This is the first in a series of stories about how big policies affect real people, and how we get it wrong, and how the people most affected would choose to shape that policy to improve it. I promised those who had already shared a story with me that I’d go first, so they could see me be just as vulnerable and scared as they are to talk about how the system we’ve created to help people often hurts them in unexpected ways.
Mostly, these stories are about how good intentions in policy spaces that are led by people who have never lived through the experiences in question can lead to terrible outcomes.
- The policy aim: to help kids access free mental health services through schools.
- The method: School counselors refer parents and kids to a children’s mental hospital for federally provided services so that they are free to kids in need.
- The problem: Federally provided services are free — which is great. The mental hospital requires that as soon as you walk in the door, they take away your ability to leave, which is not.
- The policy is intended to allow enforcement of committing individuals who are in crisis, but often winds up trapping kids and parents in a sudden cycle of mental health services that far exceed what they actually need — which is a stipend for counseling services for their children, or for someone to finally make it free on all health insurance.
- Mostly, this happens to poor people who don’t have insurance, or whose marketplace insurance is so blindingly expensive that they know their $18K deductible won’t help, or that they don’t have coverage.
- The outcome: If you’re a parent, and you’ve been firebombed with the call from the school that your child has cuts on their arms from a self-harm incident, when the school counselor hands you a piece of paper with a phone number on it and says ‘this is where you go for help,’ you don’t ask questions. You just show up, hoping to get a therapist that day, for her, and hoping one day you’ll make it far enough up the ladder to get one for you.
- The situation: This one happened to me personally, as a low-class striver aiming for a middle-class life, with a kid and a semblance of a career, in a cheap but not poor part of town apartment, in a middle school that could be any suburb in America. It happens to hundreds of families every year.
- What I’d change: At best, that we find a different way of providing mental health resources to kids that doesn’t involve sending them to mental hospitals. At a middle ground, understanding that what a lot of these kids need isn’t locking up, but love and care and attention and feeding. At worst, that school counselors realize what they’re doing and take the time to prepare a list that includes both that option (the one that feels nuclear) and a list of therapists who work with teens and nonprofits in the area who help provide payment for services.
fresh cuts | an essay
My daughter and I stepped into a room today not knowing we’d never be the same.
The door clanged shut and locked behind us, our first clue and one we didn’t catch. The quiet-voiced secretary took my name and we sat together under the TV in hard cheap plastic chairs. It only took a few minutes to realize we were no longer innocents, in this particular universe. At the moment, there are three other girls in the waiting room with us, and as the hours pass there will be a rotating selection of damaged girls.
These first girls all share double-wrist bandages that were once white and now are spattered with old brown blood and they all wear paper gowns over leggings and socks. One girl, small, with brown skin and almond eyes, talks about how the preppy kids are not really that bad, not really. A quiet redhead agrees with everything anyone says, even when they’re contradicting one another, and the loud brunette girl with the eyeliner and the blood soaking through her paper neckline talks endlessly about her brother, who has her cell phone.
Where’s god in this world of broken girls in paper clothes and socks?
About an hour later, a silent cop brings in a tall thin girl; she’d been picked up by the wrong county and taken halfway home before he was told he didn’t have jurisdiction to take her back, so she got to turn around and drive back to sit in this room and wait for the correct sheriff’s deputy to arrive. The secretary apologizes quietly to the policeman and he looks bored and keeps his hand on his gun and the girl lets out an almost inaudible sigh of relief as she carefully places her clear bag of shampoo and underwear on the floor at her feet. For the next two hours she moves only to subconsciously jitter one leg up and down, without stopping.
That child looked like the world soaked straight through her white clear skin, so thin I could see her heartbeat through her bones. She never met anyone’s eyes and she never said a word. Later, I’d see that my daughter had drawn her, captured just her outline and her thousand-yard stare in quick brutal pencil strokes.
The other girls raise their cracking voices higher to be heard over their own chatter in this silent echoing room. Their eyes are defiant and their mouths are vulnerable and they compare scars and cop cars and cafeteria food in different wings and stepdads and schools. They’re brazen, unfazed.
Once in a while, they go silent one after the other, accidentally sucked into this Disney show playing above my head like the children that they truly are. The show is about some preteen having misadventures that always result in a lesson and a laugh track, insult adding to injury.
