Mental Illness Has a Face

What I learned while visiting a mental health facility.
Mental Illness Has a Face

The large door labeled "Mental Health" stood at the end of the hallway. Maybe it really was ominous, or maybe it was just my imagination, but I took a deep breath before pressing the black button beside the door, fully aware that a camera was trained on my face and that someone—somewhere—would be scrutinizing me.

"Yes?" a woman's voice emerged from a speaker beside the door.

"Yeah, I'm here to see Paige" (names have been changed). I tried to sound confident, as if I'd done this a million times—or at least once—before. "I'm, uh, her campus minister."

I heard a buzz as the outer door unlocked. Cautiously, I pulled the door open and stepped inside.

I'd been a campus minister for roughly seven months. The previous summer I'd sat in a classroom taking notes during the Coalition for Christian Outreach (CCO) New Staff Training. As extensive as those weeks of training had been, they hadn't quite prepared me for this. Not for official visits to a mental health facility. Not for Paige.

After being admitted through both sets of locked doors, what I found inside was … exactly what I expected. This mental health unit (the first I'd ever entered) looked just like every facility I'd seen portrayed in a movie or TV show: white walls, blank faces, a patient sitting alone and murmuring (and occasionally weeping), people walking laps in the hallway, pills dispensed in little cups by a nurse behind a counter, group therapy sessions, and a noticeable absence of belts and shoelaces.

I signed in at the counter where the pills were dispensed, but I had to wait for a few moments before I could see Paige. As I loitered by the counter, trying to pretend like I belonged, one of the patients—a middle-aged woman—approached me from behind. "Are you the pastor?"

Campus minister? Yes. Pastor? No, not really. But that's not what I said. Before I knew it, I was saying, "Um, yeah. That's me." (I suppose this is what I get for parking in one of the two spaces reserved for "Clergy Parking.")

"Will you pray for me?"

"Um, sure."

She bowed her head.

"But, uh, what's your name?"

"Dorothy." She bowed her head again, expectantly.

I didn't ask Dorothy how to pray for her. Maybe I should have. But then again, when someone is a patient in a mental health facility, the answer to that question might be somewhat obvious.

So I bowed my head and asked God to give Dorothy peace, and I prayed that she would know how much God loves her. I concluded with a tentative "Amen." She thanked me, and then she wandered off. (I would visit Paige regularly for the next week, but Dorothy and I never spoke again.)

Paige had emerged in the hallway during my prayer session with Dorothy, but she hadn't wanted to interrupt. After Dorothy left, Paige gave me a hug. Hugs became a regular thing during that week. We usually hugged when I got there, and we always hugged before I left. For almost 30 years, I'd never been the kind of guy who initiated hugs. But that's one of the ways I changed during that week. Because I think she needed the hugs.

And I know I did.

My relationship with Paige dated back roughly six months—when she was, in fact, one of the first college students I met on campus. One morning she plopped down near me in the student center, and, after answering a couple of my questions, she launched into her faith journey—which had been derailed somewhat abruptly when she walked away from God the previous spring. She was very aware of her lack of faith—or at least her lack of answers—and that was one of the most beautiful things about her: that she wasn't content with this uncertainty. From the day I met her, Paige was relentlessly diligent in her pursuit of answers.

Pretty soon, she and I were talking regularly. She helped me start a small group that met weekly to explore who Jesus is and what that means for us today. She and I started meeting one on one regularly too. Pretty soon she was texting me things she was noticing in the Bible, or questions she didn't want to forget before our next meeting.

In short, Paige was the committed, hungry college student that every campus minister hopes to find when they first step on campus. By the end of that fall semester, by the grace of God, she was different. She recognized that if Jesus is truly who the Bible says he is, then there's no choice for us to become anything other than a "sold-out, crazy person" for Christ. (This was the first but certainly not the last time I heard Paige talk about being a "crazy person.")

And it was beautiful to see how God was transforming Paige into that sold-out, crazy person. She was witnessing to friends. She bought a Bible to give to a friend back home. And she also decided she wanted to be baptized in the spring as a public expression of her faith.

When the spring semester started, Paige hardly resembled that girl who, just months before, hadn't understood why Jesus was relevant. And I was fortunate enough to be her mentor, advisor, confidante, and even her friend. As the weeks passed, I learned more and more about her past—about her distant and somewhat dysfunctional relationship with her parents, her destructive experiences with guys, her history with drugs and partying, the years she spent cutting, and her tendency to be ridiculously hard on herself.

Weeks after the start of the spring semester, Paige was still reeling from the devastating news that a relative had sexually abused her sister—in addition to all the other issues from her past that she was still trying to process. And she confided in me that her urge to cut herself was strong—that she had been resisting it, but it kept resurfacing. She said it felt like an ocean that kept assaulting her with wave after wave. We talked about it, prayed about it, talked more, prayed more, and I thought she had found some freedom from that temptation—that she was committed to letting God stand in front of her to hold the waves back.

