I’m not sure what the difference is, but I must say that since November, there has been a dramatic increase in emotionally disturbed persons (EDP’s) in my work. I mean, I have always dealt with EDP’s in my job, responding to many calls of persons in emotional distress, wanting to commit suicide or maybe self-harm, or those that are so crazy out-of-their-mind on drugs. But something has shifted, drastically, since November.
The EDP’s I have been dealing with are those in complete psychosis, requiring our intervention for their own and public safety. I have been astonished at how many more people seem to be in this state. It might be they have been pushed north from the city center. Or perhaps it is the number of rooming houses in larger homes offering affordable housing north of York Mills. But what I really suspect is that somewhere within our city and the system, beds have been closed. Quietly, without much notice, mandated by one of our governing authorities, and we are now seeing the repercussions of this out in the street. And in our emergency hospital rooms. Last week, on a Monday evening, I had never seen so many people at the hospital, and there was a wait list of 17 people to see the crisis team or a psychiatrist. And it was still only 7:00 pm!
I’ve meet them all, in different levels of functioning and consciousness. There are those that require intervention because of drugs. Some are completely hostile, unco-operative and are jumping through glass windows and not even slowing down. They spit, bite and yell as they are held down and restrained long enough to have a paramedic shoot some sedative into their arm, just so we can transport them to the hospital where they will detox. Then there are the ones, the tweakers, who are very hyperactive and restless. They just can’t stop moving and are usually only semi-aware of their surroundings. They usually just need a safe place to come down and get some much needed sleep and nourishment. Sometimes persons on drugs are argumentative and belligerent to deal with and they can be dangerous in their volatility. They usually have a few choice words for me, ultimately telling me how to get lost. But there are also those that rush at the scout, screaming and begging for help as they try and climb into the back seat. Their skin is on fire and their heart is pounding. They are usually in a drug induced psychotic state, but they are also in a life and death struggle and they are responding to this unknowingly. It is called Excited Delirium brought on by the combination of severe mental health issues and drugs, and their heart is about to burst. They run at you, desperate for the needed help. We have to get them to stop moving.
The drug induced EDP intervention is usually a run-of-the-mill type of call that we get quite often, usually daily. There are those too, diagnosed with anxiety, depression, post-traumatic disorder, or a personality disorder, who are being medicated and treated, but are suffering a mental health crisis on this day and they feel like harming themselves or others. These are the majority of the EDP’s we see on a day-to-day basis. And they all come from different walks of life. Some were born to drug users; others grew up in loving homes. Some come from poverty, while others come from wealth. The one common thread is how isolated and alone, not all, but most become. Unable to have steady jobs or relationships, often the family became distant years beforehand, after maybe the tenth hospitalization. Or perhaps the EDP person became hostile and suspicious of family members and has cut them off. It is not always true for every EDP, but it is often the case. There are those of course that have family involvement and support. However, the vast majority, having been in and out of hospitals for years, are isolated and alone.
What has changed since November, besides the sheer numbers of person in distress and requiring intervention where I work, are the number of those that are truly in a psychotic state. These are people who are experiencing delusions, hearing voices, and are paranoid and suspicious of those around them. They are usually the ones making the call, sometimes recognizing they need help while other times it’s to report being followed or some such imagining. What strikes me though is that each person in these states, thus far, has been obsessed with religion, good and evil, and God. I mentioned it to the MCIT Officer (Mobile Crisis Intervention Team) about this phenomenon. She said she noticed this as well but had no explanation for it.
A young male, lying on the platform next to a stopped subway train says “Don’t you recognize me?” very loudly and in a deep voice. Then, “I know you know who I am.” I am attending a jumper call at the subway, and besides a couple broken ribs at this point, it appears he has successfully survived jumping in front of a train. “I am God’s son Jesus. That’s why I survived being run over by a train.”
A male sitting in front of a gas station was waiting for us. He was concerned about George Bush and that the President blamed him for the Sept 11 attacks. He wanted police help before he took a 9mm gun he had purchased and shots the gas station attendant where he was waiting. When we pull up he does not have a gun but he is highly agitated. He grew up in Haiti and is consumed with the religion of voodoo where he says they make sacrifices including cutting peoples head’s off as a sacrifice. I was little taken aback given his background, when in the ambulance he turned to me and said “I am God.” Boom! There it was.
They want to discuss their beliefs with you, ad nauseum. They are trying to work out their thoughts and feelings while looking at the world around them, trying to make sense of it all. They are infinitely easier to be with than with those that scream and yell at you. They are definitely more entertaining and interesting and the time spent is generally gentler, if not a little more exhausting at times. But there is a real sadness and empathy I feel as I sit at the hospital with these persons. They are usually alone in the world, often living in shelters. And their treatment is only somewhat successful, as they will often find themselves back in this state, again and again, throughout their life time. The drug users, once detoxed, are returned to normalcy. The higher functioning EDP, once receiving some crisis intervention, is usually able to get back on track with the added support. But for these psychotic souls, once released, they become a resident of our shelters and often taking their drugs regularly becomes a problem.
These are our vulnerable persons. All of them. Our EDP’s, the majority of my work. The system has failed them. There are not enough beds for long term care, hospital beds are quietly closing, mental health resources are all about brief solution therapy which is crisis intervention for 6-10 weeks. But for some souls, more is required and they are suffering these cutbacks. Again, I don’t know what has changed since November, but the system is bursting at the seams. I’ll bet more beds have closed.
I’m going to finish this off with a little story about Johnny, whom I spent about five hours with one night at the hospital. He is one of those characters that I will never forget. He called us, concerned about the way he was thinking and feeling and concerned if he didn’t get help he’d need to kill himself. He was a young fellow living in the shelter system. I noticed the tips of his right hand where quite raw with cuts and bleeding. I asked him about this, expecting he’d tell me he cuts the tips of his fingers. However, he told me he plays guitar and that he is the best guitar player, even better then the greatest in the world – Jimmy Hendrix. He was obsessed with playing the guitar and even while he didn’t have one with him, he spent his time strumming out tunes while he talked to me. Then it was there. Boom! “You know I am God.” Yep, he was just like all the others, consumed with the idea that they are God. But he further clarified for me “I know there are people who suffer from mental illness out there and they believe they are God. But they are not. I am the true God.” Johnny was truly a creative soul and he seemed to have one leg in reality and the other in psychosis. When he said that, he made me smile amongst the sadness of it all, and he indelibly etched his memory in my mind. I won’t forget that I met the true God that night. I sure hope the system doesn’t let him down this time!