Mental health is no joke, for any of us. As long-standing stigmas on the subject slowly melt out of our cultural consciousness, more and more of us are recognizing that mental illness isn’t just a term that describes the extreme, but also the mundane, in the same way that “illness” covers everything from stage 4 cancer to the common cold.
But it’s equally important to remember that mental illness can be quite severe, and the severity is to be taken seriously, as it often presents a danger. People who work in the mental healthcare profession know this all too well, as evidenced by this Quora thread that kicked off with a simple question posted by a user:
To psychologists and psychiatrists: have you had a patient you really feared? Why?
There are tons of stories told from the perspectives of a range of professionals from therapists working in offices to psychiatrists working in prisons to paramedics just trying to get a patient from one place to another. Here are a few of the revealing tales.
1. How Are You Doing?
It was decades ago, during my internship in the Psychology dept. of a state mental hospital, I treated only one patient who really scared me. Let’s call him Hannibal Wrector. Not only was Hannibal on a locked ward, he was locked in his room! This was quite unusual.
This was Hannibal’s 42nd hospitalization. He suffered from severe Bipolar Disorder and enjoyed hitting people when he lost his temper. He was here because he had punched his 18 year old daughter in the stomach during an argument, and aborted her pregnancy. I was asked to meet with him to determine whether he was a good candidate for individual therapy.
One of the staff unlocked his door and told me to just knock when I was ready to leave. I wondered how long it would be before someone heard me knock or scream.
Hannibal sat on his bed. He appeared middle-aged, disheveled, and sluggish, with one seriously mean-looking face. I offered my hand and said, “Hi! I’m Rick Cormier.” Instead of shaking my hand, he looked at it as if were a dead rat. I sat on the empty bed across from him.
“So, how are you?” I asked.
Hannibal just sat there staring at me. I wondered how long it would take for him to jump up from his bed and kill me.
“Do you think you might want to work with someone on a one-on-one basis?”
He just glared at me. I wondered how long it would take for me to get to the door and break it down with my fists.
“Well, Hannibal, it’s been a pleasure meeting you!” I lied.
I went to his door and knocked. Thankfully, I soon heard the sweet sound of the door unlocking.
[…]
The professor listened to my story and asked if I planned to see Hannibal again.
“No way! He’s not ready for individual treatment!”
“I want you to do me a favor,” he said. “See him just one more time. But, this time, don’t feel pressured to draw him out. Say hi but then just sit there and wait for him to talk. I promise you won’t have to wait even 30 seconds before he talks.”
I was torn between relief that I would never have to see Hannibal again and my admiration for this particular professor, who was the most intuitive therapist I’ve ever known. He was known for making ‘predictions’ like that in class… and he was always right. I so wanted to be as good as him.
So I agreed.
The following morning, that door was unlocked and I was led into Hannibal’s lair, once again. I said, “Hi.” and sat on the empty bed.
…and waited.
After about 20 seconds of awkward silence (though it seemed like much longer) Hannibal frowned and said, “So, how are you doing?”
Two weeks later, his door was unlocked for the last time. He and I began having our sessions while walking the hospital grounds twice a week. Thanks to the medication regimen and his new anger management skills, he was calm and stable enough to be released several months later. I have never been afraid of another patient or client since.
– Rick, M.Ed Psychology, Harvard University
2. Blood-born
There’s one chap who’s been in seclusion for a couple of weeks now because he was so aggressive towards the staff and other patients. Yesterday, he was seen by the consultant, who was worried that the patient was vomiting and looked a bit physically unwell; the consultant decided that I needed to go in and examine the patient, and take a blood test.
It took six staff to restrain him, so I could go in – all aproned up and wearing spitmasks as he continually tried to spit in our faces. The chap has a couple of bloodborne viruses and I was terrified that he was going to thrash about while I was doing the bloods, and that I would needlestick either myself or the nurse restraining that arm; but I kept talking to him, explaining that I needed to find out what was making him feel so sick so I could make him better, and it would be over fastest if he kept super still for me, and he just about managed to hold it together for the blood draw.
It was a poor quality physical examination, though – he was kicking, spitting and making too much noise for me to really listen to his chest / feel his tummy / examine his legs. In that seclusion room, despite having six fantastic colleagues looking after me, I did feel frightened.
– [anonymous], Trainee Psychiatrist
3. Strong Enough
The other chap who scares me is also violent to staff, mostly females and people of other races.
He has, in the past, very graphically described to me how he will rape me and rip out my throat; at other times he’s as sweet as pie to me, but I don’t see him alone, even for a chat in a corridor – I quite believe that if the mood took him and he had the opportunity, he would carry out those threats.
He has completely destroyed a seclusion suite in the past; he’s strong enough to tear down doors designed to contain our most dangerous mentally unwell patients.
