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Dear Emergency Room: People With Mental Illnesses Are Real Patients, Too

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Editor’s note: The following is based on an individual’s experience, and does not reflect every emergency room or every emergency room staff member. But, according to the National Alliance on Mental Illness, two out of five people going to the emergency room for a psychiatric emergency rated their experience as “Bad” or “Very Bad” — and we believe this is an issue that needs to be addressed.

Dear Emergency Room:

I am writing to inform you that people with mental illnesses are tired and angry. We are tired of entering your doors with urgent needs only to be often passed off as faking, attention-seeking or nuisances. We are tired of your changed attitude toward us once our chart arrives. In that instant, we experience a shift from real patient to “borderline,” “schizoid,” or depressed malingerer, with all the negative, stigmatizing attitudes and beliefs which accompany such labels.

We are tired, ER. We are tired of the disdainful whispers outside our cubicles. We are tired of the sometimes suspicious nature of your questioning. We are tired of the knowing glances and rolling eyes. Do you think we cannot feel this callousness? But that’s the intention, isn’t it? Maybe you think treating us this way will deter us from coming again.

You’re right. It has. It does. Are you OK with that? How many overdoses, drunken accidents or suicides would have been avoided if you’d treated us with compassion rather than disdain? Of course, we’ll never know the answer to that. But we can tell you, ER, our suffering is sometimes increased, not decreased, once we exit your doors.

ER, you may think this is not true, that we are treated differently, but I can tell you from multiple experiences, it is true. From the moment our past medical history is viewed, we are treated very differently.

The other day a woman approached me, “You know,” she said, “I haven’t always had a mental illness, but because of my physical disability, I’ve been to the ER a lot.” She continued, “After I was diagnosed with depression I got treated totally differently in the ER, even though I was there for my physical disability! Can you believe that?” I could only nod, ER. I’ve experienced the same thing.

I think the problem is likely worse than to which this woman attests. I’m willing to bet those of us with mental illness — and other invisible illnesses — are not only treated more rudely — yes, in some cases, we’ve been treated downright rudely. I’m willing to bet we also have fewer face-to-face provider minutes, receive fewer diagnostic tests, have positive diagnostic tests read as negative more frequently and get discharged without so much as an aspirin far more often than those without a mental illness diagnosis. Has anyone ever looked into that, ER? Maybe I’m wrong. I’d be happy to be proven so. Unfortunately, ER, experience tells me I am all too correct.

We know we’ve been dismissed. You know we’ve been dismissed. But if we spoke up while we were visiting, it only reinforced your negative beliefs, ER. If we questioned, complained or simply asked for that which we needed, and felt we weren’t receiving, it only fueled your disdain and suspicion — further proof we were not real but rather nuisance patients. The word seemed to go out, “See, I told you so,” and our experiences only worsened.

It’s frustrating, ER, to be treated with stigma and stereotype by an institution which is supposed to assist us. When we come to you we need help, urgent help. Our needs are no different than your patients with diabetes or heart disease. Yet we are treated differently, less urgently, less objectively and far too often less compassionately.

What can we do about this, ER? We need to change this situation. It doesn’t do any good to bring experiences to light if no discussion ensues. Perhaps some staff education would help. Perhaps some real-life stories from those of us with mental illness, those of us who want this situation reversed for the better of all. We can listen to you. You can listen to us. Wherever, whenever you wish to meet, ER, I’ll be there. I’ll bring others for an open, respectful dialogue. I pray for all who’ve yet to grace your doors, ER, we can affect change. Please consider our offer.

The Mighty is asking the following: Write a letter to anyone you wish had a better understanding of your experience with disability, disease or mental illness. Check out our Submit a Story page for more about our submission guidelines.

Originally published: June 11, 2016
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