When I was first admitted to the psychiatric ward, I anticipated being bombarded by invasive daily assessments and the distressing wails of neighbouring patients. My expectations were entirely based on films like Girl, Interrupted. I thought I would meet the “regulars,” caricatures of every condition listed in the DSM-V, and we would partake in communal lunches on grey plastic trays. I harboured delusions of befriending my psychiatrist, who would be enamoured by the juxtaposition of my quick wit and bleak nihilism. I convinced myself that a multidisciplinary team of nurses, a psychiatrist, a therapist, and a social worker would meet me and, within seconds, know just the right regimen to reassemble my shattered psyche.

Besides the buzzing of harsh artificial lights and the squeaking of non-slip socks on vinyl floors, it was eerily silent when I arrived on the ward. I peeked around the few rooms and saw very few patients and even fewer nurses.

“It’s the long weekend,” my assigned nurse said, shrugging.

I patiently waited for an in-depth psychiatric evaluation — something to explain why my mind incessantly catalogued creative ways I could hurt myself, why crisis-line conversations only exacerbated the thoughts. Because of pandemic-related safety measures, I was not permitted visitors. Given my form-one status (involuntary hospitalization due to self-harm), I was not allowed to leave, even for a supervised 5 minutes of fresh air. I encountered a total of 4 people during my stay.

Nevertheless, I tried to stay positive. The ward had a few silver linings, like floor-to-ceiling windows, which allowed me to enjoy the city’s Victoria Day fireworks, and high-speed Wi-Fi, which enabled me to message friends, peruse social media, and play trivial mobile games. It also had some incredibly perceptive nurses. On only the second day of my stay, one nurse noticed I had exhausted the hospital’s amenities for youth — I had sifted through all the shows the TV room had to offer, coloured in every available Crayola sheet.

When I was granted access to a short-wire charger for my phone — the nurse citing my docile and cheerful behaviour as the reason — I soaked up the praise like the first drop of rainfall in a year-long drought. A few hours later, I could feel the nurse’s stare from the doorway, equal parts hesitant and amused. Perhaps it was the strange sight of me, barely 20 years old, hospital gown at least two sizes too big, sitting cross-legged on the floor and eagerly recording my review of my “bougie” three-course dinner on my smartphone. Or perhaps he could sense what lay underneath my desperate attempts to stay preoccupied: the fear, the isolation, the loneliness. I wondered if he felt empathy or pity when he looked at me.

I am often told, both by people within the mental health system and those served by it, that hospitals are not meant to provide long-term resources and care; they aim only to keep you safe. But when I was an inpatient, struggling with severe suicidality and an undiagnosed mood and anxiety disorder, confinement to a near-empty psychiatric ward did little to help. Admittedly, I could not act on the thoughts, and perhaps that was as good as being safe in clinical terms, but I never felt safe.

I was not seen by a psychiatrist until the fourth day of my stay; I was discharged that same day. During her visit, the psychiatrist asked only two things.

“Do you still want to kill yourself?”

The weight of the question startled me. I looked her in the eye, attempting not to wince at the bluntness. I wondered whether she would know, or care, if I lied through my teeth. If I said yes, how many more days would I be kept here, “safe” but otherwise helpless?

I responded with conviction. “No. I would like to try to help myself.”

It was mostly the truth.

She hmmmed. Right answer. I let out a sigh of relief as she glanced back at her clipboard.

“I see that you are a postsecondary student. Are you familiar with your university’s student health services?”

“I have heard of them.”

Within a matter of minutes, the psychiatrist was gone. I was signing forms I did not have the energy to read. My mind was racing at the absurdity of the whole situation — was that really it? Was that the only help the hospital could offer me? Four days of closely monitored solitude, 15 minutes with a psychiatrist, and a referral to my own university?

I looked up from the administrative papers at a support worker, eyes pleading for some kind of clarity.

“Now what? How do I help myself?”

Her gaze met mine; once again I could not discern whether she felt empathy or pity. “Contact your university,” she said.

And that is exactly what I did. At first, it was the miracle I had long awaited. The university designated a case manager to help connect me with professionals at the student health clinic, bypassing any existing waitlists for support. I began attending sessions with a mental health counsellor twice a week, engaging in talk therapy to cope with my recurring mood swings and anxiety attacks. Simultaneously, I began working with a psychiatrist, who provided an official diagnosis and a prescription for mood-regulating medications. An academic counsellor was also in the picture, registering me for accessibility services and corresponding directly with my instructors to establish accommodations for my disability. For the first time in a long time, I let myself hope again. The colour was back in my cheeks, the pep had returned to my steps. Finally, I had the resources to truly help myself.

But in the span of just 3 weeks, the support system that had been tightly assembled around me began to loosen. My case manager was the first to go; she was reassigned the moment I was no longer experiencing active suicidal thoughts. My psychiatrist, who was perhaps one of three serving the entire institution, became increasingly unavailable. This made follow-up appointments virtually impossible as I cycled through various medications. My mental health counsellor stopped seeing me after six sessions; apparently the university provided only short-term support, after which it was the student’s responsibility to find a suitable private therapist. When I began looking for one, I quickly realized that my student insurance would cover no more than five sessions a year — less than once every two months. With blind optimism, I convinced myself it was better than nothing but continued desperately to seek alternatives.

I reached out to two different student support groups — no response. I contacted a women’s shelter about counselling services — I was told I would not qualify unless I was experiencing domestic violence. I realized I was losing a marathon I didn’t sign up for. With nowhere else to go, I put myself on the waitlist for every publicly funded cognitive behavioural therapy program in the city, telling myself a few months was not that long to live without help.

It was.

The next few times I was admitted to the hospital, my expectations were not cinematic. I knew I wouldn’t get the help I needed, enclosed within eggshell-white walls. I knew my visits may do more mental harm than good.

But I also recognized it was the first step in being taken seriously. That by procuring those initial referrals, I might have another chance at finding the depth of care I really needed. Too often, mental illness is treated like an acute cold instead of the chronic condition it is. If I had to crawl back on all fours, coughing up blood at automated sliding doors to earn the perfunctory attention of a psychiatrist that could potentially change my life, I would do it in a heartbeat.

That didn’t stop me from harbouring different hopes though. I hoped one day I wouldn’t have to stand at the edge of a cliff to be heard. I hoped I would never have to claw my way back, lest I slipped through the cracks again, joining the ranks of other twenty-somethings whose stab wounds were treated with band-aids instead of stitches. I hoped I would never become a regular at a place that made me restless at its very mention. And I hoped someone would look at me, genuinely see me, and I would need no more than a second to gauge that it was with empathy and not pity.

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