I spent most of last Thursday in the emergency room at McGuire Veterans Hospital in Richmond, Virginia.
When I arrived, my blood pressure was 215/95. My heart rate was dancing between 90 and 140 beats per minute. During the course of the nurses asking me questions, the inevitable question about depression came up.
Nurse: Are you feeling depressed?
Me: Yes. I have been sick for months and recently, I have been very depressed.
Nurse: Are you thinking about harming yourself or others?
Me: No. I will say that the idea of dealing with whatever is wrong with me in the long term makes me more depressed though.
Nurse: You need to choose your words very carefully because if you have to go through mental health, this visit is going to go a whole other route.
I do not know how other people might feel about that last statement, but in the moment, that did not sit well with me.
Why, when I am having obvious physical problems, would my visit have to go any other way?
Why do we separate the ideas of mental and physical health as much as we do?
The body and the mind are inextricably linked. What affects one affects the other. So why are the "mentally" ill treated like biblical era lepers?
There needs to be a new paradigm for treating so-called mental illness in this country. It has to be looked at in the context of both physical health and environment. Especially as it pertains to how the VA in particular treats people with "mental" illnesses.
Right now, it feels like every doctor I see is quick to ascribe my symptoms to a "mental" illness, simply because I have a history of anxiety and depression. Even though both of those things originated with and are linked to a physical health problem.
The VA needs to shift how it operates clinics and hospitals in order to treat patients better. It needs to set up teams that treat a fewer amount of patients per team. For every two to three nurse practitioners that see patients on a regular basis, there should be a psychologist, a psychiatrist, and a medical doctor working in concert with them. The nurse practitioner should not be allowed to prescribe psychiatric drugs. No psychiatric drugs should be prescribed without at least one visit to a psychologist.
The medical doctor, and psychiatrist if need be, should periodically review cases handled by the nurse practitioner to ensure that there is progress being made in regards to patients with long term health concerns.
Lastly, we have to stop thinking of mental illness as the fault of the individual. I am aware, as someone who has struggled with anxiety and depression for twelve years now, that I need to guard my thoughts against both of those things. I am aware that there are behavioral aspects to both of those things.
But there are also physical problems that lead to both. To present with dangerous symptoms at a hospital and to be told that those symptoms may be disregarded or not taken seriously if I did not "choose my words carefully" is utterly absurd.
The mental and the physical should be treated equally, with no threats and no stigma. The focus should always be on the long term health of the individual, not on simply hiding or masking symptoms.
