Irony About ER Screenings

I don't know about you, but at the hospitals I do clinicals at (there are three), the ER and most floors have a screening for domestic violence, self-harm, suicide ideation, and depression. The questions are simple:

1. Do you feel safe at home?
2. Do you feel safe in your relationship?
3. Are you depressed or feel down?
4. Do you harm yourself?
5. Do you ever wish that you would die or try to kill yourself?

Little questions like that are considered a screening. Now, they are kinda trick questions. By this, I mean that if you answer any of them wrong, then the proper authorities have to be informed and then your life is about to get a whole lot more stressful. If you say that you harm yourself or have thought about/tried to kill yourself, you now get to be under a 72 hour M1 hold in the hospital with the company of a sitter who watches your every move, every moment of the day (even when you use the bathroom). You then also have that in your chart and on your record. If you say you do not feel safe at home or in your relationship, then you might have the police come in and chat with you or child protective services come do a whole long investigation. Yikes.

I have been thinking a lot about this since having been in the ER as a patient and as a student nurse. We ask these questions, thinking they will be a help in some shape or form, but are they really? How easy is it to answer "no" to these questions when your heart is screaming "yes" (or vice versa, depending on the question) just because you know what will happen or you are scared to admit any of these things to yourself? When I went in, I answered appropriately to all questions to avoid the outcomes that would result upon answering any of them "incorrectly". After the assault, I was majorly depressed, I wished that G-d would allow me to die, and the temptation to begin self-harm again was at an all-time high. However, I knew that saying any of these things in the hospital would result in me actually being admitted to the hospital for a few days so that they can see if you're emotionally and mentally able to be released out into the world. So, what good do these questions really do? I have seen so many nurses go into a room and not ask these questions to the patients because the nurse felt it was unnecessary to do so.

In my last med/surg clinical group, my instructor brought up a good point about getting help for depression and suicide: there aren't really great systems to get help. If you go somewhere and say you're depressed and struggling to not hurt/kill yourself, people will lock you away, then you learn to not seek help for your emotional struggles which will likely lead to suicide. If you go somewhere to talk to a counselor, professor, or whomever else you choose to confide your struggles to, you can explain your symptoms of depression, but leave out that you are struggling to stay alive, but then you cannot receive the help you truly need because you have one of the deepest, darkest secrets that will eat a hole right through you until you either end up dying, or you somehow find hope to survive long enough to get out of the depression.

For me, the depression lasts years. I don't go anywhere for help because counseling didn't work in the past, I know what happens if you say the wrong thing and I'm scared of going through that, friends don't know how to support me when I can't figure out how to be happy, and nobody understands, they think I'm being dramatic and a whiner. So, I live with the knowledge of the things I've done, I wear the scars, and I battle with myself daily. When friends ask what is wrong, they usually persist in the beginning of the friendship to figure out what is happening in my mind, once they find out, they stop asking and I stop telling. This usually causes big rifts and eventually we move on from each other. Yet, I am still saddled with the constant war, fatigue, struggles to remain alive, sleeping for several days straight to escape without dying, distracting myself when I feel so numb that I know hurting myself would at least offer a chance at coming back to reality and feeling something, and I deal with it all by myself because people don't stick around once they get a glimpse of the darkness they tried so hard to uncover.

That's probably one of the hardest things to deal with: losing friends because they don't feel close if you don't tell them every single thing that runs through your brain, but once they figure out what you deal with then they no longer want anything to do with you. I end up feeling used, hurt, sad, angry, more depressed, and I deal with a lot of guilt because they tell me how hard it is to watch me and listen to me go through my depression cycles. I've watched a lot of people cry at my expense because of that and I am about to lose another roommate because of that.

In my defense, I try to keep it a secret and keep it at bay. Pretending to be happy and carefree is not all that hard, but my face doesn't keep secrets at all and so they start digging. It happens every time I get a friend and we start to get close. Going through this just makes me want to stay superficial with everyone I meet because they like me when it's just a "hey, how are you?" kind of friendship. Unfortunately, girls don't really stand around and bullshit like guys do, they want to explore feelings, family life, and other happenings that involve deeper levels of intimacy. And so, the cycle continues and it pushes me deeper and deeper into my pit. I keep more secrets from everybody, and I refuse to trust anyone because everybody lies.

So, that is where I am and what I've been thinking about for several months now. Something needs to be done in this country to fix the "suicide prevention" system that is currently in place because there are an awful lot of suicides and even more suicidal people out there and nobody seems to be getting much help where they feel safe to share what's truly going on in their minds. I want to change things, but I don't even know where to begin. Maybe it could prevent deaths like Country Boy's, maybe he could have had a better chance.