Discharged while still suicidal — Q&A with a recent patient
Content Warning: This article discusses sensitive topics, including suicide.
And things can be even harder for transgender patients, who need specialised treatment from professionals.
Paul* is non-binary and uses they/them pronouns. They recently went through Canberra’s mental health system after a serious suicidal episode.
With a lack of available beds for acute mental health care, they were discharged after only a day. They’d recently moved to Victoria from Canberra, and didn’t have anyone in the city they could stay with to be monitored. They returned to Victoria they day of their discharge.
I spoke to them about their experience.
*Name changed to protect identity.
Q: What was it that brought you from Victoria to Canberra?
A: I went to Canberra for university.
Q: How did that go in the first few weeks that you were here? How did you find the adjustment to Canberra?
A: Canberra is a deeply strange city. I think that it was very telling when I was just hanging out with this guy, and I was joking about trying to get trans-led healthcare, he told me, “oh, good luck with that. You’ll need it,” and then went on this long bit about how he’d been screwed over by the Canberra system.
So it was quite foreboding, I would say.
Q: How long have you been trying to access those services?
A: Three years, almost.
Q: How has that process differed in Victoria, compared to Canberra?
A: I would say that the process in Victoria has the upside that you have the option to have it public – it will be covered on PBS. I didn’t have very good luck with the gender clinic in Victoria, for a number of reasons, so I couldn’t access it there – but I will be trying to go back to it.
But, in Canberra, there is essentially no places that do bulk billing; it is largely private.
Q: At what point in your stay in Canberra did things start to get particularly bad where your mental health was concerned?
A: Obviously, I wasn’t doing very great when I first arrived to Canberra, on account of aforementioned being screwed over by the gender clinic.
I would say that things got especially bad when I realised I had called every single place in Canberra who is known to be trans friendly, and asked if they were taking patients, or if they were bulk billing. Every single person that I got back to said no.
I contacted a GP back in Victoria and asked her if she could help me. Her advice was that she could help me find somebody in Canberra, which I knew would be impossible due to the nature of the system in Canberra. So, that was when things especially plummeted.
Q: It was around then, or shortly after, that you presented to Calvary Hospital, is that correct?
A: Three days later, yeah.
Q: What was your experience first arriving at the hospital and the emergency room.
A: I mean, it was pretty standard for a hospital admission in the first place. They, you know, sit you down, they take the bloods, they do this that and the other. I didn’t really quite have a long wait to get a bed, which I’m very thankful for.
Q: Once you were in the bed and admitted, what were the conditions placed upon you in terms of monitoring?
A: I was under pretty much constant monitoring. You know, I had someone coming over every four hours to do tests on me, to make sure that I was still breathing – as they say – and so on and so forth. I was being monitored at the hospital.
Mostly just due to the fact that I wasn’t allowed to close the blinds to my bed, because I had to be visible at all times, I think.
Q: Why was it that you had to be visible at all times and constantly monitored?
A: Because I went into hospital because I was going to kill myself.
Q: In the hospital, as I understand it, the nurses were fairly respectful of your gender in direct contact with you, but were not when speaking about you. Is that correct?
A: Yeah, that’s correct.
I did notice, on multiple occasions, how I was being talked about outside of the curtain, where they thought I couldn’t hear them (but I could). They would explicitly refer to me by my birth name and exclusively use she/her pronouns, despite me explicitly telling them not to do so.
Which is just absolutely insane, to do that as a health professional.
Q: What happened next, after you got in the bed, what were the steps taken?
A: I didn’t really see anyone until the following morning, early arvo.
It was kind of shocking. I was basically just given a print off of different health services in Canberra that I could access – but I’d tried to access them beforehand, and nothing happened.
Then I was told that I was free to go, despite me telling them – literally during the interview that I’d had with this man 15 minutes before – that if they let me go I would kill myself.
I did have a bit of a freak-out at the hospital, and I told them that, “if you let me go I’ll kill myself, why are you trying to get rid of me?”
I was given an anti-anxiety medication and passed out because of that, because that’s what it does. And again, once I’d come around, they told me again that I could just leave, and that I couldn’t stay in the bed because… I don’t know why, and that they could try and get me a place in a different hospital in Canberra, but there was no guarantee.
So, it was very clear that they wanted me to go.
Q: What did you do then, after you were removed from the hospital?
A: It was not a good time. I essentially had to get back to my dorm, get as much of my stuff as I thought I would need, and immediately drive seven and a half hours back to regional Victoria so I could be monitored by my family.
Q: If you were someone that didn’t have family you could go and stay with, I imagine there would’ve been a different outcome.
A: I agree completely.
I honestly don’t think I’d be here.