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The Elephant in the Room: Mental Health Professionals Experience Crisis Too

Stephanie Hepburn is a writer in New Orleans. She is the editor in chief of #CrisisTalk. You can reach her at​

When Shelby Rowe realized she needed help in September 2010, she called a close friend, asking the friend to drive her to a hospital out-of-state. As the executive director of the Arkansas Crisis Center, Rowe didn’t want to run into anyone she worked with or had trained. Her distress had been slowly escalating, culminating in months filled with ruminating flashbacks and anxiety. Her marriage was quickly unraveling, triggering trauma from when she’d been in a similar position. Years prior, during her first marriage, Rowe and her husband had a terrible argument, and he left. Thirty-minutes later she received a call that tragedy had occurred: while at a friend’s house, someone accidentally shot and killed her husband. “The last time I’d been in this situation, someone I loved died. During our fight, I’d told my husband, ‘I hate you and wish you were dead.’ A half an hour later he was. Years later, at the end of my marriage, I feared if I walked away, one of us was going to die. It didn’t make sense, and I knew that, but it didn’t lessen my fear.”

As Rowe spent her days overseeing the implementation of the Arkansas plan for suicide prevention and running the center that operated the state’s only 24/7 crisis hotline, she was simultaneously experiencing increased distress. To mitigate it, she applied the coping skills she taught others, but it wasn’t enough. Her expertise in suicide prevention made her achingly aware that she was experiencing hopelessness, but Rowe questioned her symptoms: how could she, a mental health expert aware of critical interventions, be at risk? She wasn’t the only one applying scrutiny as her therapist told Rowe, “You don’t need hospitalization because you’re aware of what you’re experiencing.” The therapist, and other mental health experts Rowe came across during her crisis, assumed, because of her expertise, that she was a lower suicide risk than she was and knew what to look out for and do for herself during a crisis. “A mental health professional may know the signs and what to share with others, but it’s challenging to apply those skills to one’s own crisis. That’s why people don’t treat themselves.”

As Rowe’s symptoms increased, she performed the assessment she did with callers, asking herself, “When is the last time you ate or slept? How long do you think you can keep yourself safe?” The answers weren’t comforting. She knew it was time to seek help. In the hospital, she received what would generally pass as good care—she met with the therapist daily and the psychiatrist every other day—but they failed to address what was at the core of her crisis, Post-Traumatic Stress Disorder (PTSD) from her first husband’s death and childhood traumas. In the high-risk months following the hospital stay, Rowe continued to experience ruminating thoughts and felt frustrated that she couldn’t just shake them off. She felt despair settle in her bones with no end in sight. “Hospitalization isn’t a magic wand, and I came back feeling more hopeless because the experience hadn’t changed how I felt, and now there was an additional hospital bill burden to figure out.” Rowe wondered if this was how life would be from this point forward, getting angry at herself for not being able to control her PTSD. “It was the night before Thanksgiving, and I went into the bathroom, looked at myself in the mirror, and said, ‘I hope I never see you again.’ I then made an attempt on my life.” Rowe woke up two days later in bed, not knowing what happened. Her 19-year-old son was home and said, “Oh, you’re up. You missed Thanksgiving.” She asked why he didn’t take her to the hospital, and he said, “I didn’t want you to get fired.”

It took four years before Rowe publicly shared her story, doing so because she felt there was a great need for more people in the mental health profession to speak about their experiences. What people often don’t understand, she says, is that just because a person survives a suicide attempt doesn’t mean she’s committed to living. It took years, separate from public scrutiny, to set the groundwork for healing and learn to acknowledge her feelings and not be angry at herself, which reaped a highly favorable outcome: a release from fearing failure. Before that, Rowe felt embarrassed and thought her suicide attempt was an indication she should no longer work in mental health. Fortunately, Rowe’s therapist when hospitalized reassured her that the field needed her perspective and expertise. He told her, “I would hire you.” This shifted Rowe’s perception because he could have easily suggested she pick a different career path. “I’m not certain I’d be working in this field today if it weren’t for the fact that, in my moment of crisis, this person believed in my ability to do my job and to play a meaningful role in mental health.” Even so, Rowe did initially have concerns about coming out as an attempt survivor because well-intentioned colleagues, some of whom heard of or directly had negative experiences when coming forward, warned her not to go public with her story. 

The final push for Rowe to speak about her suicide attempt was the release of The Way Forward Report in 2014 by the National Action Alliance for Suicide Prevention’s Suicide Attempt Survivors Task Force. They were putting together 60-second YouTube videos featuring attempt survivors and others directly impacted by suicide such as siblings, parents, children, and spouses. Rowe says it was remarkable to witness the field start to recognize the value of experts with direct experience. Among those coming forward were Dr. Quincy Lezine and Dr. Sally Spencer-Thomas, who asked Rowe if she’d be willing to record a video as an ally, not realizing that she was an attempt survivor. After Rowe shared her story with Dr. Spencer-Thomas, the psychologist asked her to record a video about her experience. She did. “As mental health professionals, we work against stigma, calling suicide prevention a public health issue, but then we often hide that part of ourselves for fear of rejection within that same community.” Still, Rowe says sharing isn’t right for everyone, and those thinking of doing so should carefully examine what they are seeking. “I never tell my story hoping to get validation from the audience. This is who I am, and my perspective is one of the tools I bring to the table.” Rowe has continued to work in mental health as the suicide prevention program manager for Oklahoma’s Department of Mental Health and Substance Abuse Services. She says sharing her story with those working in mental health is destigmatizing, making it easier for others to do the same. “They see me sharing my story in front of 100 to 500 of their colleagues and think, ‘No one is judging her. Maybe I can do it too.’”

Rowe says the mental health community needs to work together to alter the perception of mental illness not only in the general population but also within the very community designed to treat it. “For many of us, we are facing similar struggles to the people we work with every day but hiding in the shadows regarding our own experiences for fear of stigma. That needs to change.”

#CrisisTalk is committed to sparking ongoing dialogue on behavioral health crisis and including diverse perspectives and experiences. We’d like to hear what you think about this or any of our articles. Here’s how to send a letter to the editor.