Health Care Providers Must Ask the Difficult Questions

There is a common thread that is running through many of the conversations about mental illness and domestic violence; the failure of health care providers to properly assess and ask the important but difficult questions.  I have asked questions about a patient’s mental illness in a routine questionnaire, but I was never trained on how to start the conversation without that form or how to be prepared for those who said yes.  I asked the question with the assumption that the person would say that they did not have any mental health issues or suicidal thoughts.  If a person would have responded differently, I am not sure what my response would have been.

After seeing this video (posted below) this morning, I was disappointed in myself.  Personally and professionally.  One of the survivors discussed how she went to the hospital because she had a black eye and no one took the time to ask her how she got that black eye.  She said that if anyone would have asked her, she might have opened up and received the help she needed to escape from her abuser.  Her words struck me right in my own heart.  It reminded me of all of the times that I had suspicions or could have asked more in-depth questions, but failed to go that extra mile and discuss those things with my patient.  I have failed professionally at the bedside but that does not mean we cannot change this conversation.  Healthcare professionals have to continuously remind ourselves that we are providers of holistic care, not just symptomatic care.

A patient may come to you with symptoms of high blood pressure and obesity, and the only questions that may arise are those that focus on their eating and exercise habits. We never stop to explore any underlying mental issues or emotional problems that may trigger overeating, depression or stress.  All of these factors could lead directly to these disease processes and their resolution could in turn fix the overarching issue.

Many times we enter into a patient-provider relationship with preconceived notions that block our natural interactions with our patients.  We do not pick up on the subtleties because we are focused on our agenda.  Quality health care is effective care.  We can only be effective if we are asking the right questions.  We can only ask the right questions if we are listening to the actual responses that are being given.  We have to open our ears and eyes to see more than the primary issue but all other issues that could possibly be connected.

We have to ask the difficult questions about child abuse, sexual abuse, rape, drug abuse, mental health, suicide ideations, depression and domestic violence, to list a few. It may be hard, uncomfortable or may be offensive to some but that one person who needed to hear those words will thank you.  We may be the only outlet or opportunity that they have to get them the help that they need.

Healthcare providers are angels on earth. Our work is never done.  We have to continue learning and expanding our skills through traditional and nontraditional means.

Be you.  Do you.  Tell your own story.  On your own terms.

http://shine.forharriet.com/2014/08/nbcs-tamron-hall-shares-heartbreaking.html

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Suicide Isn’t For Black People

I sadly believed this statement up until I began working for Dr. Donna Barnes at the Mental Health Center at Howard University.  At that time, I had never personally dealt with suicide, and I had only heard of a situation that occurred on campus the previous summer.  That incident was discussed more as an accident than a potential suicide.  I wrongly assumed that this was not an issue that affected people who looked like me and therefore I did not have to deal with it.  Working with Dr. Barnes on Suicide Prevention on campus and learning more about suicide changed my outlook and way of thinking.

Suicide is the 10th leading cause of death overall, but the 3rd leading cause of death in persons aged 10-14, and the 2nd leading cause of death in persons aged 15-29 (CDC Vital Statistics 2011).  Suicide was the 3rd leading cause of death among young black males from 2001-2010 (CDC Report 2010).  Comparatively, African-Americans commit suicide at a lower rate overall,  but there still remains a concern amongst our Black youth.  Black youth are affected by suicide at a higher rate than Black adults, and on average, die from suicide a decade earlier than White Americans.

The numbers may not be alarming enough to make people wake up and realize that we have an issue on our hands, but the reality is that we cannot wait any longer to discuss this topic.  Now is the time to begin to look at the root of the issues that are affecting our youth.  Suicide is not a comfortable conversation to have.  As a health care provider, I have never become comfortable asking someone about their mental health status.  It is a very private and personal topic that very few feel comfortable sharing.  Understanding suicide, the warning signs, and knowing where to go for help, may not be able to save every single person, but may be able to teach us how to reach someone who may need our support and save a life.

The first thing we have to do is stop putting a face to suicide.  We see suicide as a White issue and that barrier prevents us from taking the time to discuss, understand and recognize suicide as our issue.  Secondly, we have to be ready to relinquish the idea that we have to be strong to survive.  Yes, our strength and resilience can be an asset you our success, but it also can be a trap that leads to someone feeling overwhelmed trying to live up to that image.  Lastly, we have to support each other and check-in on one another.  Many times someone crosses our mind and we brush it away, instead of picking up the phone and reaching out.  When people say things that show that their troubles are beginning to overwhelm them, we have to express empathy and patience, instead of ignoring or sweeping it under the rug.

