People often ask me why I went into Mental Health.
I wish I could give some altruistic, selfless answer. But the reality is, I think it was equal parts curiosity and voyeurism.
I was intrigued by the case studies I read in text books, beguiled by the personal narratives that our guest speakers offered. I loved the stories that came with studying Psychology. I didn't fit the action-oriented model of most of my classmates. Instead, I excelled in the creative classwork of studying...not exactly the DO-ing that comes with the helping profession.
And I've always found those personal qualities, of introspection and rumination, to be detriments in a field marked by too much to do and not enough resources to do it with. My co-workers seem to show up, get things done, then go home. I've never been able to compartmentalize it all. I find my admission interviews taking twice as long as other peoples. I get engrossed in the histories in patients' charts. I want stories and conversations...and find that Medicaid is reluctant to reimburse those.
Action. Results. Yuck.
Slowly, over the past few months though, I've been noticing that, perhaps, my lyrical soul isn't quite the ball and chain I've always imagined it to be. Typical suicide assessments focus on "thoughts, plans and actions." That is, has the patient been thinking about death? Have they formulated plans for suicide? Finally, have they taken any action toward those ends? Three check boxes to measure lethality.
And recently I've been hearing (imagine that!) a person's suicidality can't be neatly summed up in just three questions. A thorough clinician needs background information, past history, family history. One needs to look for a climax to the story, why now? To find out about supporting characters, family and friends. To ask questions and look for themes. To get the patients to tell their stories, not simply check off boxes.
So perhaps narrative, theme, story have their space in the psych. hospital too. And maybe caring and personal attention have a place in my career after all.
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