened. Who are they going to believe? Me? Who was admitted to a psych ward, or the NP who has a master's degree, right?
Michelle: So I'm no longer on medication for depression, but was for a while. I personally don't think that I should have been, but that's okay, I still took it dutifully for like a good 10-15 years. And the person that I saw who originally prescribed it for me, first of all, just kept trying to prescribe more like, well, that one's not working? Then, why don't we supplement it with this other drug that will, like, fill in the details of all the drug that this drug's missing? And when that wasn't something I was willing to do, then it was, okay, well, we just need to constantly up your dose. We're just gonna always, like, up your dose. I had to explain this to her, almost every single time I saw her, because the one time that I did, I had extreme negative side effects. In which, like, I was more depressed and suicidal than I had ever been in my entire life. It felt very unnatural. I reached out to her immediately, she said, stop taking it right away. I stopped taking it right away. I felt much better. That small change in the dosage, which I then spent like a good five years reminding her that no, I didn't want to go up on my dosage because the last time we did that, I had a really bad time and it was a really bad idea. But it's just, it's also that they would do it so casually when to me that is such a significant danger is really galling and really concerning.
Jesse: And if Kaylyn had not questioned that change in dosage and there had been some sort of serious problem that resulted, then the story told by the medical records would be that the clinicians did everything they were supposed to. That they did everything right. And maybe that wasn't done in bad faith, maybe that was a miscommunication, or a mistake.
Jim: But the whole point of things like informed consent, informed consent just as a concept, as an idea, is built on the premise that the conversation is intended to communicate to the person who is receiving the “care” in a way that they can make a decision about it, right? And so the person needs to understand the risks, the benefits, what might happen to them and alternatives. So even if there are alternative versions where the hospital staff are recording those things as conversations about a treatment or something, it's still very much in violation of what informed consent is and what it's supposed to do. And it's really just a way to check the boxes on a list of things that they're supposed to. Check the boxes and say that we did what we're supposed to do, and it's the routine and then we just go home and sleep like babies.
Jesse: I mean often, for me at least, being inpatient felt like just a prolonged period of confinement broken up by instances of someone checking a box. But for most of us, eventually, we do get released. So my last question for Kaylyn was what happened when, eventually, she was released?
Kaylyn: Well, when my husband met me in between the double doors I, like, just fell onto him. And I was like, dude, get me out of here, this is insane, I need to go. And I told him to bring our dog, so the dog was in the car waiting for me, so that was nice. But when I got home it was, like, immediate. I just went into bed and just, like, I just had to reset. I needed to be like, I'm safe now, nobody can get me and nobody's going to come take me away somewhere. And I don't know, it's continued to be like my bed is the only place I feel safe like that anymore. Sometimes I'll get really intrusive thoughts about what happened, even in my living room, and I'm like, no, I got to go lock myself in my bedroom. Because that's the only place that police aren't going to break in and get me. Nobody's going to see me and think, Oh, she's labile, she needs to go to the psych ward.
Jesse: So you had academic experience, you had essentially studied this, studied this field. Does the personal experience change how you understood the things you studied? Does it change your perspective on that at all?
Kaylyn: Yes, I have found that once you're labeled a psych patient, like everything is different. You are not reliable, your history is not reliable. You're manipulative, you're attention seeking. I hear a lot of cluster B traits getting put in charts. Like, in school, we're taught to evaluate and write down, you know, what we're noticing objectively. But everything is so subjective, and I didn't realize that until all of these things were being applied to me and I didn't feel they were true. But, so there was one tech at the hospital I was at who was, she is the one who told me the secrets of how you get out and after talking to her, I got out pretty quickly. But, um, I told myself I'm going to be that tech, like, that's going to be me and that's how it's okay for me to do this. And I did, I, I did that for a while, but it got to a point where I was like, I'm doing things that I don't feel are ethical. I mean, it's Pediatric psych, right? So legally you can have a nine year old in seclusion, and we would have nine year olds in seclusion. You know, forcibly medicating minors and putting them in restraints. I would just see that and be like, that could have been me. That easily could have been me. And I was like, I can't do this, this is insane, this is not where I need to be in the system. But I don't know, it did give me perspective on, you know, I always say that a regular day at work for you is the worst day of a patient's life. And I think that a lot of people forget that, especially if they've not had that experience, but I did not have the luxury of forgetting that.
