After years of battling depression, anxiety, and chronic pain, my younger son, Alan Ross Jacobs, died on Jan. 10, 2015, from an accidental overdose of prescription drugs.
Three months later, I attempted suicide by overdosing on pills and alcohol in the hopes that I could be with Alan again. As a result of my failed suicide attempt, New York State incarcerated me in a mental institution.
For 21 days, I was confined in an environment that was degrading, stultifying, and downright depressing.It’s six years since my discharge from the hospital, and I have not made another attempt on my life. Sadly, Emily — a very beautiful young woman I met in the hospital — took her life a year after her discharge. She was one of 130 suicides that occur each day. Emily was only 40 years old.
Why were our outcomes so different?
At least part of the reason can be found in what psychologists refer to as “self-determination theory.”
According to this theory, people’s need for competence, connection and autonomy must be fulfilled if they are to grow and change. These three needs were utterly unmet in the psychiatric hospital.
First and perhaps foremost, institutionalization stripped us of autonomy. In the hospital, our every move was dictated by the staff — when and where we slept and ate, the clothes we wore, the toiletries we used, the books we read, even whether we could open a window.
In addition to taking away our autonomy, hospital policies suggested that we were not competent to make any decisions for ourselves.
If we sought explanations — particularly explanations about the drugs we were given — we were told that non-compliance would lead to increased time in the hospital. Emily already had feelings of incompetence.
During her early school years, she had struggled to succeed because of dyslexia. That early struggle had left her feeling inept.
On the other hand, I’d had a good deal of academic and professional success throughout my life which gave me a strong sense of my own competence even while the hospital made me feel as if I was incapable of taking care of myself.
Furthermore, my hospitalization can be seen as resulting from a loss of connection. My younger son’s fatal accidental overdose had left me reeling from the loss of a vital connection.
I was fortunate that my feelings of connection to my family increased during my hospitalization. My son flew up from Atlanta and visited every day. My sister, niece, nephew and boyfriend called constantly.
Emily didn’t have a sense of connection to her family. She was divorced, and her husband was in jail. Her parents were also divorced and lived far away as did her brother. They never visited and rarely called.
Emily expressed to me her fear of being alone when she returned home. In the hospital, we were surrounded by people and noise but many patients go home to a silent, empty house.
Discharged patients are, in a sense, “set adrift” and lose the sense of “connectedness.” Sometimes the patient interprets the return of emotional distress even after being treated in a hospital as a sign that there is no help to be had, no hope for recovery or improvement. At least in my case, my older son was going to stay with me for a few days after my discharge.
No wonder many mental health professionals today are calling for treatment that prioritizes autonomy, empowerment and respect for the person receiving services.
To help patients find a way to go on living, therapeutic approaches must give patients a sense of their value by giving them respect and treating them with dignity. Hospitals must also give the patients some autonomy so that they learn to deal with living on their own.
It’s time for hospitals to turn to a new way of preventing repeat suicide attempts.
You can read more about my experiences in “Broken: How the Broken Mental Health System Leads to Broken Lives and Broken Hearts” available on Amazon.