How to Fix a Broken Mental-Health System.

Though set in an American context, How to Fix a Broken Mental-Health System does have parallels to Canada, and I'm sure many parts of the West. The piece speaks to laws enacted to get the mentally ill out of institutions with deplorable living conditions and into community-based centres.

The law was built around a two-step process—release and catch, as it were. De-institutionalize the mentally ill in these deplorable institutions, and then get them into the system of community health centres. But there was no step two. More than half of the proposed community health centres were never built.

In a Canadian context, similar policies were put in place. In a Quebec/Montreal context it's been said that CLSC's (our local health clinics), are meant to pick up the slack. My local clinic said there was a 3-year waiting list to see a psychologist, and closer to a 5 + year wait if I wanted one who spoke English. Hence my decades worth of travel and high-cost to access English services.

The read is interesting, especially if you're American. There is so much work to do be done.

Hells bells (palsy).

Well, what the fuck. If this my life?

I woke up yesterday with a numb mouth. I thought I slept on my face weird, and went back to bed. When I woke up I had lost all control of the right side of my face. If I try and sip water, it falls out of the right side of my mouth. I tried to eat toast and couldn't properly bite into it, or taste it. My right eye doesn't close. And when I smile, only half of my face moves.

I called Info Santé (which is a free health-care question line, answered by registered nurses) and the nurse asked me some questions and had me test some other muscle functioning. I could grip my hands, and the paralysis seemed to only be of the face, but the nurse recommended I go to the closest emergency room.

Initially, I was worried about a stroke, I was worried about being permanently "disfigured," I was worried about not being able to drink coffee in coffee shops, bite into a tomato sandwich or you know, smile ever again. I have this lopsided smile that seems sarcastic and shitty at best.

So we headed to the ER, where I went through triage and was coded as a Priority 3. I ended up getting in there at about 4:00 pm, I saw a nurse, did some muscle tests,  an EKG and a blood pressure test. Turns out, I didn't have to take a blood test because 24 hours earlier (more on that later) I had been to my local CLSC (a community-based health centre) for another medical test, so they happened to have those blood samples on-site. I was given a bracelet and a wait number. After that, it was a long wait. I was re-evaluated once, to see if my stats changed, and then continued to wait.

I saw a doctor around midnight. She did further tests. She said it seemed to be Bell's palsy. She said in most cases it resolves itself within a month or two. It can go away in as little as a week. She also said it can be permanent (like with Jean Chretien) and there can be long-lasting after affects, that maybe only I would notice. And so I left there around 1 in the morning shaken and exhausted.

Today, I've been resting and just kind of a mess. I've texted some friends, since yesterday the only people who knew I was in the ER were my mother, brother and my friend S. I texted her then called her once I was through the triage process. Her mother is actually partially paralysed due to a malpractice at her birth (the woman birthing her wanted to wait for the doctor so she "pushed her back in" and broke her fucking neck).

I explained what was going on with my face, and said it was great to have this happen right before my work review - which is this week. I'll be eye-patched and slurring, so here's to hoping that plays in my favour for getting a fucking living wage.

I don't look forward to going to work on Monday. I'll need to wear my eye patch and explain to my boss and co-workers what's going on. What a shit show.

Not even two months ago it was vertigo! Now it's fucking Bell's palsy! What the goddamn fuck! Before that it was my mom's global amnesia! All of this in the last 4 months!

Is this what happens once you hit your 30's?

The last time I went to see Dr. Rishi, I mentioned this bump I have at the top of my shoulders at the base of my neck. It's known as a buffalo hump. He said it's in line with something called Cushing's syndrome, which I then looked up, and for which I have 90% of the symptoms. It's eery. Down to the big'ol moon face.

So, he had given me a prescription to go for a blood test, and do a 24-hour urine cortisol test. So, Thursday of this week I got up earlier and went in for the blood test and got the giant pee-pee jug. No joke. Giant.

So, before I could even complete those tests I got Bell's. The thing is, Cushing's deals with cortisol levels, and the test I was suppose to do does as well. So I guess I have to wait to be off the cortisol to then test my cortisol levels.

I left a message with Dr. Rishi, it's easter weekend, so he'll be back in on Tuesday. I said I had been in the ER and that I was diagnosed with Bell's palsy, and that I had questions about my urine test and stuff. Hopefully he'll call me quick on Tuesday.

I would hate for the cortisol derivative I'm taking to fuck with me even more if I do in fact have Cushing's.

