, 62 tweets, 9 min read Read on Twitter
CW: suicide

Tomorrow is #BellLetsTalk Day, but I've got a bit of time so I'm going to share my story now.

Last week, a colleague phoned 911 because I disclosed that I was struggling with suicidal ideation. This is not a safe or helpful action for marginalized folks in crisis.
After I posted on Facebook about what had happened, a friend reached out and asked what you *should* do if you know someone in crisis, if not phone 911?

So let's break this down a bit.
What happened to me last week highlighted the fact that there's a mismatch between how people living on the margins of society experience civil authorities, versus how people living more normative lives experience them.
For the latter, the authorities are friends who are there to help and support. For the former, they are dangerous, abusive and sometimes deadly.
On Monday, I accessed crisis housing through my region's mental health service, and ultimately had to return home that night because they were unable to allow me to take my medications as I need to in order to control my chronic illnesses.
CW: emeto

There are a couple of reasons for this: one of the medications is an herb that I take to control my narcolepsy, because it contains a natural analogue of the narcolepsy drug pitolisant, which is not currently approved for use in Canada.
According to the crisis centre, they cannot permit anyone to take medication in any way that deviates from the instructions on the packaging.
This also meant that I would not be able to take my cetirizine at the correct dose, because over-the-counter packaging for cetirizine says it should be taken at a 10mg dose. I take it at a 40mg dose.
I could receive a prescription for it - but the Ontario Drug Benefit does not cover it, and I have been denied Exceptional Access "because it's available over the counter". So I buy it "over the counter" from Amazon, at a twentieth of what it would cost me to have my Rx filled.
So because of the limitations of our healthcare system, and the decisions I have had to make in order to provide my own care, last Monday I was left with the decision of whether to protect my mental or my physical health.
Not being able to take my medications would have caused a severe exacerbation of my physical symptoms and was therefore not an option for me.
For 26 years, I have been falling through the many cracks of our healthcare system and I continue to do so.
Last week, it became tangibly clear to me in a way that I've previously only understood abstractly, that our mental health systems, and particularly our crisis systems, are not set up to be accessible to people with complex health needs...
...,nor are they used to dealing with people who have the ability to advocate strongly for themselves.
When I called the crisis centre on Tuesday at the suggestion of the woman who had done my intake, to see if any accommodations could be arranged, the person who was on duty told me that I was wrong...
..., refused to check my record or to give any further information to me, told me I was being argumentative when I continued to reiterate that I was simply following the instructions of I had been given, and hung up on me when I asked for her name for my own records.
My mental health crisis was precipitated by the fact that I live in an inaccessible and abusive situation that I cannot get away from because the priority housing waitlist in this region is 3 years...
...and the portable housing benefit program only covers up to 80% of average market rate, which is not a realistic amount when you have accessibility needs.
So back to calling 911.

On Tuesday morning, I woke up late because I'd gone to bed with a terrible migraine after not being allowed to take my afternoon meds at the crisis centre (they needed to inventory everything first, which took five hours).
I was making coffee in the kitchen wearing only my nightgown when someone began hammering on our front door. My mother answered it and an armed police officer walked into our house.
Now, as a disability justice activist whose friends and colleagues have experienced serious violence at the hands of the police, this was not a person I was interested in engaging with.
He was shortly followed into the house by his partner and two paramedics, none of whom asked permission to enter, and whom I had even less interest in dealing with, given the violence I have directly experienced from them.
I told them I would not be speaking with them, and went upstairs to contact my friends on Facebook for help because I wasn't sure if I was about to be forcibly institutionalized against my will.
They initially told me that someone had reported a comment I had made on Facebook, and insisted on my showing them what I had posted on Facebook.
I refused on the grounds that it was a violation of my civil liberties, that they had no need for me to show it to them because presumably they were here because someone had already shown or quoted it to them, and that if they had seen it, they had no reason...
...to fear for my imminent safety and therefore no legal right to take me because I had specifically stated I was actively seeking help.
The first police officer insisted that they needed me to show them the post or they would be obliged to forcibly take me away.
Some time later, the officer's partner returned and clarified that they had actually been alerted to an email, at which point I reiterated that my email had specifically mentioned that I was actively seeking help...
...and was therefore not in what would legally be considered imminent danger. The second officer confirmed that this was correct.
This interaction went well, despite the fact that I raised my voice and swore at the officers and paramedics, because I am white, verbally articulate and appear middle-class.
CW: police violence

