By Lisa Gennosa, PA-C
If you or someone you know is experiencing a mental health, suicide or substance use crisis or emotional distress, reach out 24/7 to the 988 Suicide and Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) by dialing or texting 988 or using chat services at suicidepreventionlifeline.org to connect to a trained crisis counselor. You can also get crisis text support via the Crisis Text Line by texting NAMI to 741741.
There’s always more to the story. My son’s story began well before the fateful night of Dec. 5, 2017, but it was this night that changed everything.
My son, Tyler, found himself isolated, living in his car and feeling suicidal. After consuming lethal levels of alcohol and other drugs, he reached out to me for help, expressing his suicidal thoughts.
Even though I am a physician assistant who occasionally handles mental health and substance abuse cases, I was completely lost when it came to my son being the one who needed help. His texts and calls were ambiguous, and I was confused by what he was telling me. Was he really contemplating suicide? Was this really happening?
I contacted my mother, who lived near Tyler, and thankfully, she was able to locate him and his vehicle. On the other end of the phone, I could hear her exhale with relief. She opened the back-passenger car door, saw that Tyler was incoherent and crying, with an open wound on his forehead and made the decision to call emergency services.
When the ambulance arrived, I asked to speak with the responders. I explained my level of experience and listed the psychiatric medications my son had recently taken. I also explained that I thought my son was having an uncharacteristic change in his mental status from a combination of his medication’s side effects and alcohol toxicity. I felt this could be contributing to his suicidal thoughts and behaviors — and asked that they provide that information to the attending physician or charge nurse in the emergency department.
They said they would, but I don’t believe they did.
When Tyler arrived at the hospital, disheveled and intoxicated, he was first treated as a disposable annoyance for the evening. Unfortunately, I didn’t find this surprising; in many cases, even trained professionals simply don’t know how to de-escalate a situation of this nature, so they often treat individuals with substance use disorder like criminals. That said, having a mental illness or substance abuse disorder does not equate to committing a crime. And being suicidal, in my son’s case, was a mental health crisis, not an unlawful act or a moral failing.
When Tyler arrived at the medical center, he began begging the police officers to shoot him. He wanted to remove himself from the pain he couldn’t find a way to bear anymore. Tyler was put in restraints and given a sedative. After this, his ability to function with any control became impossible. The report states that, after waking up in a confused and scared state, realizing he had been tied down, Tyler started yelling and spitting. His medication-induced psychosis at that time was likely the reason, but there was no mention of this in the report.
I don’t excuse my son’s actions, but I also don’t have the full story — and I know, based on his grandmother’s first-hand account of the situation, that the officer was irritated about having to “handle” an “addict.” Even though Tyler was under the influence, de-escalation should have been the tactic in this case, not verbal escalation from trained professionals with a suicidal patient.
Some nurses later told me and my son that they expected difficult behavior in these situations and never take it personally. However, this officer did, and he charged my son with a felony.
After my son’s psychiatric assessment, the social worker and board-certified physicians collectively determined that he needed immediate psychiatric care.
Over the phone, the social worker told my husband and I that the officer would certainly take Tyler to a mental health treatment facility — and I had no reason to believe there was anywhere else he could possibly go.
The next morning, after miraculously getting a flight into Texas, I assumed I would drive directly to the hospital to find my son there. Instead, I got a call from Tyler, who had been redirected to the county jail. He only had a minute to make his one call and inform me of his location.
What began as both a physical and psychiatric emergency had turned into an incarceration and a felony. My mother, who had been at the hospital, told me that the deputy assigned to transfer Tyler was quite unhappy that he had to deal with another “drunk” in the middle of the night. He disregarded the directive to take my son to the psychiatric hospital and instead drove him to jail. He placed a bag over my son’s head and left his hospital gown gaping in the front leaving his naked body exposed.
After arriving at the jail, my son sat on a bench for several hours in handcuffs, unable to cover himself and begged someone for some clothes. Eventually, he was put in a main cell with all the other unfortunate “criminals.”
Within 24 hours, he would start the real process of withdrawal from alcohol. This is an incredibly dangerous experience — heart attacks, seizures and sudden death are all possibilities in alcohol withdrawal. And yet, at this critical point, my son was put into solitary confinement. He was held in a small cell with a urine and vomit-soaked mattress thrown on the floor near a gaping hole in the cement meant to be used as a toilet.
He yelled out to find out what time it was periodically because the bright, fluorescent lights were never turned off, but nobody would answer him. He asked for water, but he was left thirsty. He was shaking uncontrollably in withdrawals, but it didn’t seem to matter. He was still suicidal, but that didn’t seem to be important to anyone.
When I arrived in Austin, I drove directly to the jail. Tyler walked out in a jail issued jumpsuit, tears soaking his face. We sat down, looked at each other and bawled. I never thought I’d see my son in jail, but what was killing me in that moment was that just hours before, he had told me he wanted to end his life. I just kept thinking how scarring his experience must have been.
After several additional years of self-destructive behavior, my son is healthy, happy and in recovery. I’m grateful to be able to say that now. But this is only after our family discovered that Tyler had experienced severe trauma as a teenager and grappled with the compounding effects of trauma from his treatment that night in hospital. We have been able to get him extensive counseling and treatment, and he is in a much better place in his life.
But this happy conclusion could have been reached earlier. There is always more to the story — and I’ve always believed that if law enforcement or hospital staff had approached Tyler with empathy instead of annoyance, his healing could have begun sooner.
After our traumatizing incident with law enforcement, I reached out to NAMI. They were the very first organization to actually listen to my story and give me guidance, resources and real help for my son. I am eternally thankful for their contributions at the time when we needed them most. They were the only ones who took the time, showed compassion and listened to my story when I just needed so desperately to be heard.
Lisa M. Gennosa lives with her husband, and two pups in Tarboro, NC, where she is a practicing physician assistant. She is a dedicated wife and mother — and her son remains the greatest gift in her life. Her exposure to the health care system, the legal field and the challenges of parenting a son with substance use disorder has helped her to recognize that mental health issues are too often shrouded in secrecy. She has worked with police, parole and correctional officers, paramedics, nurses and other hospital staff in an effort to create positive change. Her book, “Incurable Hope: A Memoir and Survival Guide for Coping with a Loved One’s Addiction” is scheduled for release in February 2023.
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