But at midnight that night, after a stream of confusing and scary texts and a phone call from her best friend, Paige and this friend showed up at our house. As soon as she walked in our door—hidden in a hooded sweatshirt and hunched over—it was clear that all of Paige's fight and resolve were gone. She had cut herself (not severely enough to require medical attention) and yet the urge hadn't gone away. It had actually gotten stronger. And she was shaken, sobbing, and desperate.

I had no answers to offer. Her friend and I sat with her. We prayed. We talked. We watched a funny movie. They made grilled cheese sandwiches. Then we talked more. And then we prayed again. Sometime after 5 a.m., we all went to bed.

The next day, they both skipped classes. I canceled meetings. She talked to her counselor on the phone, but she didn't want to leave the safety of our house quite yet. In the course of just a few days, these two girls became little sisters to my wife and me. They ate meals with us, they crashed on our sectional sofa, and we stayed up late praying together every night. Paige's urges to hurt herself weren't going away, but she was resisting them. And we were all committed to keeping an eye on her and bathing her in persistent prayer. And through all of this, I kept assuring her that it would get easier. It had to, right? (But what did I know?)

It wasn't easy for her, but she made it through spring break without hurting herself. When she came back to campus she stayed with us a few nights a week (as a way of rewarding herself for being strong and staying on campus most nights, and for resisting the urge to cut herself). Overall, things seemed to be improving.

Then, during a conversation I'll never forget, as Paige and I sat outside the student center one afternoon, she told me that she couldn't live like this for the rest of her life. She had started having thoughts of dying. She didn't really have a plan (or even a desire) to kill herself, but she fantasized about being dead—about not having to deal with the stresses and complications of life any longer.

That was when I called counseling services (the CCO had definitely trained me for this scenario). The following day, Paige met with her counselor again. And after their meeting, they decided to take her to the hospital. She called me in tears and asked me to bring some of her things to the ER.

I ended up sitting with her in the ER for six hours—watching some show about tattoos on the little TV above the door in her room and asking her questions like, "So, what's your favorite candy bar?" After a while she said, "Tell me I'm not overreacting." (At this point she thought she still had the freedom to leave the ER if she wanted to, although I'm not sure she did.)

"You're doing the right thing," I assured her.

Finally, the ambulance arrived to take her to a mental health facility in another hospital. I offered repeatedly—practically insisting—to drive her, but the nurses wouldn't let me. We said our goodbyes as they strapped her onto the stretcher she didn't need, and I promised to visit her as soon as I could.

During my visits, Paige and I would sit in the courtyard (even though it was often far too cold), because she wanted the fresh air. Plus, in the courtyard, if she got the sudden urge to dance, she could get away with it (sometimes) without the nurses accusing her of causing "too much stimulation." In mental health facilities, apparently, energy and emotions are dangerously contagious.

During these visits, Paige and I talked about both the meaningful and the mundane. And often our conversations were interrupted by other patients. Cathy, a delusional schizophrenic who was being subjected to electroshock therapy and who seemed to be half-fried most of the time, developed a real attachment to Paige. And someday when Cathy gets elected president, she plans to appoint Paige to be her secretary of state or something important like that. I, on the other hand, am slated to be one of her boring, run-of-the-mill cabinet members.

On nice days, the patients could write on the concrete walls of the courtyard with sidewalk chalk. I sat on the ground and watched while Paige drew designs and wrote in large letters: "God is good. Always."

God is good. Always. I believe that to be true, but if I had been the patient, I'm not sure I would have been able to declare it with the same confidence Paige possessed. But it was clear that Paige had a peace and a hope that seemed almost foreign in that place. So maybe it's not surprising that later that week Cathy got her own sidewalk chalk and wrote: "Heaven = Paige."

And it wasn't just Cathy. Everyone in that place loved Paige. By the second day, she and three other women had already started joking about eating their meals together at the "bi-polar table." (Paige had been diagnosed as bi-polar almost immediately.) Everybody in that place who was sane enough, and not too drugged, to have a sense of humor seemed to enjoy making jokes about being crazy. I wasn't allowed to join in, Paige informed me. Only the patients could call one another crazy. But I didn't like those jokes, anyway. Not when they referred to Paige. Because I didn't want Paige to believe she was crazy. After all, she couldn't be crazy. I mean, how could she? I knew this girl …

On the third or fourth day of Paige's stay, I finally got to sit down with her social worker. After going over Paige's past and hearing the social worker's impressions of Paige's family, I finally said what I'd been thinking from the moment I first stepped through those two sets of locked doors: "Paige is different from these other people, right?"

"What do you mean?"

"I mean, she knows what's going on in her mind. She knows what she's dealing with. She's probably the most self-aware student I know."

"Yes, she's very intelligent."

"Yeah, but … ," I couldn't find a delicate way to say it, so I finally just let it out, "but she's not crazy. You know? She's not like these other people."

I could tell that the social worker was reluctant to agree with me. "Everyone who comes in here is different. They struggle with different things, and no two patients are exactly the same. But no one is here who doesn't need to be here."

I wanted to immediately write off this social worker's professional opinion. Sure, she might have years of experience, but she didn't know Paige. Not like I did.

