I wanted to talk today about what you can do when you see someone experiencing psychosis. If a person is in psychosis, often they may be talking to themselves or shouting while walking down the street. I have noticed in my experience that they are almost always alone. There are times when you can help and times when you need to do what you can from a distance. One time, ages ago, I was riding a late-night bus not long after being released from the hospital. A young man got on the bus and he looked to be in extreme distress. I overheard him asking the bus driver about a place he could go to pray and I thought this seemed strange. It didn’t take me long to realize that this young man was in the same shoes I was in not that long ago.
I talked to him, gave him directions to some places to get help and tried to explain to him that he may be seeing and hearing strange things, but that they weren’t real. At the time, I thought I was doing him some huge favour, but when I look back I see a lot of mistakes I made.
One of the things I think I should have done was to stay with this guy and keep giving him reassurances about what was going on until I found help for him. That was a long time ago and a lot has changed. One of the key things that has changed is that, in Canada and in some parts of the US, Police have developed a way of responding to this type of thing. What some jurisdictions do now is send only mental health workers, and others will send both a police officer and a mental health worker. Unfortunately here in Western Canada, most smaller communities don’t have the benefit of a large police force or a large budget to respond in this way. Many communities are served by RCMP or Quebec or Ontario Provincial Police. Resources can be stretched so thin that only one constable at a time may be on call.
What is tragic is the number of deaths that occur when police respond to mental health calls, more so in the US than Canada, due possibly to the greater risks police face responding to calls. In the US, from what I understand, a police officer has to keep tight control on the people they are called to deal with and mental illness is something that often resists this type of authority. When you add in the greater risk of violence, it is easy to see why police feel forced to take down the person in question. Not that I condone this, I am just trying to make sense of why these things happen.
The large number of deaths and other negative outcomes of mental health calls has caused a lot of people to raise their voice about defunding the police and simply having different types of crisis response teams, most notably a mental health crisis response team.
It often seems when I go anywhere, especially around this time of the month, there are people who have severe mental illnesses in a lot of public places. It is my hope that anyone reading this will arm themselves with a little knowledge I have to share. The first thing that should be done before you leave your house again is that you should look up your local mental health crisis response agency (sorry, I don’t have the room here to list even the Canadian ones) and program that number on your phone. In Edmonton, as in other major cities, there is something called “The Hope Van” this is a converted ambulance funded by a local shelter that responds to people in crisis. Usually they focus on people who need to warm up or get a ride to a local shelter or are experiencing substance use problems like overdosing. We also have a mental health crisis response team that will intervene for just about anyone who is having a mental health issue. When I was last in the psychiatric hospital, this team actually staked out my apartment, called my parents and followed me until they could intervene on my behalf and get me the treatment I desperately needed. If you are ever on a bus and someone is having a crisis, or downtown or any such place and you recognize some of the signs of severe psychosis, call these people and give them a description of the person and a location. If for any reason you feel they are a danger to themselves or others, call 911. If you think you can help them, talk to them slowly and carefully, repeat yourself when needed, try to get them away from noise and distractions. By all means, if they smoke, let them smoke (though it is bad for you in the long run, nicotine is known to affect some of the same neurotransmitters that psychiatric medication does). It can also be important to ask them what they want to do. You may be able to get them to go to a hospital. Although it is hard to reason with a person’s delusions or hallucinations, or even paranoia, you may be able to logically convince them that things will end up a great deal better for them if they consent to go to a hospital.
There are some sad things to consider. One of them is that you may see people on the streets who are clearly struggling and even the paramedics and police don’t want to help them. This can be where calling something like the “Hope Van” I mentioned can come in handy. It is also sad to consider that some people you see who are mentally ill and struggling are on drugs or so traumatized by life events that they can’t be helped. This doesn’t mean a person shouldn’t try and help them. In a case like this, if I am able, I will try and get them some food (rather than give money that may go to drugs).
The other sad thing to consider is another reason why some feel police departments should be defunded. This is where homeless people or ‘nuisance’ mentally ill homeless people get fined or charged by police for things they have little control over, like public urination or possession of drugs they are so addicted to that they will literally die if they don’t get a hit. These fines pile up and turn into warrants for that person’s arrest, and then all of a sudden we have a local jail taking the place of a psychiatric hospital.
I wish I had better answers. Helping a stranger who is unstable is not always easy. What is important though is that people who have a mental illness or are family members of those who have a mental illness, ALONG with people who want to help change things like stigma, homelessness and untreated mental illness, need to educate themselves on the facts. This could be as simple as reading this blog, or as complicated as people in the US contacting the National Institute of Mental Health to learn more about how they can help, and people in Canada contacting the Canadian Mental Health Association or the Schizophrenia Society. A great way to start is to try and locate a class called “Mental Health First Aid”. Volunteering is another way you can help and begin to better understand people with illnesses and finally, many of these places need your dollars. More to come, thanks for subscribing!