Interactions that began very similarly have resulted of the deaths or extended forced institutionalization of disabled people of colour, including in this country.

thestar.com/news/canada/20…
I am acutely aware that I am alive and physically safe right now because of my white privilege.
From the perspective of the person who phoned 911 after I disclosed what I was experiencing, they were doing the right thing because they were preventing me from dying.
From my perspective, I ended up in a position where I was confronted in my home by uniformed police officers wearing guns, and by paramedics, from whom I have experienced sexual harrassment...
...and who joked over me a year ago as they misdiagnosed a protracted anaphylaxis as a "meth overdose".
Because I refused to comply with the authorities' wishes to see my private Facebook posts or to disclose detailed information about my life and health to them, they threatened to forcibly take me to a psych ward.
Again, I'd just arrived home after leaving a crisis bed situation because that facility would not permit me to take my meds as needed, presenting me with the option of sacrificing my physical safety in order to access mental health care.
On Tuesday morning, I was suddenly in a position where I now had to choose between disclosing private information I had no interest in disclosing, to authorities I don't trust, or having them forcibly take me to another medical institution...
...where I would almost certainly have incomplete access to my needed medications, this time without any power to remove myself from the situation.
[Intermission - the dog needs a pee break]
There's also the fact that my mental health problems are down to my very literally being trapped in an abusive and inaccessible living situation, and once again being in a position of needing to fight for access to healthcare for someone...
...after barely finishing with my own battle with the healthcare system (and only finishing that battle because I was able to begin effectively treating myself without any help from the system.)
What I need is not mental health intervention for myself.

I need affordable, accessible housing, full stop.
I have experienced intolerable side effects from every antidepressant I have tried (and I've tried a lot of them). Sedating psychiatric meds are a sure way to trigger my sleep disorder, especially if I weren't allowed to take my regular meds as I need to.
CW: suicide

So while phoning 911 may have seemed like the most straightforward solution to the problem of me wanting to die...it really wasn't.
CW: suicide

Because I didn't and don't want to die, I'm just really damn tired of living this way.
And being forcibly hospitalized for a short-term involuntary hold wouldn't solve any of the problems that are causing me to feel that.
It would almost certainly just make things worse because on top of all of it, I'd also be dealing with new medical trauma, and an exacerbation of my physical illnesses due to the broad inaccessibility of psych facilities.
CW: suicidality

I think we need a shift in how we think of suicidality, to realize that sometimes it's a rational response to really untenable living conditions.
.@PhilosophyTube has a very tough, but excellent, video on this topic, which is worth watching if you can manage it:

So of course the question becomes, what do you do when someone you know is considering suicide?

Honestly, just ask them.
Some people may find a wellness check from the authorities helpful depending on their circumstances.

But for a lot of people calling the authorities literally puts them at risk of violence and death - especially if they are nonwhite, nonspeaking, trans, homeless, etc.
Asking is the only way to know whether it will be helpful or not.

I would also suggest asking more generally things like, "what kind of help do you need?" and "do you need someone to talk to?"
And - this is key - if they don't respond, then accept that.
Recognize that maybe you're not the person who is best positioned to help them and...accept that.
If you're not in intimate enough contact with them to know what will help them, and for them to feel safe responding to you when they're in crisis, then accept that maybe it's not your place to step in at this point.
When I'm in crisis, I often don't have the energy to talk to anyone other than a couple of my best friends who are unequivocally 'safe people' for me.

So just because I don't respond doesn't mean I'm not actively trying to keep myself safe.
Sometimes, limiting my interactions is a necessary part of keeping myself safe, because as an Autistic person I experience sensory and social overload and I don't know what expectations people who are not very close to me may bring into our conversation.
And more often than not, it is only the people who are closest to me who know what I need, and when I am at a point where I am struggling that badly, I don't have the damn energy to expend on educating more people about my needs.
CW: suicide

And as morbid as it sounds, if isomeone can't offer me any help that's relevant to my situation, I'd prefer they respect my autonomy enough to let me decide whether I want to keep living.
CW: suicide

Because to me, forcing someone to stay alive, while not doing anything to address the actual reasons they are considering dying, isn't a matter of care at all. It's a matter of control.

/fin
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