It seems that here in this particular universe these conversations — the babble and silence of the girls and the short quiet sentences of the secretaries and nurses and cops — are normal. But for my daughter and for me it is an entirely new experience to sit on a hard chair bolted to the floor in a 10 x 10 waiting room unable to leave. I cannot take her to the restroom with me when I ask, and I must wait to have the door unlocked. (I have to ask to have the door unlocked, and I am a good grownup. I usually ignore the ‘bad’ grownups that I don’t hang out with any more, but this is a stark reminder that they are still out there unable to heal their own traumas and consequently continuing to ruin people.)
The only thing to read is the poster warning us about what we can’t bring in — including pocketknives, cell phones, and shoes with laces, all of which I have. The highlight of the hours is seeing the janitor come in and pick up a paper bag I thought someone left accidentally by the desk, and slowly realizing he is replacing it because we can’t have trash cans in here, the same way we can’t have shoes or chairs that can be thrown.
This will prove to be the longest day of my life, longer than childhood, longer than childbirth, longer than marriage and death. When I woke up I was stressed about work, rushing through the morning to get her to school on time (day two, seventh grade), finishing up the laundry from the camp she attended the week before, throwing on some comfy dress clothes, charging my laptop, prepping for a meeting, drinking coffee and packing lunches and remembering to bring my water bottle.
Less than an hour later on a Tuesday morning I am hands shaking on the steering wheel and not being able to find the flashers in my new car when I cut off that guy making a completely illegal turn on some road I don’t even remember and screaming at the google lady to find the fastest route to middle school and it’s not her fault she can’t understand me through the sobs and holy fuck, fuck, fuck echoing over and over in my brain.
We sit in that waiting room for four and a half hours before someone calls my name.
There’s a fourteen-year-old girl sitting in this room with us, talking a mile a minute and bleeding through that paper shirt for two and a half hours, and we are talking about the paperwork and sorting out the fact that although I am poor enough to not have insurance I am most assuredly not here to commit this child who is my heart to the care of these questionably competent professionals who, to be fair, probably see more shit in a day than I’ll see in a lifetime. I explain over and over that we are only asking for a referral to a therapist, that I thought I was doing the right thing by going to the place where the counselor said they could help me.
Turns out, I have to take my child back through that door that clangs shut but never opens again for any of those girls, the ones we built stories for in our heads in the waiting room, the ones who go in and never come back out. That’s the rule, says the nurse we finally see, after five hours of waiting. If you show up here, obviously this child is a danger to themselves, obviously we will need to examine her to be sure she is safe.
It is only when they say we can keep her if we choose to now, because you have walked through that door that I begin to crack under the weight of it all, begin to realize how wrong this day has gone, how wrong this moment is. She looks at me with her heart in her eyes and cannot even speak to ask if I am leaving her here, for a moment of weakness in the maelstrom of her twelve-year-old hormones, and it is only many days later that I will think that perhaps this riveting fear was a better lesson in “coping strategies” than I could ever have designed for her on my own or with any therapist I could afford.
Two hours after that we are finally released from the prison of my paperwork mistake and her small rebellion against the world. We buy tacos in silence in a parking lot up the road and although it’s been endless years, almost a day, neither of us eats much, and then we drive home, slow and gray, too tired to even speak.
An hour after that I am digging through her room while she’s lying on the couch, trying to find the scissors she hid in the desk drawer when she got home and wondering if she’ll get in trouble at school for not having scissors which were clearly listed in the materials list we purchased only that last weekend and hiding the Tylenol and Nyquil up on a shelf in the closet and throwing away her razor.
I try to keep myself from reading her journal even though I’m questioning my parental morality by wondering if privacy is still a right when there are FRESH CUTS FRESH CUTS FRESH CUTS or if it becomes a privilege, oh, the rational brain’s attempts to veer away from what is really important right now.
All day I keep having the stray thought that we should not all be accepting this as a normal way of being. I cannot fathom how this existence, these beautiful brave battered girls, are a given, how broken girls in paper clothes are not a national goddamn crisis but a workplace from which one would go on a lunch break and make jokes in the staff lounge.
The other thing I think all day is why I keep having to explain we’re all worried that she’s just trying it on — when we should be worried about what it says when an entire generation thinks mental illness is an identity to try on.
Maybe we should be focusing instead on what the fuck we are doing to our children that they feel cutting their own skin is a trend worth checking out.
That night finally draws down and I have not eaten or stopped crying really at all, although when she is here I am quiet when I weep. (Oh, the things we hide from our children that we shouldn’t.)
