Lost in the Gap

Joshua R. Beharry

Reprinted from "System Navigation" issue of Visions Journal, 2014, 10 (1), pp. 12-14

In the fall of 2009, I became severely depressed. When I finally reached out for help, I thought I’d come to a turning point. I didn’t realize getting treatment and navigating our mental health care system would be just as hard as the struggle to ask for help.

At first, since I was a student at UBC, I tried to get help through student services. I saw a doctor at Student Health Services in mid October, and was told to make an appointment with Counselling Services. Appointments there were hard to get. I had to skip classes to make an emergency appointment, going to the office early and staying until I finally got to see someone.

I saw that “someone,” a psychologist, just once. He helped calm my stress and anxiety, but couldn’t see me more than a couple of times, weeks apart. There weren’t resources for long-term (or even short-term) treatment, and getting an emergency drop-in session was very stressful.

I gave up trying to get help at the university. It would’ve been helpful if the doctor at Student Health had told me what level of support I could expect at Counselling Services. It certainly wasn’t the start I expected after finally confronting my stress and emotions and reaching out for help.

I also thought about seeing a private psychologist, but my student health plan wouldn’t cover more than a couple of sessions and I needed more support than that. Trying to find a psychologist or psychiatrist (I didn’t really know the difference) was like drawing names out of a hat. I couldn’t find information about individual practitioners and what they specialized in.

After my initial experiences with the student health and counselling services, I made an appointment to see my family doctor. After speaking with her about my stress and sadness, I was diagnosed with depression, at the age of 22.

After a couple of weeks, which seemed endless at the time, my family doctor got me a psychiatric consult at the Vancouver General Hospital (VGH) outpatient psychiatric clinic. My family doctor was a great advocate, calling repeatedly to get me on a standby list in case earlier appointments opened up.

When I saw the consulting psychiatrist, and the psychiatric resident I started seeing at the outpatient clinic, I didn’t admit how hopeless I was and avoided answering painful questions. I’d never talked about the things that were bothering me, and to share them with a stranger was an unfamiliar process.

I was relieved to get more routine help, but after a month or so of weekly meetings with the resident, I realized our sessions were ending. I didn’t know why at the time, but basically, my resident’s placement was over.

I was doing slightly better, though my mood was still very low. It was hard to tell, because I was so stressed about school and my career path, about hiding what was happening from my friends, and whether or not I’d ever recover.

Around this time, I also attended a cognitive-behavioural therapy (CBT) course suggested by my resident. The CBT course ran weekly, for eight to 10 weeks. It helped me understand just how warped and distorted my thinking had become—I was consumed with worries and thought only in absolutes. But I really needed more individual care, as I had many longstanding issues.

The resident also told me about a drop-in rapid-access counselling group, where I could see a mental health worker in a group setting. It sounded like something I was being referred to for lack of better supports, though, and I didn’t try it out.

Through the resident, my family doctor and the CBT course, I did learn more about depression and what I was going through. The process was much slower than I’d hoped for though, as every day was difficult to get through.

I started seeing a counsellor at SAFER (Suicide Attempt Follow-up Education and Research), a suicide prevention centre that my resident referred me to before our sessions ended. My counsellor at SAFER didn’t seem to have a good grasp of what I was going through, and there wasn’t the same personal connection as with my family doctor and resident. I kept going, for a few weeks, hoping this would help me get better. But I didn’t really trust him or value his advice, so wasn’t forthcoming about the things I worried about most.

Meanwhile, at school, I’d hoped to receive advice and help managing my courses through UBC and the Faculty of Science advising centre. I didn’t receive any help. Instead, I had to get a note from my doctor, which I did, and then scramble to negotiate extensions for coursework with each of my professors. I ended up dropping one of my four courses, but my remaining professors gave me extensions. One went out of her way to express sympathy for what I was going through, which meant a lot to me.

In December 2009—while I was still doing the CBT course and seeing the counsellor at SAFER—I went to emergency at VGH to see about being admitted to a psychiatric ward. I was having suicidal thoughts and was afraid of what I might do to hurt myself.

At VGH I was seen by an emergency room doctor and a psychiatric nurse. I found out I’d only be admitted to the hospital as a last resort—I’d have to have a specific plan to kill myself already in place. I was sent home, and left thinking that a hospital wasn’t a place to get better.

A few weeks later, I formed a plan to end my life. I didn’t go back to VGH to seek help—instead, I attempted to take my life by jumping off the Oak Street Bridge.

I was incredibly lucky to survive the fall. I had texted my brother just before, counting on his usually poor phone service to ensure he wouldn’t see it right away. Fortunately, he did and stepped into action to get help. I was taken by ambulance to VGH, where I stayed for a week. I had six broken ribs and five hairline fractures in my vertebrae. Luckily, I didn’t have any spinal cord damage.

I’m not sure what the best care option for me would have been, but again I was sent home without being admitted for psychiatric treatment.

Recovery from my physical injuries took many months, and I ended up dropping all my classes in the January 2010 semester.

Recovery from my mental illness has taken years. I’m still not consistently at the place I want to be, though I’m doing infinitely better than in the weeks and months surrounding my suicide attempt.

End of summer 2010, my family doctor was able to find a psychiatrist who could see me on a long-term basis. I began taking university courses again in fall 2010. It’s now four years later, and through talk therapy, CBT, mindfulness practice, medication, and overall improvements in my sleep, exercise and eating habits, I’m doing much better.

Trying to get well has been a confusing process. I was met with a disjointed system. Each time I met with someone at another service, I had to once again explain what was going wrong. No one told me the extent of, or limits to, the supports I was receiving until much later in the process. It all eventually led me to recovery, but only after a tremendous amount of luck gave me a second chance.

 
About the author

Josh is 27 years old and lives in Vancouver, BC. He is currently working on a Movember-funded project to create a men’s depression help website. He enjoys hockey, photography, sci-fi and hiking. Visit Josh’s website Mental Health Point of View (mhpov.com) to learn more. 

Close