I was at the hospital the other day. Across from the main emergency triage desk there's a lone chair that sits facing a podium where a hospital security guard is usually posted. I don't know what the official designation of that chair is, but I refer to it as the "MHA seat;" MHA an acronym for "Mental Hygiene Arrest." We love acronyms.
The MHA seat is where we usually leave patients who have been brought in for being a "danger to themselves or others." Generally these are people who have just about given up on life and don't feel as if they can go on. Sometimes they cry, sometimes they yell, sometimes they sit silently--sometimes full of thought...sometimes thoughtless. The majority of those who occupy this seat have tried, in some way, to put an end to their own lives. Usually the ones that make it to this seat are the ones who just want someone to talk to...someone who will listen to them--the ones who still have a little hope. The ones who have truly given up never make it to this seat.
What disturbs me is not the fact that so many people feel that their problems in life are such that they would be better off not living at all, but that so many of the individuals who occupy the MHA seat on a daily basis are children. I must have walked past that seat a dozen or so times the other day, and each and every time it was occupied by a different child. The last one I remember was a girl, no more than 12 years old, who was sitting quietly. Her voice may have been silent, but in her eyes there was rage. She didn't need to say a word.
I'm not sure if children today face more serious stresses in life or if it has simply become fashionable to talk about committing suicide. Whatever the reason, it seems that more and more children are ending up in the MHA seat and they are coming in younger and younger. The other day on the radio I heard the dispatch go out for a suicidal eight-year-old.
As an EMT I usually have only about 20 minutes of contact with each patient. They bend my ear for a few minutes en route to the hospital and then that's the last I'll probably ever hear of them. Still, there's a lot you can learn about a person in 20 minutes—even if it doesn’t make you an expert on their life. More often than not, it seems that a suicide threat or attempt is merely a means of attracting attention. Usually these children feel as if they are overlooked every day, that they don't stand out or--if they do--for the wrong reasons.
A good number of these patients have legitimate problems and will truly benefit from the assistance that they are about to receive, while a good number of these patients are simply master manipulators of their parents, their peers, and the system. For many, this is a means of gaining attention—of having all eyes focused on them for a while.
Unfortunately, most of the patients who truly need help will never receive the proper support. Most will get thrown on a cocktail of psychological medication and be declared cured. Aside from the number of pediatric MHA’s that I transport on a given week, the number of pediatrics whom I treat for medical reasons and who happen to be on at least one psychological medication (usually for depression) is mind-blowing. Can there really be so many psychologically disturbed children? If so, what is wrong with our society that is thrusting such adult problems onto children as young as eight years old?
The other day I overheard my partner saying to an MHA patient: "suicide is a permanent solution to a temporary problem." Nothing could be further from the truth.
Still, when I go back to work tomorrow afternoon, there will be another little girl sitting in that lonely seat across from the security podium with fire in her eyes and a bottle of pills in her hand. I will have brought her there.
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