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Waiting in the emergency room for help that never came, 17-year-old Grace started writing.
"I'm going to have a brave moment with you guys today, not necessarily because I want to, but I feel like what I'm about to say could save a life," Grace began her Facebook post in the middle of the night, in the middle of her first hospital stay of the month.
"Many of you don't know I struggle with mental health issues," said Grace, an honor student with a loving family, a bright future, and a history of anxiety, depression and intrusive thoughts that began when she was in first grade. "Maybe that is a blessing because I can see how broken the mental health system is."
Grace arrived at the hospital by ambulance, suffering a panic attack that led to, in her words, pretty significant self-harm. Her hospital searched the entire state for an inpatient facility that could treat her — Duluth, Thief River Falls, Twin Cities, Rochester — all hours away from their central Minnesota home.
"All of the beds in the state were full," Grace explained. When beds did open, "the people on the other ends of the phone decided I was 'too acute' or 'not acute enough' to take up a bed in their facility."
After four days, Grace went home without treatment.
A few weeks later, she was back in the hospital, waiting for help again.
Remember, early in the pandemic, when everyone was worried that we'd run out of beds, run out of ventilators, for all the gravely ill people coming in to the emergency room?
Minnesotans living with mental illness — and about 20% of us do — have lived with that fear for years.
There are never enough resources, never enough beds. And every day, people arrive in the emergency room with life-threatening illnesses and nowhere else to turn.
The mental health care system in this country isn't broken, said Sue Abderholden, Minnesota executive director of the National Alliance on Mental Illness, "it was never built."
"We've never really had enough inpatient psych beds," said Abderholden, who hears from struggling families all the time — parents in southern Minnesota who had to drive their child to Fargo, N.D., to find a bed; the mother this week who found her adult daughter, delusional but newly released from the emergency room, standing alone in the snow.
The pandemic made everything worse. There's less space in treatment facilities and more children and adults are isolated and under stress.
Emergency room physician Dr. Carolyn McClain has worked in both rural and urban hospitals. There are psychiatric patients boarding in all of them.
She's seen a child wait 10 days for a bed to open up somewhere. Ten days in a windowless room, without a television, without a phone, without proper treatment. Just waiting.
"If somebody comes in with a heart attack, we give them the help they need within 30 minutes. There's a standard," she said. "This is like, 'We'll get to you.' "
There is no timetable to help the patient suffering a psychotic break, or the elderly man with dementia who can't stop biting people, or a 17-year-old girl writing down her story in the hope it might help someone else.
"It's really, really, really hard," McClain said, "to be the doctor who can't give the compassionate care you want to give."
It is even harder for Grace's parents, who had to rush her back to the hospital this week. She was waiting in the emergency room — brave, clever, amazing Grace, who needs more help than her state has to give.
"They said today there's one bed in the entire state," her mother said, fighting tears. That bed went to someone else's child.
Just days before her second hospitalization, Grace was smiling beside her dad through a Zoom interview, hopeful that sharing her story might push Minnesota politicians to act. Helping others, even while she was hurting.
"People need to change the way they look at mental health," she said. "If I were to have broken my arm that day, they would have fixed it right away — not make me wait four days in an ER."
She was willing to share her full name and hometown with her story, but we're withholding it because the internet is forever and people can be so cruel.
People talk about the stigma of mental illness, Abderholden said, but it's really just discrimination: treating someone differently because their illness makes you uneasy.
Grace expected people to treat her differently after she posted her story on Facebook. Instead, supportive comments rolled in, from people who've struggled themselves, or who love someone who's living with mental illness.
"Look at me — from the outside, I'm kind of perfect," Grace said with a sidelong grin at her dad. "I have a 4.0 GPA, I'm involved in literally everything, and I struggle. You'd never know."
If you're experiencing a mental health crisis, here's how to get help:
In the seven-county metro area, call **CRISIS (**274747) to reach a mobile crisis team.
Anywhere in Minnesota, round the clock, seven days a week, people contemplating suicide or experiencing a mental health crisis can text MN to 741741 to connect to a trained counselor.
Or call the National Suicide Prevention Lifeline for free, confidential support 24 hours a day at 1-800-273-TALK (8255).
jennifer.brooks@startribune.com 612-673-4008
Twitter: @stribrooks