Suicide is not a new issue and will not quietly go away with any one solution.  There are so many pressure points that we have to recognize, address and deal with in order to provide people with options.  We have to change the way we talk about suicide, mental health, depression, counseling and even the use of prescribed medicines.  The conversation may be hard to start but once we are honest with ourselves and each other, we can grow and empower others.

After working with Dr. Barnes I became more aware of suicide and the potential signs, but it did not prepare me to lose someone close to me.  To this day, I think of my dear friend often and I have vowed to continue the conversation as a way to honor her life and all that she was to so many.  The pain that those left behind endure after losing someone to suicide is indescribable, but I can only imagine the pain that she was dealing with that led to her decision.

On September 20th I am walking in her honor at the Out of the Darkness Community Walk, to appreciate her contributions and to continue the conversation.  Feel free to support or send words of encouragement.  I continue to pray for her family and loved ones.  We will never forget who she was to each of us. This conversation is deep and has so many layers.  This is the first installment of many that will help to facilitate the conversation.

Know that you are not alone.  Be you.  Do you.  Tell your own story.  On your own terms.

Donation page: http://afsp.donordrive.com/index.cfm?fuseaction=donorDrive.participant&participantID=585209

Resources to learn more: 

http://www.nopcas.com/absu.html

http://www.cdc.gov/violenceprevention/suicide/

Dealing With Trauma

A few years ago I went through a series of really traumatizing incidents.  My sister gave me her car and the first day I was in DC with it, I went to a friend’s house and it was stolen with my new laptop inside.  It was found a few days later, completely destroyed.  A few months later someone tried to kidnap me while I was walking to work at 5 am on a quiet residential street in Maryland.  Then a few months after that incident, a child (14-16 year old) jumped into my car at a gas station in Maryland and stole my brand new car.  It was also found days later but I had already bought a new car.

Through this very tough time, I thought I was processing it all mostly because I talked about it frequently with friends and family, I kept pushing through the process and I had a positive outlook on the entire situation despite the judgment I received.  People were telling me I was cursed, that I should quit school and move back home or that I needed to atone for some unknown sin.

These are some really scary incidents that some people may deal with individually at some point in their life but together and back to back, it became exceptionally difficult to feel safe.  Who is my protector?  I am pushing through the pain, proclaiming I am still blessed, and staying prayed up yet I am subject to these attacks.  Even my own father told me that I deserved all that I was getting because I did not listen to him and decided to finish high school and go to college instead of following his plan, which is still unknown.

I had to withdraw from the noise and stop allowing people to one, blame me and two, shame me.  People will tell you that you deserved things that were clearly out of your control.  They will steal the victim card from you and make you out to be a villain.  If you internalize these things, your mind will begin to blame and shame yourself for the actions of others.  Yes, I had an older car and should have had a club steering wheel lock on.  Yes, I should not have gone to a gas station so late with my roommate.  Yes, I should have tried to take a safer route to work even if it took more time.  But even if I had done all of those things, life still would have happened.  Anything could have happened.

So many of us have dealt with or are currently dealing with some form of trauma: sexual abuse or assault, physical abuse or assault, mental abuse, sudden deaths in our families, personal illnesses or illness amongst close family members or friends, thoughts of suicide, drug abuse.  Do not take responsibility for things that are out of your control.  I blamed myself for being my father’s child, for deciding to move with him after growing up with my grandparents, and after staying when I should have ran away.  I blamed myself for being poor and deciding to go to college, for never being able to fully enjoy my experience, for not making wise financial decisions when I took out my loans.  I blamed myself for every attack that I went through during that period of time.  I replayed it in my head on how I could have done things differently, what I should have done differently, why I didn’t do things differently.  I blamed me and not the actual perpetrators who should have known better and who only targeted me because of my vulnerabilities.

Many of the traumas that we experience in life are inflicted onto us by others. Some of us do not even realize the extent of the trauma and endured it, or suppressed it  and many of us have never even healed from it.  The lack of healing causes us to drag much of the wrongly placed guilt and shame on ourselves into the future.  Although we may not be able to prevent every traumatic incident, we can take control and get help.  Seek professional counseling, avoid those who attempt to blame you, and release the guilt that comes with self-blaming.  We are powerful and resilient.  Our bodies continuously regenerate new cells that replace those old cells that help us to heal internally and externally.  Although the scar remains and the memory exists, the pain and past does not have to control our present or our future.

I share my story to let you now that the road is never easy.  We all go through somethings as we walk through this life’s journey but through it all you have to remain steadfast and unmovable because YOU WIN when you don’t give up.  I won. She, Me, Her WON. Get help. Start to heal.  Be blessed.  Be you. Do you. Live in your truth. Tell your story.  On your own terms.

 

https://www.youtube.com/watch?v=F7syiF3Qim4