Jesse: You're in this setting, you're doing the best you can given your personal experiences, like, how long did you last? And how did you last that long?
Kaylyn: Well, I lasted from the beginning of March until tomorrow's my last shift, so that's almost a year, but I don't know. At first it was really hard, like I remember getting onto the floor for the first time and someone scanning their badge, like expecting me to open the door. And I just stood there because I can't touch this psych floor door, like, that would get me thrown in seclusion. And they're like, you can open the door, I was like, Oh yeah, okay. So it was very weird. It was very weird to be in the nurse's station, on the other side, but I don't know. At first it was hard, and then I think I kind of got numb to it for a bit, and then I just started not being numb to it again, and I was questioning every intervention I would do. I got self aware of charting. I was like, Whoa, wait, this is what they did to me. I'm watching this kid, writing down everything they do. That's what they did to me in the psych ward, like, that's creepy, I don't like that. Yeah, I don't know, and then it's just from there it was like, I had a nine year old who was autistic and she had no emotional regulation. And I had worked with that population previously, I was at a school, so I didn't have security, or psychiatrists, or medications, and I was always able to handle that situation. I don't know, it would always get resolved without seclusion, but this girl ended up in seclusion. And I'm thinking that is so traumatizing for anyone, add on to the fact that she's only nine and she's autistic, so she's got a lot of sensory issues. It broke my heart, she was in the seclusion room just yelling like, “Kaylyn let me out” and I'm like, I can't let you out I'll get fired.
Jesse: So, after your experience of going through the pink slip and then working for almost a year in a pediatric psych setting, how does that impact your longer term career goals? How does that impact the type of thing you want to invest your time in?
Kaylyn: Well, my intention was to get my RN license, then work in inpatient psych for a bit and then go for my NP and do outpatient. But I have decided I can’t do inpatient, it’s not for me, not even on the medical floors. I can't do it. Especially in Pediatrics because you know, a lot of the times the kids don't want whatever's happening but they're not in control, the parents are, right? And I just like, even if it's a lifesaving intervention, I don't feel right doing something that someone doesn't want done, because I've had that done to me. So I have decided that I'm staying outpatient no matter what, even when I get my license. The role I'm going into now is a lot of prevention and early intervention to keep kids from getting to that acuity. So I'm really excited about that, but I just, I could not work in a setting that was inpatient, I don't think.
Michelle: That's heartbreaking, some of those stories. And I just, I don't know, I don't know the right ways of dealing with these things. I don't know the right thing to do. I don't have an answer for every scenario that's scary, or overwhelming, I just know that the way we're doing things now is so obviously broken and is hurting more people than it's helping. And so we need to rethink things and we need to do things differently. We need to center the people who are going through these things, have been through these things, may go through these things. To get their perspective and to get a better understanding of what the actual needs and wants are.
Jesse: But often when people hear a story like Kaylyn's they will respond by acknowledging that was bad, but that must be the exception. That's not what's supposed to happen, right? So next time on Committable, we'll be talking to an attorney about mental health laws in Ohio to figure out exactly how this process is supposed to operate.
Jim: Can it be held accountable?
Jesse: Yeah, when something like this happens, is there any accountability?
Jim: Oh, they're not questions, I’ll tell you right now the answer is no, no one will be held accountable, nor could they be. I just, I don't want to spoil anything, but...
Jesse: Next time…
Jim: Ok.
Jesse: …on Committable.
Jesse: Committable is produced by Jim McQuaid. Michelle Stockman and me, Jesse Mangan. All music is from the song Reasonable by Christopher G. Brown.