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Kate Spade and Anthony Bourdain’s tragic suicides — plus the news of climbing suicide rates nationwide — have spurred an important public debate about how to ensure that those suffering from serious mental health conditions, from chronic depression to bipolar disorder, receive the help and support they critically need.
Effective mental health interventions, carefully staged and tightly scripted by expert professionals, are one of the most important means of guiding such individuals to treatment.
That said, interventions — go-to plot devices in innumerable books, movies, and other media — have become exceedingly familiar concepts which many individuals and families attempt to undertake with minimal professional support. It’s no wonder: The public has seen them depicted time and time again — an individual, usually in denial about drug and/or alcohol problems, returns home to unexpectedly find family and friends seated in their living room, waiting to take turns expressing their love and concern in addition to airing grievances about all the ways the individual has hurt or disappointed them. The person being confronted initially capitulates and concedes to therapy or, just as often, storms out.
Unsurprisingly, this fictional scenario does not accurately represent an effective intervention or even capture the full scope of how interventions can be utilized to help those with serious mental health issues.
Interventions are not exclusive tools for those with alcohol and/or drug dependence. They can also serve as an effective means of facilitating a path to treatment for those struggling with serious mental illnesses, like schizophrenia, bipolar disorder, and other related diagnoses.
As one might expect, afflicted individuals can be secretive, isolative, and unpredictable, even toward those who love them and are doing everything in their power to keep them safe and well. They are likely to be defensive, resistant, and even hostile to suggestions of treatment; otherwise an intervention would hardly be necessary. For those with mental illness, this can be exacerbated by paranoia, delusions, depression, mania, and/or other psychotic symptoms.
Such strong possibilities point to the need for interventions to be highly choreographed, tightly scripted processes to ensure that they have the best chance of effectively guiding individuals to treatment while keeping all participants safe and their privacy protected.
First, depending on the issues afflicting the individual, it is necessary to enlist a range of mental health professionals as intervention participants. These include:
- a mental health attorney to be sure of legal entry into the home and the protection of participant rights;
- a psychiatrist to evaluate and ascertain the level of “danger” or “harm” the person poses to himself/herself and others;
- a case manager to assess the services needed immediately and later, on an ongoing basis, such as housing and out-patient treatment;
- a security detail to assure the safety of all the individuals and other participants, as well as to communicate effectively with law enforcement should it be required to call them.
In advance of the intervention itself, it’s important to meet with this full team to verify logistical information; confirm what participants will say and when; and even review such details as how an individual might try to flee using back doors, fire escapes, windows, etc.
Also, advance preparations should be made with appropriate facilities, such that interventions conclude with the individual immediately entering treatment, perhaps a rehab facility or an in-patient psychiatric unit, which should have an opening reserved specifically for them at that date and time.
When individuals represent an immediate risk to themselves and/or others — for example, someone who has become symptomatic due to having refused or stopped taking medication for a serious mental illness — it might not be prudent to stage an intervention, but instead obtain a court order to involuntarily direct them to a hospital emergency room for evaluation and hopefully admission. This process requires an experienced mental health attorney to not only successfully petition the court, but also guide loved ones through any necessary follow-up, such as discharge planning, housing placement, supportive services, or legal proceedings, including Guardianship, Orders of Protection (OOP), and court-ordered assisted outpatient treatment (AOT).
Those struggling with mental health issues often point to reasons why they shouldn’t enter treatment. Reportedly, Kate Spade was worried that details about a stay in rehab could tarnish her brand if leaked to the public. It’s a tragedy that no one could convince her otherwise. The truth is that there are extensive safeguards available to ensure that those who need psychiatric care remain anonymous. More crucially, individuals in crisis must face the truth: They’re in life-threatening situations, which should be prioritized above all else. Often, a team of professionals is needed to help loved ones understand and accept this fact.
Families who have mentally ill or drug/alcohol-dependent relatives face a daunting challenge that can carry a considerable emotional toll as they try to “do the right thing” for those reaching a crisis point. Planned and executed correctly, mental health interventions can be an important step in guiding struggling loved ones toward wellness and, hopefully, recovery.
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