– [anonymous], Trainee Psychiatrist
4. Do Not Engage
I was rounding one time with a psychologist friend of mine, and I really didn’t know the guy who was in the cell. Big guy. Big scary guy.
I didn’t have caffeine in me, and was still a little sleepy. He was asking who was responsible for him being there and who could discharge him. I started to open my mouth to explain that I was the only one who could write discharge orders when my psychologist friend basically shoved me down the hall and shot me a look to shut the hell up.
Now remember, this guy is behind a solid steel door that is inches thick. She proceeded to say “we’ll go call the discharge planners” and practically ran away from his cell. With a door solidly locked.
She knew the guy, and he is scary, and he hurts people.
– Carol, former Psychiatrist
5. Fixated
I recall a client that suffered from treatment resistant chronic paranoid schizophrenia. No matter what medication we tried, he experienced significant positive symptoms.
The client was placed on a community treatment order almost a decade ago. And has resisted treatment ever since. Insisting he was normal and the mental health services were harassing him.
In addition to his paranoia, he had a particular long standing delusion. He believed that his daughter was being abused, both physically and sexually by various people.
Prior to my taking him on as a client, he had accused other workers of abusing his daughter (he never had a daughter) and abused and assaulted them. And he tended to associate or incorporate his therapist or mental health worker into his delusion.
This client was always unwell and during periods of stress he would become unstable and take it out on his psychologists or therapist. To make things worse, he was about 6 foot 4 inches and weighing 120 KG [about 260 lbs]
[…]
I asked a colleague of mine to accompany me to conduct a home visit so I could check on his welfare and ensure the community was not at risk.
We knocked on his door and he did not appear to be at home. On our way out of the building (we were only 10 meters away from the exit) I heard a loud voice calling out to us. It was the client!
I turned around and noticed that his body language and gait seemed aggressive. His back was erect, chest pushed forward, fists clenched, eye-pupils dilated and facial muscles were tense.
He approached us and started to tell us to F… O… and that we were not welcome at his home. I tried to engage the client but he ignored me. His mental state seemed to have deteriorated and for some reason he was fixated on my colleague.
He started to scream at the top of his voice! “You raped my little girl, how dare you show your face around here, I’m going to kill you”. He invaded my colleagues’ private space, was face to face with him, spitting and spraying as he was screaming and yelling so loud that my ears began ringing,
I tried to stand between the client and my colleague. And asked him to look me in the eyes and to swear at me instead, not my colleague!
But the client ignored me and continued to circle around me so that he could face my colleague and continue to threaten and abuse him. I decided to call the Police because I knew that I could not control the situation and was concerned for my colleague.
My poor colleague initially tried to speak and deny that he had hurt the client’s daughter to no avail. After a few minutes my colleague stopped talking, and the client continued to scream, threaten, abuse, and bump his chest on my colleague for about 10 minutes before the Police arrived.
By that time, a couple dozen people were watching the incident and no one tried to intervene.
When the client saw the Police, he accused my colleague of calling the Police for no reason and tried to assault him (the Police were 10 meters away). At that point, I raised my voice and stood between the client and my colleague, raised the mobile phone up in front of my clients face and said “I called them; I got the phone, look at me”.
By that stage the client was fixated on the Police and was swearing at them
– Kamal, Clinical Psychology and Research Specialist
6. I Figured You Out
He was a boy, barely 15.
When I was looking at his medical chart, he was surprisingly a very bright kid, with an IQ level of 140.
But, he was arrested by police when his own parents lodged a complaint; they feared their own child might kill them.
He had his own way dealing with his life: he showed no emotions, nor answered any of my questions.
But, the one thing scares me the most was when I look through the CCTV, it seemed his body reacted with time; like some sort of a timetable.
He only went to the washroom at 2pm, 6pm and 9pm; and, slept exactly at 10pm.
Just before I retire, I revisit him back and had the chills for lifetime when he told me this, ‘when you were observing me, I too, was observing you. I figured you out, but you had no clue about me.’
– [anonymous], Psychiatrist
7. Oh. My. God.
So one afternoon we got a call for transport from the local medical center. They met us in the ER and handed over the patient. He looked to be about 30, had long dark hair past his shoulders, and a full beard. Good-looking, but very intense. He was strapped into the gurney with multiple restraints. The nurse introduced us. “I’d like you to meet Jesus, Jesus Christ.”
He looked up at me peacefully. “Bless you my son.”
I was about to laugh but the nurses words cut me off like a punch in the gut. “They’re waiting for him in the Vroom Building.”
Oh. My. God.
The Vroom Building Was the infamous locked ward for the criminally insane at Trenton State Psychiatric Hospital. And it was more than an hour away. We were neither trained nor equipped for this kind of transport.
“What did he do?” I asked.
“You don’t want to know,” he replied, “just don’t let him get a hold of anything sharp.”
