‘Jack’ needs understanding, not labels

By Telawna Kirbie

Research indicates that one in five adults will have at least one mental health diagnosis in their lifetime. It is highly likely this will be you or someone you know.

There are many reasons why people do not acknowledge mental health issues or seek treatment, but the stigma placed on mental illness in our society is one of the largest barriers in people getting the help they need to cope. The stigma around mental health has improved in recent years, but there is still much work to be done.

One way to help combat the stigma is to practice using person-centered, trauma informed, and culturally sensitive language. What does this mean and how does it combat the stigma around mental health? A common phrase for some is, “You are crazy.” This can refer to any type of unusual or abnormal behavior and is typically meant to be funny and harmless in nature. However, it is not harmless if you suffer from mental illness. There is nothing funny about mental illness and if you have suffered or known someone with mental illness, you need no explanation.

Jack, a man in his late 40s, shows up at a local coffee shop. He is seen by business patrons swinging his fists in the air, swearing loudly at someone or something that no one else can see. Others around him are fearful by the strange behavior — some concerned for his well-being and others for their own.

Behavior like this can be scary and unpredictable. At home, Jack can’t sleep for fear of nightmares and when he is awake, he suffers from extreme paranoia and delusions. He is constantly in fear that someone is trying to get him — the police, God, the devil, his deceased and abusive stepfather, etc. Tending to the thoughts and paranoia takes too much energy for him to be able to do much else.

Jack is so consumed with thoughts and hallucinations that eating and basic self-care are minimal. He is alone as relationships are nearly impossible, and he clearly cannot function enough to maintain employment for any notable length of time. As a result, he must rely on disability benefits and government assistance, which provide him with a very limited fixed income.

Money management and general adult responsibilities are difficult to manage. Due to this, Jack can easily get behind on his bills and often gets utilities disconnected or loses his benefits because he missed an appointment or failed to reapply for continued assistance. He has a caseworker who provides a great deal of assistance, but family support is non-existent. As a result of past behavior caused by untreated mental illness, he has lost all relationships that were important to him.

Jack is now on a medication regimen that is working better than any in the past, however, it helps but does not resolve or cure the debilitating symptoms of his mental illness. When he takes it, he has his best chance at having more high-functioning days. But, if he has too many of those in a row, he begins to feel so good that he is convinced that he no longer needs to continue taking the medication.

The result is that being unmedicated leads him into a state of mental health crisis, and he then needs an inpatient hospital stay to get back on his medication regimen. He may stay in a psychiatric facility for three to seven days. During this time he is started on new medications, participates in individual and group counseling and medication management until he becomes stable enough for discharge.

Jack does not have transportation or anyone to call on Saturday when he is discharged from the facility. The hospital provides him with a bus ticket to his home. When he arrives home, he realizes very quickly that he does not have any electricity in the house. It is Saturday so he cannot really do anything about it until Monday. Even though it is not during business hours, he makes a call to his caseworker and leaves a voicemail.

Any food in the refrigerator has gone bad. There are a few dry good items in the pantry. He decides to eat some saltines, drink some water, and go to bed. His only option is to wait it out until Monday when he can get help. His source of heat is an electric space heater, and temperatures are predicted to be below freezing much of the weekend.

He tries to sleep but it is too cold so he ventures out to a local coffee shop where he can get warm. Luckily, he is able to come up with a few dollars and can get a cup of coffee. One of the employees recognizes him as the man who was there a week or so ago when the police were called. He whispers to a coworker, “Hey, isn’t that the crazy guy from a week ago?”

Neither one of these coffee shop employees understands the depths or gravity of Jack’s struggle with mental illness. He meant no harm when he was there a week ago active in his hallucinations, and he means no harm today as he utilizes the warmth of the coffee and the coffee shop for his basic survival.

People we interact with in our daily lives come with their own stories, struggles, failures, and successes. We are all in search of connection and meaningful experiences. Sometimes our struggles further alienate us from these two very innate desires that are critical to our growth and development. Call me Jack, don’t call me crazy. Referring to Jack any other way than with compassion, empathy, and understanding is a tragedy.

One of the ways to demonstrate leadership is to lead by example and provide guidance to those we interact with. Equity, justice, and impartial treatment for everyone are at the heart of the work in which Prosper Waco engages. Look around you and see where changes can be made in respect to this. The change begins with your own individual awareness. Ask yourself if your language, thoughts, and actions represent these principles. We all have room for improvement in this and small changes can be made every day toward this effort. What can you do today?

“Prosper Waco expresses a renewed commitment to equity because current circumstances require more concerted efforts. Equity involves the fair and impartial treatment of people and organizations for justice. It’s a core value of Prosper Waco, and the pursuit of equity is essential to a thriving community.”

Prosper Waco’s Board of Directors Statement on Equity — 2020

Telawna Kirbie is director of behavioral health initiatives for Prosper Waco.