I realize now that I was simply struggling to reconcile my impression of mental health facilities with the reality that someone I cared about—someone incredibly intelligent and wonderful—needed to be there. After all, I had convinced myself that it was her rough past which was to blame—that it was the abuses, the drugs, the sudden death of a friend, and parents who didn't know how to love her the way they should that prompted all of this. But again, what did I know?

Maybe I wanted reassurance that Paige wouldn't have to deal with this for the rest of her life. Unlike some of the other patients, who came in and out of the facility somewhat regularly, I wanted to hear that Paige would never need this again. I wanted to believe that, because Paige was a Christian, this was just part of God's healing process for her—but with the right combination of prayer, discipline, and medicine (if necessary), she'd walk out those two sets of locked doors and never look back.

Maybe I didn't like hearing that she doesn't really have that assurance.

But who among us does, really? After all, the social worker also told me that one of the women in that facility had been a nurse in a psychiatric ward before she had a breakdown of her own. So if even those who are trained to treat the "crazy" people aren't exempt, then maybe we're all only one circumstance or a couple chemicals away from becoming "crazy" too. That's not the comforting conclusion I had hoped to attain.

After a week, armed with a couple prescriptions and helpful suggestions for anticipating and avoiding "triggers," Paige was released. I picked her up and watched as she said goodbye to the other patients and nurses. And it was clear that they were all sad to see her go. Cathy even wrote her address down and gave it to Paige, making her promise not to let anyone else see it.

That night Paige and her best friend crashed at our place again. And the following night, five of us went to the movies together. It wasn't a seamless transition back to life outside the mental health unit, but it wasn't too bad either. My wife and I were both thrilled to have our "little sister" taking up space on our couch again—back home, safe and sound.

A little over a month later, Paige got baptized on Sunday morning. Her family and friends (Christians and non-Christians) showed up to support her. Just before she was baptized, Paige stood up and shared her testimony:

"Jesus means more to me than a guy who lived and died 2,000 years ago. He is more than a friend. He is the one and only God who saved my life. I walked away from him a year ago. I called him a liar and I didn't want anything to do with him. But that's impossible. He is everything. When I prayed to God, a God who I saw separate from Jesus, I too felt separate. I was not made right before God. Jesus is my atonement. He's my Savior. He saved me from my broken heart, broken by drugs and drinking—a heart that needed healing after I was raped. But he also saved me from myself. Every time I hurt myself, he hurt too. He gave up his life to make mine new, and it is. My life is new."

By the time she was finished, tears were flowing freely in that room. It was powerful. And although we wouldn't know it until later, one of Paige's friends was paying extra close attention. That friend, Lori, also had a history of self-harm. And just as Cathy had seen a glimmer of hope in Paige ("Heaven = Paige"), Lori saw potential for healing that she hadn't found anywhere else.

Days after Paige's baptism, Lori shared with Paige that she had been hurting herself and she couldn't stop.

"I know exactly where we can go," Paige said. And then she called me to make sure it was okay to bring Lori to our house.

That first night, the three of us sat on our patio and I listened to Lori's story. I hardly knew her, so I didn't know what to say, but Paige didn't hesitate. And as I sat there listening, I had to conceal my smile. Because I heard Paige saying the same things I told her two months before—about God feeling our pain with us. And now, not only did she believe those things to be true, but she was trying to extend that same healing to others.

For the next week, Paige and Lori crashed on our couch every night. As Lori's struggles continued—and her inability to sleep worsened—eventually her counselor suggested that she go to a mental health facility. Not only did Lori get taken to the same facility where Paige had been, but they even put her in the exact same room.

That facility doesn't allow previous patients to visit until three months after their release, but they made an exception for Paige. And she and I went to visit Lori together. I doubt those nurses—who remembered Paige and me both—have ever seen a clearer representation of the healing God can do in our hearts and minds than they did when Paige returned to walk laps in those hallways and play cards with her friend only one month removed from her own stay in that facility. I tried to be there for Lori, too, but throughout her time there—and in the weeks following her release—I couldn't help praising God for the work he had done and was doing in Paige's life. And I continually thanked him for letting me be present to witness it—even though it meant wandering into the unfamiliar and intimidating territory of a mental health facility.

I don't think I'm the only one who longs to have answers. As leaders, sometimes we're expected to know what to say and what to do. Throughout Paige's struggle, I wanted to be able to assure her that it was going to get better and easier; I wanted to believe that, if we prayed about it enough, it would be so. I wanted to believe that God was going to hear our prayers and answer them—in the exact way we wanted him to.

It wasn't until after I visited Paige for the first time in that mental health facility that I realized just how powerless I am, just how much I truly need to put my trust in God. Because there really wasn't much else I could do for my "little sister." And really, no matter what the situation is, there's never anything more important we can do for those we love than to be present and prayerful.

But that's good news, actually. Because it means we don't have to have all the answers. We just need to remember that God is at work. And his plan is better than ours. Sure, at times God's plan might be more tumultuous than we would like, but it's also more beautiful than we could ever imagine. Because God is good. Always.

A "crazy" girl in a mental health facility taught me that.

Tyler Charles is a freelance writer and a campus minister with the CCO at Ohio Wesleyan University.

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