Minor Emergency Response

I spend my afternoons at MERT, the Minor Emergency Response Team at the Sacramento County Mental Health Treatment Center. Police, families, foster parents, and hospitals drop off kids here who need to be evaluated for possible involuntary psychiatric hospitalization.

Mentally ill kids are fascinating and emotionally intense to work with. Their stories are immensely tragic, yet with early intervention, they have a better chance at being able to live normal or semi-normal lives. Today, I witnessed the impact that sudden onset of severe mental illness has on the life of a child.

My patient was barely a teenager, very innocent and shy, and she had just had her "first psychiatric break".

Those three words are chilling. They imply an end to a certain normal part of this child's life and the first of many future struggles. She had been a normal teen, who was part of a large and supportive extended family. Played saxophone, went to church, got A's in school, and loved to watch wrestling on TV. She came in after hearing voices several weeks ago. The voices started out pretending to be her friends but soon began to tease her and get aggrevated.

Voices in psychosis do not sound like they are "in your head". They sound like any other voice in the room, which can be frightening and extremely distracting. She had spent the last few weeks struggling to keep the voices down. She was exhausted, sleeping only a few hours a night, always vigiliantly trying to keep these voices at bay. She was frightened and confused. She had no idea what was going on with her, and being a sheltered child from a fairly religious family, she thought that she might be haunted by the devil. As the staff said, she was 'definitely psychotic'.

What was unique about this patient was that unlike many of mentally ill I have met, she was still separate from her illness. You could still see who she was before she became sick and she did not look like "a typical patient with schizophrenia". The illness was something that was still trying to break the shell around her, and it didn't own her. It was as if they were monsters trying to break into her brain, and not just a tragic physiological and chemical imbalance that was coming from within her.

This evening, she was placed in the inpatient psychiatric hospital where I spend my mornings. I am excited to work with her (and some of the best doctors specializing in diagnosing psychiatric breaks) and I hope that she will get the help she needs early enough to be able to live a fairly normal life.