Imagine this… You have been struggling with symptoms of depression. Getting out of bed each morning has become sheer torture, you fantasize about suicide on a regular basis and believe wholeheartedly there is no way you can go on another day. Six weeks ago you completely broke down and made an appointment with a psychiatrist and finally the day has arrived for you to get the help you desperately seek and deserve.
Your anxiety is at an all time high because you fear sharing all your dark and scary thoughts and feelings with a complete stranger, you are aware of the stigma associated with seeing a psychiatrist and you constantly second guess your decision to keep the appointment because depression has convinced you it is all pointless anyway. But as you pull into the parking lot you are able to force yourself to take a deep breath and cling to the hope that this is a step in the right direction.
As you head toward the entrance, which is tucked neatly around the side of the building, you can literally feel your heart pounding in your throat so you take one more cleansing breath, close your eyes and offer up a prayer for courage before you finally take that step through the door. What awaits you on the other side completely catches you off guard. You are thrust into a dark and crowded waiting area with no empty seats. In fact, people are leaning up against the wall as they wait restlessly for a chance to sit. As the door closes behind you, you realize everyone is now staring at you as you make your way over to the receptionist who then hands you a giant stack of paperwork through the protective glass. Fortunately there is a sympathetic woman who offers her seat to you, but you still bump elbows with the person next to you when you write. You feel claustrophobic and overwhelmed by the amount of people surrounding you. As you attempt to honestly answer questions about how often you think about killing yourself panic threatens to swallow you whole because the reality of where you are has set in and at least for the moment it is anything but comforting.
Perhaps it may seem overly dramatic, but unfortunately this is exactly how my first visit to a psychiatrist went down. What really fired me up though to share this is that I have been to many other mental health offices over the past ten years and the visits really never got any better. It always amazed me how stressed out I would get on my way to these appointments because of the chaos that would be awaiting me. I used to just blame myself and chalk it up to me being crazy but unfortunately it seems to be a trend that I am not ok with.
Try to picture the following places I have frequented over the years.
Doctor #2: The office was once again at the very back end of an office building that definitely needed some TLC. This waiting area was a slight upgrade from the first place though because there was a tv in the corner that provided somewhat of a distraction and the seats afforded a bit of personal space. However there were a few occasions when I found myself there standing in the middle of the hallway after an appointment waiting to check out, eyes swollen and red from crying and pleading with my doctor, barely able to keep it together, praying desperately for them to hurry up and let me pay so I didn’t have to stand there in front of everyone humiliated.
Another office I visited was literally around the back of a building which was creepy to begin with but nothing compared to what was on the other side of the door. A dimly lit room, dark bare walls, a single chair next to an end table, an open door that led to a bathroom and two closed doors on either side. No receptionist, signs or instructions. I tried one of the mystery doors and found myself staring into what seemed to be the furnace or mechanical room. I had just about made up my mind to leave when the final door swung open and out came an older man who without even a hint of friendliness introduced himself to me as the doctor. I fought the urge to run, rushed through this appointment with my eyes on the door the entire time and never went back.
Yet another place was decorated with white and beige stained walls, water stains scattered throughout the ceiling tiles, fluorescent lights littered with dead flies, black plastic chairs, dirty tiled floors that were covered with stickiness and a small tv on an old shelf that replayed the same 3 pharmaceutical commercials over and over. Not a speck of color or inspiration to be found.
I think my current doctor’s office takes the prize though for worst environment. I had my routine appointment this morning and as I sat in one of the mismatched, beat up plastic chairs awaiting my turn I took out my notebook and started to write down my observations. The walls were coated in old, gray paint and were completely bare except for a sheet of paper hung by the receptionist that declared, “NO CURSING! NO YELLING!” In the corner hung a tiny tv, there was a magazine rack with only a third of it occupied by old, shabby magazines. The floor tiles had buckled in several places while dirt lined the corners and space against the walls. I honestly don’t think the floors had ever been swept. Part of the wall behind me was painted a promising yellow, but the cracks, chips and dents in the wall removed any semblance of cheer. The door leading into the back where the doctors’ offices are housed a giant keypad where everyone who entered had to punch in a code that would beep and click relentlessly. The hallways were dark and very institutionalized. On a beat up shelf in the corner of the room there were pamphlets from pharmaceutical companies and two or three toys that realistically belonged in the garbage.
