Just Another (Almost) Routine Mental Health Crisis

Prelude: Lento

It’s after midnight and the other members of the household are either asleep or pursuing their own consolations in the silence of their own rooms. So, much as I might desire the consolation of recorded orchestral music played at concert hall volume, it just wouldn’t be fitting so I shall have to settle for the consolation of writing eloquent prose. Well it pleases me to think it eloquent and, right now at the time of writing, mine is the only opinion that matters.

Part I: Andante Moderato

On Monday (27^th May) I finally, after several weeks of procrastination, contacted Centrelink to organise and advance on my DSP so that later in the week I could take a stroll down to the local music store and buy myself an electric piano. Even my maximum available advance wasn’t going to get me a concert grand and there’s no room in the house for such a monster piece of furniture so an electric piano would just have to do. And so begins the story of how an apparently simple consumeristic self-indulgence and the desire to resume a pianistic career that was cut short a little under 5 decades ago unleashed an emotional tsunami that led to a depressive crisis. I have to tell you, this one totally blindsided me; usually I know a bit in advance when I’ve got one coming because I know what stressors to watch out for.

Tuesday, knowing the money was in the bank and wanting the sale finalised before I had a chance to fritter it away, I took that walk to the music store. In consultation with a very helpful sales guy I finally picked out a standard 88 key Yamaha electric – with a MIDI port in case I ever get it into my head to start plugging in synthesisers and the like and take to playing German style electro-pop. 88 keys was fine – I doubt I’ll ever play anything written specifically for the Imperial Bösendorfer.

During the sales pitch I started to experience ‘symptoms’. To hell with the euphemism; I was starting to cry. But when this happens to me I always describe it as ‘having symptoms’ or somesuch because most people deal better with the situation if you present your situation as a manifestation of illness (the affective disorder major depression); that,at least, is one thing that beyondblue and various other organisations involved in raising awareness of depression have achieved. A grown man can cry in a music store and ask for a private space where he can recompose himself without being made to feel weird and more than a little contemptible.

In real life, I can – usually – display my depression without incurring the contempt of strangers; on the internet things are very different where discussing it in a post like this opens you up to abuse from ‘personal responsibility, free will, sticks and stones, individualists’ who take a perverse pride in the deformations of adult character that result from the systematic brutalisation of children. And this isn’t something that only happens within the confines of the despicable underclass – try tracking down a copy of Terry Lane’s book As the Twig is Bent sometime and read his interview with Kerry Packer. It’s a heartbreaking read.

Anyway, I managed to get through the rest of the business OK, save for one small hitch – the model I now wanted was out of stock and had to be ordered in. I arranged to come back the following day, with the readies in my hot little fist and that was that, give or take the lingering emotional distress and off I went. Picked up some tipple at the bottle-o, missed the bus, walked home and started to break down again about three-quarters of the way there. And this time I knew it was going to be a biggie.

I know how weird this sounds and there’s little I can do to explain to you why buying a piano affected me this way beyond saying that there are some big emotional issues involved. Now that I’m sort of half-outed as a blogger my freedom to go into that sort of detail is curtailed by real world concerns. However, onward.

Passed early Tuesday night – my second night of insomnia in a row, in activities I can no longer quite remember although there was a long bath listening to Claude Greenhill’s Vespers for the Blessed Virgin in there (and I probably dozed off a bit) but I still couldn’t sleep and I had to ask someone to try to get a CAT (Crisis Assessment and Treatment) Team for me. It was too late at night – CAT Teams out here are only available between 9.00am and 10.00pm – so I got to talk to a worker on one of the mental health crisis lines instead. I didn’t make that call myself; by this stage I wasn’t acting much like a human being, much more like a wounded animal. At best I was proto-human, trying – very retardedlyⁱ – to restart the fire in the wood-burning heater for the warmth and comfort it offered.

After I spoke to the guy from the mental health crisis line, I spent much of the night sitting by the fire, listening to Oscar Peterson (‘Hymn to Freedom’ off the Night Train album, Most of the West Side Story album) then finally took myself to bed. And at long last, slept.

Part II (Fugue): Molto Agitato

I woke the next day still very retarded – so much so that it took two hours to carry out the simple task of ringing the Music shop to tell them that I wouldn’t be down to do the business that day. Then ructions that resulted in me leaving the house, getting lost and having to call someone to come find me and then, once again in wounded animal mode, emotionally blackmail them into taking me to the local hospital so that I could see a psychiatric triage nurse…

Part III: Larghissimo

… and waited six hours until she was available to see me. Like all the psych triage nurses I’ve seen at the local hospital she was very competent and not at all fooled by periods of calm lucidity that gradually grew longer once the wounded animal howling was out of the way. She said that she would organise a CAT Team to come see me early the next day and provided some handy hints. She’s not going to last in the public system; she’s too cannily aware of its deficiencies and sooner or later (I hope for her sake that it’s sooner) she’ll get the hell out of a system managed by people – bureaucrats and politicians alike – make it very obvious to the public who use the hospital and the staff who work in it that basically they don’t give much of a damn about much else than keeping costs down.

