The “Bad Patient:” When Doctors Drive People with Mental Illness to Suicide
Lets be real about mental health access for a second: It sucks. Well, allow me to rephrase… it sucks IF you’re poor (or a Person of a Color, a Trans person, Sex Worker, houseless person or anyone on the margins). The medical system in America is highly paternalistic and punitive to those who cannot walk the straight line of mental health treatment.
I have Bipolar disorder. I have been in and out of hospitals for the management of my bipolar all my life. Most of the time due to abuse by the medical system and not simply my own organic defunct brain chemistry. I have been seen my dozens of therapists and psychiatrists in my life. Back in 2016, my psychiatrist at the time who met me when I was highly suicidal decided to refuse me further treatment after I missed an appointment to get my labs done. Mind you, the reason I missed the lab appointment was because I didn’t have the $20 co-pay. Rather than have a conversation with me, she had her secretary inform me that not only would she not take my calls or take appointments with me anymore, but she wasn’t even going to refill any of my medications or help me find a new provider. What happened after this? I drank anti-freeze after my medications ran out and had no one to prescribe me more.
Sadly, this was not an isolated incident. After I found a new prescriber who I had been seeing for over a year, in 2017 the same thing happened. My psychiatrist had his secretary inform me that he would not book appointments with me or refill anymore of my medication until I paid a $100 balance. I had just been fired at the time after my employer at a social service agency found out I used to be a sex worker (ironically my role there was as a case manager for trafficking survivors).
I’m not saying psychiatrists do not have a right to refuse to work with a patient anymore. I’m not saying medical providers don’t deserve to be paid (medical treatment in general should be free, but that’s another article). What I am saying is that the inhumane ways in which I was tossed aside, denied access to life saving medication and not given any help or referrals to a new provider are beyond unethical. It is actually medical abandonment according to the law and make no mistake- it is outright abuse.
After my second psychiatrist in a row refused to help me any longer because I was a “bad patient”, I managed to keep myself afloat for a few months without meducation. I was on Medicaid at the time, so I could not afford a private psychiatrist and was already on the waitlist a for all of the mental health programs that would take state insurance. There was nothing else I could have done. I managed to stay afloat off of my meds for 6 months until I drank half a bottle of kitchen cleaner one day on an impulse and ended up in the ER.
Most recently- yesterday, in fact, I was informed by a secretary for the overloaded, overburdened state run mental health facility where I had been seeing a prescriber that they had “un-enrolled me” because apparently it was part of the program that I check in with them by phone. No one ever told me this was the case. Ever. I didn’t even argue with the guy on the phone when he told me this. I was already very familiar with being cast aside by the mental health system for not following THEIR rules. For not being a “good patient.” Because I was a “bad patient”, I wasn’t deserving of medical treatment for the severe, life-threatening mental illness I will have until the day I die.
Now I have worked as a case manager in social services for years. I know how it is to work with someone to better their circumstances- to navigate someone through systems and to watch someone’s successes and struggles. Now I may have lots of opinions about what someone should do in a given circumstance, but ultimately I know that the people I work with are the experts on their own lives. Doctors do have special knowledge- but it is not up to them to define for us what treatment looks like without this being a mutual conversation between doctor and patient. Doctors have special knowledge of chemistry and biology but I have special knowledge of Laura LeMoon. And that matters, too.
The medical system and it’s treatment has been the direct cause of many of my more serious suicide attempts. This can’t be taken lightly. A doctor would never haphazardly deprive someone of their blood pressure pills or their diabetes medication without this being a direct conversation that included the assurance that said patient was able to access a new provider and be able to continue their current medications uninterrupted. To do otherwise would be unethical and just inhumane. Well, having been denied my bipolar medications many times now I know from experience that being refused my meds is lethal. I get doctors have their policies and procedures- but isn’t the most important one to “cause no harm?” Do medical providers not take a Hippocratic oath to this effect as a contingency to starting in the field?
Without question, I have been severely harmed by the medical community and I know it’s due to the fact that since I’m “mentally ill” I must not be capable of making any informed decisions about my own treatment in the same ways in which a diabetes patient, say, would in their treatment. I’m incapable- mentally “disabled” even. Deserving of the infantilism and paternalism of medical systems who believe I’m inherently mentally lacking.
What I deserve is to be alive. What all people living with mental illness deserve is to be alive. My life matters. The lives of people living with mental illness- especially those who are poor and houseless and most on the margins- are important. More important than the collective egos of the medical community and of individual providers. That is the bottom line. I’m dependent on medical systems until the day I die. I will never NOT need medication and treatment. I’m beholden to this system forever. But that doesn’t justify me being under its thumb. Dependence should not justify abuse and this shouldn’t have to be something that folks living with mental illness just have to get used to and deal with. We deserve better than that.