I have smoked two packs of cigarettes. I am just beginning in earnest with my own self-flagellation, my own self-harm, which I have in some perverse way been looking forward to doing all day because punishment for problems is something I understand intuitively as a woman and a human.
I luxuriate in lying on the couch in my pajamas questioning every decision I ever made that has ever had an impact on her, cursing myself creatively from all perspectives for my crappy parenting and poor decision-making and broken fucking heart, and I continue to do this through the longest night of my life which follows the longest day.
To keep things interesting I alternate between mental screaming at my own deficiencies and a consistent sense of wonder that all of us moms are still using our own shitty coping strategies, a term I’ve heard four times as often today as I ever did in my whole life; I marvel at our endless capacity for poor decisions, bad relationships, insecurities, and the modeling of this shit we do every day for our kids.
Why are all the mothers and daughters so fucked up together and no one sees a problem?
The men in our particular lives — and many others, I’m sure, from the conversations in that waiting room — they don’t see it at all. They are angry that a woman of theirs would consider hurting herself when they work so hard to protect her. They are righteously pissed because it makes them feel powerless and unnecessary. They are incapable of seeing a solution or a cause because they react from how this act of desperation makes them feel — not from why it happened or how it feels to her.
This is probably why all the mothers and daughters are so fucked up.
All day, she’s been withdrawn and red-eyed and doesn’t talk much — although more to me than any of the therapists we wind up seeing or her father or her friends. I sit with her silently and wonder about all the shitty things I’ve been showing her how to do.
Run, mostly; run, run, fill up days with shit that doesn’t matter; how to live life through a blue screen and a few drinks and occasional retail therapy and a good enough approach to everything, in the great american routine that sucks your soul out through your teeth so that you believe that drunk online shopping or pre-cut craft projects from China squeezed into a Saturday afternoon between planned activities and self-improvement classes for the whole family are truly what you’re working for.
Well. And why would she ever want to grow up if this is what it looks like?
I say we don’t talk much but there is always some part of her touching me — hands, knees, short sweet kisses like she is scared to be in her own skin and my heart is so full I can hear it spilling over.
The world is just so big and us girls are just.so.small.
Everything goes pouring into protecting her and it’s as if I can see it all just running out her skin on the other side, but I keep pouring and pouring in the hopes that someday it will stick and she will be safe from the hundreds of thousands of horrible things we’ve created for her to wade through on her way to adulthood. It’s the only fucking coping strategy I know.
And still the world sneaks through, the motherfucking demon voice in her head telling her she’s never good enough, those kids all around her with their sharp edges and their sadness. All the strangers and dangers you train for, you talk about, but the demon voice fools us all, all us mothers and daughters, and here we are old and young still wasting our lives fighting the bastard.
And then I just always come back to
FRESHCUTS FRESH CUTS FRESH.CUTS.
I can scarcely even look at her. She’s so blindingly beautiful to me always but most especially right now and I am afraid that if I touch her I will squeeze her past breath and never let her go into the wide wide world ever again; I am afraid that if I open my eyes too far I will realize I’m standing on air and falling to a bloody and broken death. Blood terrifies.
Three weeks later we pick up her best friend after school and I’m driving them home so we can walk to the pool and toss all our cares away in the cool blue water under the tall green pines and I overhear from the backseat a conversation that goes something like this:
My child: “I’m sorry you’ve been so stressed out, I know it was a bad day at school today.”
Her friend: “You should kind of be sorry, because I am only stressed out because of you. That was really selfish and I can’t believe you would do that when you know I’d do anything I can to help you.”
My child: “ — ”
I couldn’t have created that moment for her, either, that beautiful minute in which someone you love shows you that they’ll hold you accountable and love you unconditionally at the same time, although at age twelve you can’t say it in that many words. But it happened for her nonetheless and I begin to wonder if some of the love I’ve been pouring into her skin has been seeping out into the world without our knowledge so that it can come back to her when she needs it most.
Six weeks later I go to drop laundry off in her room and she has taken my index cards and in her best handwriting written notes to herself and taped them up at eye level all around her room, on her mirrors, above the light switch, by the bed:
I look great. :)
I am surrounded by people who love me.
I am a great artist and a kind friend.
I am smart and creative and funny.
I am doing the best I can.
Oh, I think, at last, is that all I needed to show her?
And then, I think, maybe that’s all I’d needed someone to show me.