Caucasian male, well built, age about early 30’s. He had been enrolled with Mental Health Services since late adolescence. Starting with diagnosis of Mood disorders, then Anxiety disorders, then Substance abuse disorders. Multiple diagnosis piled up, while his Self Esteem and Academic functioning dived down. He picked up with Support System of some Community health agencies, Family members, Counselors, Social Workers and while in Crisis, his help came from Mental Health Nurses and Psychiatrists. Hospitalizations earlier were for Diagnostics but later emergency hospitalizations, for Suicide Prevention.
Poly-Diagnosis, Poly-Pharmacy, Poly-Therapy, Poly-Support and Disorder of Personality (Narcissistic subtype), buried in Case Files.
Patient’s last few admissions with a Specific team of Psychiatrist, Outpatient DBT therapist and Community social worker was best in outcome. His Commitment improved with the Efforts and Sincerity of the Team. His crisis hospitalizations reduced in frequency and were for shorter periods. His functioning improved and he enrolled in vocational courses with a plan of finding employment. Persona felt more consistent in Self Esteem, less fragile, less dependent on support systems, more motivated to attain Self Sufficiency. He looked forward to discharge from hospital, happy unlike many times in past when the treating teams were happy on his discharge. He had a Unified Diagnosis, Medications, Therapy, Support and Order within his Persona. He intended to make one most important person Proud. By doing this, he wished to OUTGROW the Guilt of his past failures.
A few hours later, call came that the Patient had hung himself from a Tree. Shock, Grief and Disbelief surrounded the Team. De-Briefing Meeting was called, details awaited from Family and Police Department. ‘After discharge, Patient had contacted a family member and expressed his desire to be home, for Overnight or weekend stay. While this was obliged in the past, this time the family member decided to be Firmer and declined the visit.’
Team helplessly pondered; the mental health system worked on paperwork, to cover up their (Narcissistic) Bases. The family member regretted that after years of Positivity Unlimited, this time the Positivity was limited to promote and motivate Self Reliance. A Good Intent Misfired.!
Mistimed Vision, Mis-Informed Support, Mistimed Positivity, Mistimed Goodness and Mistimed Poly-Ticks can collapse a Life, a System, a Dash of Hope or Self Reliance.!!!
My note through this story: The Psychiatrist, therapist, health workers, social workers are all human and put their best efforts to help patients through their situations. But, when their efforts combine with the intent of the patient and the unconditional love and care of the patient’s family, miracles happen.
Also read: Suicide
