Assessing for Suicide: first week on the job

What was I saying about passing go? About helping people pass go?
What was I saying about loving the work I do?

Seriously, I love the work I do, but I'll whole-heartedly admit that there are going to be days where it's difficult to leave work at the office, and I think on some levels I really actually like that. My work makes me think. It makes me feel. It makes me question my motives, my choices, my perspective, and our system. The work I do gives me a peek into the lives of people at their most vulnerable and their most powerful. The work I do shows me examples of the deepest kindnesses found in the recesses of the most ignored and marginalized corners of our collective population. My job teaches and humbles me. I couldn't be more grateful, and I hope in writing this that I will always have a written reminder for when I start to get overwhelmed or discouraged or complacent.

But I don't even know where to start. Every day I talk to people about why they do or don't want to live anymore. I talk to people who are hurting so badly they can't see life through the pain. I talk to people who can't experience joy, whose lives feel flat and grey and meaningless to them. I talk to people at the end of their ropes. I talk to people whose ropes have snapped and they are trying desperately to weave them back together. I talk to people whose own perceptions betray them, whose brain chemistry is so imbalanced that they feel like they are living life confused, rejected, misunderstood, afraid, on fast-forward, unable to sleep or sleeping too much, unable to eat or compulsively eating too much, unable find any kind of grounding. I talk to incredible people who are struggling, who are terrified, who are hopeless, who are furious, delusional, addicted, victimized, abused, neglected, sad, paranoid, grandiose, and who feel legitimately powerless over the fucked up chemistry of their minds. I talk to all walks--men, women, children, and adolescents; all races, various socio-economic backgrounds, various educational backgrounds, etc. The only thing they all seem to have in common is the untethered, chaotic, lost feeling of crisis.

Maybe I'll just note a few experiences from the week:

• I sent a 15 year old suicidal cutter (cutting does not always mean suicidal) to the children's hospital. I sincerely believe I made the best and safest choice possible, given the available resources, but I can't help but wonder about how the hospital might work with her. I hope, from my very core, that they didn't just throw medications at her and send her on her way. She needs help coping with very real life challenges. Maybe--MAYBE-- a pill needs to be part of that help, but it is a FAR cry from a solution. I can't write about this one without crying. This work effects me across the board--and I have my soapboxes about medication, diagnoses, and good care-- but my heart breaks when it comes to the kids. She was depressed, hopeless, anxious, angry, lonely, misunderstood, and terrified. If the hospital didn't handle her situation tenderly, with enormous amounts of compassion and empathy, I could see how she might never ask anyone for help again. I could see her receding further into her darkness. 
• I witnessed a family who had essentially adopted an elderly and severely mentally ill--delusions, hallucinations, and largely incomprehensible speech-- homeless man after they discovered him squatting on their land 10 years ago. They allow him to stay on their land, even giving him access to an unused trailer for shelter. They give him food. They give him money. They've helped him get set up with benefits and they look out for his well-being.
• I met a man, who by all appearances and presumptions, would seem to have no grasp on reality at all. He hangs around the building most days. Some days he seeks help getting medications or a bed to sleep in. Some days he just hangs out. Some days his behavior is unruly and inappropriate. Some days he's pretty mellow. This man is, not unlike many homeless and mentally ill, written off as a non-entity. He is marginalized. He is feared by the general public and assumed dangerous, heartless, and incompetent. This man, however, willingly gives up his own comforts to others in greater need. This man was set up with a bed for at least a few nights, complete with access to showers and laundry and hot meals; and he gave it all up to create a safe space for another young man in need, stating (I'm paraphrasing here): "I'm ok on the streets. I can handle it just like I've handled it before. Give this kid my bed." The kid had never been on the streets and this ragged old man, who'd lived years of hardship and discomfort gave up his comfort to see to it that the kid might never have to struggle through the night under a bridge. 

In just one week, there were so many other amazing, beautiful, humbling, frightening, and tragic experiences that came through our doors. These are just a few that stood out for me. This work is ALL about helping people connect with their lives, rediscover and recognize their own strength and beauty, and pass go. I kind of feel like I work in the eye of a tornado.