Part of me was hopeful the urine/cortisol testing would bring back the Cushing's diagnosis so I can at least feel justified in my having lived with, and experienced these symptoms for real. At least I'd have an answer. Maybe I could look into treatment.

Well, there's a reason I haven't written much about it or mentioned it to most of my friends, I'm afraid of being too hopeful. I don't want to set myself up for disappointment.

All of this has been side-tracked of course, by my facial paralysis.

I face-timed with my brother, which was a great distraction.

Happily I got more supportive messages from my friends.

A couple of friends in particular were kind of on-the-nose about how I was feeling. Really in the "what the fuck" "are you fucking for real" vein. I guess having them reflect that back to me was nice, like, it's not just me, it's been a rough 4 months.

Feeling vindicated in how you feel is a comfort.

I'm lucky, I have some good friends.

It's taken me most of the day to just work around to sitting down and writing. Yesterday was rough. Today I have good moments and bad moments. I'm mainly with my mother, and she was with me since the hospital so there's no discovery of it for her. But going out, and not being able to smile at people, and being impaired in my speech is hard. 

It's still early days, so those around me are pushing that it's likely temporary. I hope it is. When I think about never being able to smile again, it's a lot. 

One day at a fucking time. 

The Dr. Scavenger Hunt.

Yesterday was an interesting day. After the Doctor-debacle of 2015, I finally went out to Montreal-West to see Dr. Rishi. First, I don’t go West, so bus'n along Monkland was nice, it’s a really nice area. It’s all brownstones and anglos, it’s like being in another world.

I took the afternoon off of work, since my appointment was at 1:45 and google estimated about an hour for me to get there. I waited nearly an hour past my appointment time, but any annoyance washed away when Dr. Rishi saw me and said hello. He’s so jovial.

Any-who. . . The appointment went well. He informed me of his plans, he’ll be starting his own family practice with 4 other doctors, and it’ll be located in Westmount. This’ll be convenient for me since I can walk over when it’s nice (still about a 30 minute walk) and I can take the subway if I’m pressed for time. Either way it’s accessible from work.

I ended up talking with Dr. Rishi for over an hour. We talked about my depression, and we made a plan. We’re trying stronger meds, and he’s booked a phone consult for me and a nurse who might be able to get me some free therapy. I don’t think it’ll happen, since it’s a CLSC that’s outside of my service zone, but he’s going to try and make it happen. Side-note: The CLSC is called Benny Farm, which is insane sounding to me. It makes me think of Benny Hill (an observation Dr. Rishi actually got, and we laughed about) and also a farm where maybe Ben Affleck goes to get away from it all.

Meanwhile, I contacted the Argyle and I would be charged 50$ an hour for therapy there. So that’s an option too. I'm going to check it out.

You know, I'm kind of surprised by how much better I felt after seeing Dr. Rishi. There’s a French expression that says someone feels prise en charge which means, when literally translated being taken into someone's charge (like back-in-the-day English where a charge was a kid you took care of). Although it probably comes from this type of history, today we usually use it in a positive context, it means being handled, and you or a situation being taken care of. 

Well, I never feel that way, so yesterday was an odd sensation for me. He said his priority is my depression right now, and then we'll go into overall health. We also talked about what the St-Mary's Doctors thought about me, and he said they felt I could totally handle myself and that I seemed mildly to mid-level depressed. 

This irritated me, and I explained how I feel my verbosity and funny-nature (and big fat round face/head) often masks the intensity of my depression. My being able to talk circles around what I'm feeling often leads me to talking myself away from how dark my thoughts can be. My funny, absurd nature can also just detract from what I'm feeling and just leave people with a different impression of me than what might be needed for me to be read as "seriously depressed." He got that. 

I mean, the guy makes me sound like a dullard. He's well spoken, clear, and very quick. He's super charming, so he was able to understand that aspect of representation versus internalization. 

I also mentioned that other than "suicidal ideation" there is very little follow-up for mental health. Planning a suicide, an actively pursuing your death is a crisis. But, wishing you were dead all the time is a slow painful way to be. 

I have to go out and get my new meds, and then Dr. Rishi wants to see me in a few weeks. Once I talk to the nurse he referred me to, and I have a few weeks of meds in me. 

Overall I'm happy that . . .

1. I found him (I didn't hallucinate getting a GP).
2. He is still practising and wanted me as a client / I can follow him.
3. My first impression of him was correct, he's kind, funny, warm and I can really talk to him he also seems to like me, which is nice. I like when people like me. 

