Can someone please take me to hospital?
I can’t quite remember how I ended up there, but following an incredibly intensive period of high productivity and creativity (something I was later to understand as classic bipolar type II disorder) I sat at the bottom of the stairs completely and utterly suicidal.
It’s really hard to try and describe what it feels like to be suicidal to someone who has never been there. It’s the most utterly devastating and destructive darkness you can ever imagine. One moment you can be trucking along just fine and then the next moment your entire world can suddenly become a vast vacuum that turns everything of worth and value in your life in on itself.
It’s almost impossible to put into words how logic itself becomes meaningless as every fiber of your being is overtaken and drowned in the horrendous nothingness. Nothing makes sense anymore; there is only the complete and utter pain of your existence coupled with the last meaningless and futile attempts of your dying will as it tries so desperately to fight against the endless barrage of negative voices telling you to end it all.
I fought for as long as I could, trying to reason with the unreasonable darkness but in the end I just couldn’t do it anymore. I reached for my phone and typed in one simple sentence, ‘can someone please take me to hospital.’
No smiles, no hugs…just a call to social services
My lifelong friend, Daniel, came to collect me. We have known each other since we were kids at primary school and he was the best man at my wedding. I climbed into his car and as we set off I cried the whole journey to the hospital.
It’s not quite the response you expect when you tell someone that you feel like killing yourself. Having been here before in my life (once in my teens, another time in my early 20s), I guess I was still holding out for a shred of human kindness. In all honesty, I genuinely believe to this day that if the woman at the A&E reception had stopped what she was doing, stepped out from behind her computer and given me a hug, then the whole experience might have been different.
As it was, I waited 3 hours to see a nurse who’s first questions was, ‘do you have any children? If so we will need social services to call home to check they are ok…’ No smile, no hug, no words of comfort, just the automated collection of data and the cold application of the procedural protocol we call ‘safeguarding’.
Why do you want to kill yourself?
When you finally get to see the Duty Psych, there are a whole host of more procedural questions you have to trawl through. To answer these I was taken in to a dimly lit and soulless room. I remember there was a lifeless watercolor hung at a jaunty angle on the wall. There were also spots of blood on the floor. After hours and hours of waiting, the offer of a cup of tea would have gone a long way, but instead all I remember is a nameless and shapeless man hiding behind a clip board asking me question after question, like some kind of well rehearsed and automated monotone robot.
‘Why do you want to kill yourself… do you still feel suicidal….have you thought about how you may do it… what would stop you from doing it….if you left hospital now would you be safe… what would you like us to do?’
I can’t quite remember what I answered. In all honesty I can’t remember the Doctor’s name or much of anything that followed really. I just remember that room, with the wonky picture and the blood on the floor, and I remember the feeling that the Psych didn’t care about me. I remember no one smiled, no one offered me a cup of tea or told me I would be OK. I remember no one touched me; no hand on the shoulder, no subtle tactile gestures or even the meeting of a compassionate gaze. I can remember all of that but most of all I can remember the feeling of giving up as the last tiny and desperate ember of hope inside me fizzled out.
A smile could save your life
To this day I still don’t know if all this was related to any particular stigma around mental health. Maybe the staff were just tired, stressed out and overworked? Would it have been any different if my issue was a broken arm instead of feeling suicidal? I don’t know the answers to those questions but what I do know is that front line A&E staff need to understand something very important: When someone presents as suicidal they are in a highly charged emotional state that leaves them incredibly susceptible to what would normally be the most subtle of emotional gestures. As such, I believe this puts front line staff in a position of huge influence and power, something I think they are rarely aware of.
This may sound a little sensationalist but I hold it to be true based on my three previous experiences of presenting as suicidal at A&E. To a patient with an acute physical injury, it’s almost a given that A&E will be crowded, that you will have to wait for hours to be seen and that the receptionist will be grumpy and rude. However, to someone in an extremely heightened emotional state, the vantage point can be extremely different. The crowded waiting room can seem threatening, the long wait can seem torturous and the receptionist’s treatment of you as the first point of human contact can either serve to confirm and deny that you are the worst person in the world and that you deserve to die…just as much as a smile could potentially save your life.
Why, why, why?
It’s almost inconceivable to contemplate how suicide has now become the single biggest killer of men aged between 20–49 in the UK. I just can’t fathom it out at all. In terms of connectivity and knowledge, we are the most advanced generation that has ever existed on the earth. And yet, every year in this country, thousands upon thousands of men who are dads, husbands, sons and brothers, just like me, end their own lives.
I am incredibly blessed, or some might say lucky. My story is a story of hope and healing. I didn’t take my life that day and a new chapter eventually opened up to me, all of which was less to do with my visit to A&E, and more and more to do with the amazing friends and family around me.
I hate talking about these things and, despite all reason otherwise, I still feel ashamed and embarrassed. I have no idea how to turn back the black tide of darkness that claims so many young men’s lives every year. However, I am slowly coming to understand that appropriate vulnerability in the right setting (and with the right people) can create much needed healing and connection. I have also come to the realisation that if I don’t have the courage to speak out and tell my story, then how can I expect other men to do the same?
Things need to change and that change has to start with all of us, particularly front line A&E staff, taking a closer look at our attitudes towards the silent pandemic of male suicide. It needs to stop and we all have to play our part.
If you'd like to read more from Jamie about living with bipolar II disorder, he blogs regularly.