The clearest signal that the public gets is the state of the hospital’s exterior; grimy, unpainted for years. I call that the ‘grimy hospital effect’ after the ‘broken windows theory‘ in criminology. Or you could just call it public squalor; no matter, the point is that it tells people they don’t matter enough to be provided with clean health care institutions. Yes, it’s superficial and doubtless the hospital is kept scrupulously hygienic on the inside but that fact isn’t displayed in the public face of the institution.

As for the staff, what signals are they getting? Well, consider the signal sent to hospital staff by maintaining emergency rooms crowded with patients and long waits created by understaffing. According to the wall chart showing triage levels the longest I should have waited was two hours. I waited six – and so did the very supportive friend who took me there and stayed with me. And in the end, all the support I could be offered was the promise of a visit from a CAT Team the following day and some pointers on how I would have to behave to convince them that I needed support. And so we went home again, me with that recurring guilt I always feel on these occasions; the guilt over creating such a fuss to so little effect.

And so home to more sleeplessness and a long wait for the CAT Team that I’d be given to understand would call some time in the morning. By 5am it was too late to go to bed; I might sleep too late to patch up the situation that had sent me into the fugue state that had got me lost so close to home, too agitated to go back and unable to remember how to get to where I wanted to go (retardation again). I might miss the CAT Team by being asleep when they came.

But by 2pm they hadn’t arrived. I gave up, rang the social worker who had pencilled in a visit at 3:30 so that we could finally get the piano ordered and paid for and went to bed for some valium induced sleep. I was woken by a knocking on my bedroom door; reluctantly I forced myself to wake and went to sit in the lounge room for a talk with the CAT Team.

Did they introduce themselves? I can’t remember. After whatever preliminaries there were, I asked them a simple question: what background information had they been given on my situation? The gist of their answer – very little and that a chinese whispers version of the story I had told twice already.

I just didn’t want to tell it for a third time. Sure, it would induce a state of emotional distress obvious enough to prompt them to whatever ineffectual action lay within their remit but it was startingto feel inauthentic. It was psychologically abusive to expect me to traumatise myself for the sake of convincing a couple of obtuse jobsworths with no insight or genuine empathy that yes, I was in genuine need of assistance. They were of a type I’ve encountered before; health workers and others in the care industries with no intrinsic interest in their work.

Part IV (Intermezzo): Moderato

The first time I met such a person was during a University vacation stint as a kitchehand in a Marysville guesthouse. She was a former nurse working there as a waitress/housemaid.

One evening, I listened in appalled silence as she described highlights of her former nursing career. The best shifts, she said, were night shifts on the geriatric ward. The gerries didn’t do much – there weren’t too many buzzer calls they just lay there and slept and you could get on with your knitting (she was actually knitting as she spoke), and do the occasional crossword. Every now and then you’d do a quick round of the ward, check if anyone had died and if someone had, well that was about all the work you’d have to do that shift.

She spoke with a chilling indifference to any impression she might be making on anyone listening. In retrospect I suspect she left out the bit about checking who was considered likely to die overnight so that you could contrive a way to ensure that you’d have long session of uninterrupted knitting time before you handed over to the next shift.

Fortunately, I haven’t met any worse examples since. Bad examples, yes, but no-one worse.

Part V (Finale): Presto Infurioso

I said, in a quite quiet and controlled voice that the fact that they had no background information of any value made me quite angry. Could I go through the events so that they could get assess for themselves how bad I was? No I could not – in addition to the objection I raised earlier – the psychologically abusive element of the expectation I had another good reason to refuse; I didn’t want to get into a habit of using self-induced emotional crises to manipulate my social environment. What I needed to do for myself now was the exact opposite.

There was a long awkward silence. I said that right now I didn’t think that there was anything they could do for me but just leave.

You’d like us to leave? They seized on my suggestion with relief – they were out of their depth and I’d just shown them a convenient way to extract themselves from a situation they couldn’t handle.

With diminishing self control I told them, in a slow crescendo of fury, that yes, they should leave. That it was completely unsatisfactory to expect that I should put on a performance of method acting just because ‘you people don’t know how to communicate with each other’.

Oblivious to the fact that they’d just been given the very performance they’d been seeking, they said goodnight and left. Leaving me knowing that I’d just shot myself in the foot merely to preserve my dignity. But then there really wasn’t any ‘merely’ to it.

Postscript: that’s enough of this for now. Living this stuff gets tedious and so does re-living it through writing about it. The meaty stuff – like the institutional changes I’d suggest to prevent such unsatisfactory things to happen to me or anyone else with a mental health problem will have to wait for another time. For now, I’m all written out.