I feel hopeful, which is so god-damn rare I can't even.

CLSC help-line: a line to nowhere.

I received a letter in the mail from my local CLSC regarding my request for a family doctor. They said I was already registered to Dr. Rishi (the doctor who went missing) so I was denied. They then say if I have any questions to call them.

I called them. It’s one of those automated phone systems that just hangs up on you.

Legit. Press 1, or it hangs up on you. Listen to a short explanatory message, it hangs up on you. What you’re calling for isn’t listed? It hangs up on you.

I was hung up on 4 times. I got no information. I wasn't able to speak to anyone.

Adding to this hot-mess of medical legitimacy was the fact they they gave Dr. Rishi’s cell phone number. So I called him. This is how that went:

Dr. R: Hello?

K: Hello, this is weird. I’m sorry to be calling you but the CLSC gave me your phone number because I tried to sign up for a medicare doctor and they said I can’t because I’m attributed to you.

Dr. R: I’m sorry there’s been a lot of change with my work situation, but I can definitely help you either sign back up for medicare or you can follow me to my new practice.

K: When I called Curel-Med they were super sketchy about your whereabouts. One day you said to call you back. I called you back and you didn’t work there anymore.

Dr R: Who is this?

K: It’s Kristin (last name omitted).

Dr. R: Oh hi Kristin! I have your medical report from the hospital!

K: I know. I know you do. That’s why I’ve been trying to reach you.

Basically he left the practice at Curel-Med because of a bunch of administrative errors on their part, and he’s starting a smaller clinic near Concordia’s Layola campus. He apologized for the hot-mess, and said they were supposed to mail out letters to his clients, but didn’t (no doubt an example of their shittyness). He said he was on vacation until the new clinic opened. So I apologized for bothering him, and I’ll be able to see him in a few weeks. In theory.

The adventure continues!

CLSC: "Nope."

I just got off the phone with the CLSC - another discouraging interaction with the mental health system.

Turns out they can’t really help me since they only offer short-term help and not long-term follow-up. So, they referred me to four places, UQAM’s mental health clinic (run by students. I called, they’re waiting list is full), a clinic that offers sliding-scale services (I called and left a message) and two women’s shelters.

Being referred to a women’s shelter makes me angry. I feel as though those are clearly emergency services that I’d rather not impede. Those services aren't for me. I have a roof over my head and a job, and I'm not in a dangerous relationship.

Of course, the CLSC representative ended the call as all other mental health services seem to, “I'm sorry I couldn't help you more, good luck, and if your situation changes please call us back.” What this means of course is if I'm actively suicidal I can call back and then they’ll (potentially) sort me out.

So unless I want to kill myself live, on the phone - they don’t have shit for me.

Psychosociales.

First of all, as an Anglophone reading a French title I’d like to acknowledge that the clinic title sounds like “Psycho Socials” which rings like some type of débutante ball, but with less dancing and more internal-struggling. What it is actually is a program title within Quebec’s local clinics. It’s basically an intake service for psychological and social services.

I attended one yesterday, in order to potentially access sliding scale services locally.

It went alright. Though at this point I've answered the same series of questions a dozen times over the last two years attempting to access the golden ticket of mental health care. It’s redundant and demoralizing. Let me tell you the my story, so it can be filled away somewhere...

The nurse, Emilie, was kind and young. She was the only nurse who spoke any English. She struggled. I switched to French occasionally, but she never switched out of English, which I appreciated.

So, after an hour of questioning, I'm on a 9-month waiting list for therapy services. Of course, this could go longer since I requested someone who speaks English. I expect to be on some fictional waiting list, tantamount to having written a letter to Santa. My name is somewhere - but really who gives a shit.

My visit to the CLSC is a direct result to the 3 references given to me by the doctor’s at St-Mary’s:

First, I was referred to Suzanne Marcotte (514-369-9193). I'm not sure why. She’s French and Charges 100$ for 50 minutes. This didn't seem to align with my language preference or my budget constraints, so she referred me to L’Ordre des Psychologues du Quebec. I called and left two messages and never heard back.

Second, the Montreal Therapy Centre (514-244-1290) here sessions are 80$ a session and they’re located in NDG.

Lastly, CLSC Psychosocial Intake, where it wasn't easy pressing for English services, and where I met Emilie last night. Basically I'm on a waiting list (I'm still on a waiting list for a family doctor by the way, it’s only been a decade) and if I want to kill myself I should call them and give them a heads up.

Faith in the system: little to nil.