I tried to object but the nurse simply patted me on the shoulder. “He’s your problem now, sweetie. Just keep him calm.”
We loaded him into the back of the rig, closed the doors and drove off. As much as we wanted to get to Trenton ASAP, we didn’t want to agitate our passenger so we ran with lights and no sirens, and stayed in the slow lane. It was a two-man crew — me and the driver. I had no idea what to do. After about 10 or 15 minutes, I tried to make small talk.
“Are you comfortable?” I asked, a stupid question in reflection.
“I’d like to get these restraints off,” he said quietly.
“Sorry guy, doctor’s orders,” I responded.
“But I need a smoke,” he said “I really need a smoke.”
Can’t smoke back here,” I said affably. “We’ve got oxygen. No open flames.”
“I’m the son of God,” he said in a monotone that was somehow truly chilling.
And then he tried to sit up. He struggled for a moment as I spoke soothingly.
I had very limited experience with mental patients. The vast majority that I had encountered during my time in the psych ward were easily managed. This guy was a different story.
As he struggled to sit up, there was an odd tearing sound. It was the restraints.
I yelled for my partner. “He’s getting loose.” I could hear him on the radio calling for help from the dispatcher.
I had no idea what the right thing to do was. But the wrong thing was to have this guy running loose in the back of my truck. The cot was locked to the wall. I put a hand on the rail of the cot, and practically vaulted onto it — and him. I pushed down on his chest with all my weight behind both hands. He looked startled. “You’ll go to Hell for this,” he said in that same weird monotone. “Blessed are the meek.”
I looked him square in the eyes. “I’m a Buddhist.”
His head dropped back down onto the pillow.
I spent the 45 minutes to Trenton perched on his chest.
He never said another word.
– Tom, former Paramedic
8. Her History of Violence
I was sitting next to a rather large woman and asked her why she was in the ward. She told me she had killed a cop. I took this with a grain of salt as if she had killed a cop she would be in the criminally insane institution.
She seemed quite affable, until she said she also enjoyed strangling cats. Then followed up with ‘just like I am going to strangle you Nurse.’ She held her hands around my throat trying to choke me. Luckily there were two big male nurses who rushed out and saved my strangulation.
They must have known her history of violence and been watching me.
– Anonymous, former psych nurse
9. Safety Promise
A client told me that he was planning to shoot his wife with a gun that he had in the trunk of his car. When I was unable to extract a safety promise from him I told him that I would have to warn his wife and call the police. He was very angry with me and left the office. This was after 5pm when most of the people in the other offices had left and the building was almost deserted.
I did call both wife and police, but I was frightened when I left the office on the way to my car. However he was not there waiting for me in the parking lot. Nevertheless I checked the rear view mirror frequently on my drive home. He did not kill his wife. I don’t know whether the police questioned him.
He did not return.
– Bruce, Psychologist specializing in Early Psychosis
10. Thanks for the Coffee
I was working in a halfway house and that day I had “living room” duty together with a male co-worker. It was Friday afternoon and the staff was in session, which meant nobody was allowed to enter their room. There was a coffee machine in the living room, where you could take coffee for 50 cents, that you had to put in a plastic cup besides the machine.
At that moment there were some 30 people present in the room.
Then the door opened and a man stepped in. He used to be with us, but was returned to a closed psychiatric facility and shouldn’t be there.
He didn’t speak, just looked around and everybody froze, not a sound nor a move. And my partner was frozen too.
The fear I felt was so strong that I found it difficult to speak, but someone had to do something to keep things under control.
So I said, trying to sound normal: “Hey, have you come back?” I was not going to say anything that might have triggered an outburst, like reminding him in any form, that he shouldn’t be there.
He just told me to get him some coffee. I asked him how he liked it and brought him a cup. All this time still nobody moved or spoke.
And of course I didn’t ask for the 50 cents either.
Then he moved towards the corridor leading to the staff room. I said casually that the staff was in meeting. Again being careful not to say something like “You are not allowed”.
He said: “I know” and went there anyway. Because I was at the end of my courage, I figured that the big boys had to deal with this themselves.
Well, they didn’t. He went inside the staffroom, made everybody shake his hand and say something nice and then he went out again. What a display of power.
He gave me 50 cents and thanked for the coffee.
Then he left saying he was going back to the facility.
A little while after the door had closed behind him and we were sure he was not coming back, everybody started to talk wildly. But nobody spoke about what just had happened. The fear lingered even after he was gone.
– Jolande, Mental Health Worker
It’s really no wonder that mental illness has played such a villainous role in our literature and media. To watch a person behave in a way that you just know we’re not made to be is beyond unsettling. Remember, if you or a loved one needs help, there’s absolutely no shame in seeking it.
Do you have a story like this?
Tell us in the comments.