Helmet photos during a behavioral health crisis that won’t budge

Psychological distress can be transmitted and implanted in our physical bodies, and for me, anxiety twists below my navel in a clenched fist capable of wringing the life out of me—or at least something well-ordered and sane that I’ve put together. Ruining plans to leave home on time, sucking time into anxiety, suffocating.

I’m learning new ways to manage it, but it’s a problem that came up the morning of an event on September 21st to mark the build phase of the long-promised Behavioral Health Crisis Center. It was funded by people who voted in 2014 to be taxed higher, seeking adequate care options after Albuquerque police killed James Boyd, a vulnerable person living in the foothills of the Sandias.

The event was called a groundbreaking celebration for the center, which is slated to open in 2024 on the University of New Mexico’s main hospital campus. Officials from the state, Bernalillo County and UNMH gathered around a sound system, with iced drinks and folding chairs under several tents, along with construction hard hats and shovels lined up for photo opportunities.

I wanted to wake up in time to change into neutral professional clothes, but the night before had been rough with little rest. I had thrown on some sneakers and ran out the door in what I ended up wearing: shorts and a printed T-shirt a horror movie reference: WHO WILL SURVIVE AND WHAT WILL BE LEFT OF THEM? Hasty clothing at least raised a legitimate question.

When I later described the strategic plan for the facility to a close friend of mine—one of many with firsthand experience with the behavioral distress passing through the place—she said a psychiatric triage center sounded great. “We need this,” she said.

She sounded tired too. “And pushing a small bicycle with pedals against a large rock?”

Back in March, she started texting me from a dark parking lot outside one of our local hospitals, where she was trying to resolve an issue with her friend and colleague (I’ll call him Michael here) after he was denied admission for urgently needed behavioral health care . They were trying to get him evaluated for rehab — something comprehensive with adequate follow-up to treat his co-occurring psychiatric diagnosis and substance abuse relapse.

They had tried to sign him up for detox services at the existing Bernalillo County Treatment Center, but were turned away at the front desk. Someone decided that Michael, who was now exhausted, stressed and chemically imbalanced, was “not ambulatory enough” for treatment.

Then they returned to the first private hospital, in the middle of the night, to ask for help. They came across a nurse who took the time to look up Michael’s medical history and advocate for him, finally securing him a proper detox placement.

My friend was talking about a bike with pedals against a rock, but the behavioral health crises in New Mexico right now remind me of the angry sludge that piled up under New York in Ghostbusters II. In recent years here historical sorrows have been boiled down by new privations, dislocations and political polarization as everyone watches our fragile watersheds empty, our stressed forests die and burn around us.

We are all more excited and at least looking for emotional shelter. Gov. Michelle Lujan Grisham talks about impatience – her own and others’.

“I spent an hour with a father whose own daughter came to the emergency room in a behavioral health crisis. Twenty hours later she’s out and we don’t know where she is. These are events that are happening in our communities and across the country. … There isn’t one of us who hasn’t had a family member affected by it … or a neighbor, or a friend, or a church member, or a colleague.”

Although she acknowledged that this most painful part of New Mexico’s “behavioral health netherworld” exists, it smells more of desperation than impatience, followed by poisonous waves of more hopeless and horrifying primo, awful resignation of despair. The festive frame of the event was a gross distortion of reality, hard hat or not.

We need to be more honest with ourselves about how dire the living conditions of people here continue to be, whether we feel their grip intimately or not. Too many of us were swimming in loss and trauma before the coronavirus added additional disruption, additional grief, new forms of mass death.

We were already too used to rampant family and community fragmentation, both shared and personal violence.

It is clear that high-ranking stakeholders and officials can afford to appear blissfully optimistic, but for many of us the normal we have been being returned to lately was already disgusting.

No one I know is emotionally well these days. Copers have better protective coverings, ways to insulate or even distance themselves emotionally and materially from the worst sources of distress. Most of them know they are among the lucky ones, a kind of survivor’s guilt that causes their own dislocations and moral injuries.

We know that this place where we live is overwhelmed at this time risk factors for the accumulation of even more permanent damage. One of our local think tanks, New Mexico First, made it clear earlier this year:

“Access. Coalitions. The service/treatment continuum. Workforce Challenges. Eliminate unnecessary duplication. Insufficient funding. All must be addressed — simultaneously — to impact New Mexico’s behavioral health crisis.

And all of this must be done in the context of the root causes of these problems—poverty, lack of primary care, poor housing, language and cultural barriers, unemployment, stigma, adverse childhood experiences, and gaps in education. Remaining ‘isolated’ as a behavioral health system that reacts rather than works to prevent will not see the end of this crisis.”

Before picking up dirt shovels with other politicians in front of the assembled cameras, Gov. Lujan Grisham dished out praise, one to state senator and retired Albuquerque social worker Jerry Ortiz and Pino.

When he and I spoke on the phone days after the event, he told me that the most urgent work ahead of New Mexicans is about the basics: We need to increase the number of professionals who specialize in effective treatments. And it’s not a workout. This is an ongoing emergency.

Back in May, when Ortiz y Pino spoke with the director of Albuquerque’s Turquoise Lodge, the city’s one inpatient substance use treatment facility was operating at half capacity for patients simply because they were understaffed. He said Las Vegas State Psychiatric Hospital, surrounded all summer by the largest wildfire in New Mexico history, had an entire wing closed earlier this year due to understaffing. And a rehab center in Roswell is licensed for substance abuse detox and comprehensive treatments, but has not yet accepted patients for staffing reasons.

Meanwhile, wages for most jobs in one of the poorest states in this country are comparatively and depressingly low, including jobs that provide behavioral health services.

Thousands of nurses and hundreds of doctors are needed by the state

We need dramatically more behavioral health professionals across the state, Ortiz y Pino said, and while he’s encouraged that the state has allocated funding to train more local people in the field, providers moving to New Mexico from out of state , face daunting bureaucratic barriers.

“We need to streamline licensing and certification procedures,” Ortiz and Pino said, especially since many New Mexico residents rely heavily on Medicaid for health insurance. This federal system presents its own maze for providers to work through. “It’s asking someone to make a huge financial sacrifice.”

The governor said during his remarks that he “doesn’t want to have another hour-long conversation with a parent who is devastated.” But it will take a lot more than a new crisis triage center to make that happen. Once someone is in crisis, help is then a reaction, not a solution.

When I asked my friend last week how Michael was doing now, she had a story very similar to the parent who had spoken to the governor: He had disappeared. My friend still doesn’t know if he’s okay and is getting very worried.

The thing is, we already know what he needs to be good. He needs what we all need. Safe housing. A stable way to maintain. Safe, reliable transportation. Clean food and water. Access to quality, holistic health care. Healthy, supportive family and community connections. To carry a sense of worthy worth and purpose that can be shared with others.

This list of essentials is obviously daunting or even unreasonable for most people in power. And that in itself is a call for massive anti-celebration. This is a call not for digging more holes, but for a proper burial and mourning of our wounded, missing and departed, before we fall into a pitiless and effective lamentation.


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