My point in sharing all of these descriptions is that I find it unacceptable that over the past ten years I have not set foot in a psychiatrist’s office that was welcoming, comforting or that at least made an attempt to make me feel valued as a person and a patient. And unfortunately, at least where I live, with the waiting list for appointments typically 6 weeks to 6 months long, I can’t be picky. I even thought maybe it was just representative of all doctor’s offices in my area but when I looked at all of the physicians my family and I visit – dentist, orthodontist, pediatricians, orthopedists, eye doctor, ob/gyn and yes, even my dog’s veterinarian – not a single one of them were as cold, uninviting and depressing as any of these psychiatric offices.
Why is that?
As a provider wouldn’t you want your patient who struggles with severe anxiety and paranoia to find comfort in coming to see you? I’ve been in these offices as a person struggling from: shame and anxiety that comes with an eating disorder, restlessness and agitation during mania, hopelessness of depression and fear that accompanies all of these. I have also been there in a completely healthy state of mind as I was this day I decided to take notes.
You would think a specialist would be aware of how a person’s environment can positively or negatively affect them, especially in times of crisis. Wouldn’t a clean floor, walls freshly painted in a soothing color, comfortable chairs that matched and something positive on the walls be an easy way to provide a speck of comfort in an otherwise very uncomfortable situation? Or at the very least give me the impression when I am there seeking help that I matter?
Why is it that my vet’s office seems to have put forth more effort, time and energy into making my dog feel at ease than any of my doctors have over the past ten years?
It’s probably a safe bet that most of us dread any doctor’s appointment and perhaps don’t even think much of the waiting area unless it obviously adds to our discomfort. And maybe I’m more sensitive to it because of my overly sensitive emotional states when I’m there. But either way, shouldn’t my doctor take the effort to do things that would put my mind at ease?
I found myself getting very irritated by all of this as I sat there today and my mood definitely took a turn for the worse. Talk about counter productive! But then I forced myself to take notice of the people who were around me and wondered if they ever felt the same or if I was just too picky and negative? What about … The woman in the corner still in her pajama pants, sweatshirt inside out and backwards, talking to herself. The older man in front of me who kept checking his watch and tapping his feet incessantly. The woman who went to get a magazine and got frustrated when there was nothing to read. The man two seats from me who was in desperate need of a change of clothes. The middle aged woman in the corner, curled up in her chair reading a book. The obviously exhausted mother trying unsuccessfully to get her toddler to stop crying and sit down. Did any of them notice or care? Or was it just par for the course and they were too consumed with whatever brought them there in the first place?
I couldn’t get the thought that these people, including myself, deserved better conditions than this. I kept wondering if part of the reason I’ve encountered these types of environments is because too often people with mental health issues, especially ones that result in behaviors that can be unacceptable, are written off and considered to be “less than” everyone else. I hear it in the words people use to describe the mentally ill. I witness it when people react to a behavior that is a direct result of someone’s intense emotional pain. I clearly see it when I read about the history of mental health treatment in this country and when I’ve personally been on the receiving end of insults and poor treatment simply because I was a “mental health patient.” I’ve experienced mental abuse and narrowly escaped physical assault several times while on psych wards. The list could go on…
Not all places are like this and yes we have come a long way from the days of lobotomy. But there is still so much more work to do. I can’t help but think that it’s not a coincidence or that I’m just unlucky in choosing doctor’s offices for my mental health, but rather a sign of how much we still lack in compassion when caring for each other’s mental health. We need to show people that they continue to possess dignity during their crises and that they are worth the extra coat of pretty paint on the walls or a comfortable chair to wait in when they are in distress. They need to feel loved and cared for and not like just another number walking through the clinic to pick up meds and be back on the street. Trust me, it takes courage to seek help for mental illness so when someone finally takes that first step toward healing the least we can do is try to make the process as painless and dignified as possible. No matter how outrageous a behavior or helpless a person may seem let us never get to the point where we draw the line and deem someone not worthy of the energy it takes to clean the floor or paint the walls. We can and we must do better.