Editor’s note: This is the second of two stories concerning the large number of mental-health cases, including suicide attempts, in Saline County and those who provide help for the patients.
M.Y., who is 56 and a single mother of a teenage daughter, is very open about her depression, her attempts to end her life and the treatments she receives. In fact, she was open and brave enough to say that she could be identified by name in this story, but her doctor, officials at Saline Memorial Hospital and the Tri-Lakes Edition staff decided using initials would be better for her and her daughter, who attends high school in Saline County.
M.Y. cheerfully talked to nurses as she lay on a hospital bed in the pre-op area of Saline Memorial Hospital. Her nurses, who had started an IV, chatted as they waited for the doctor.
“I don’t know how many treatments I’ve had, but by now, everyone knows me,” M.Y. said. “They are all so friendly and helpful. They take care of me.”
The Tuesday morning procedure was her 15th in the past couple of years, said her psychiatrist, Dr. Duong Nguyen, who is co-medical
director of the behavioral-health department at the hospital and was preparing her for electroconvulsive therapy.
The ECT was recommended to M.Y. after she had made several suicide attempts.
“I started working with her when she came into the emergency department after one of the attempts,” said Nguyen, who has been a psychiatrist and neurologist for the past 22 years. “Her last attempt was not critical. It was a call for help. The one before that was much more. She was in ICU for three days and then went to Rivendell [Behavioral Health Services of Arkansas in Benton]. She took an insulin overdose; it was very serious.”
In the pre-op room, M.Y. was quick to assure her visitors that the procedure is routine and she is not afraid.
“It is not like the scene in One Flew Over the Cuckoo’s Nest with Jack Nicholson,” she said. “It is quiet and gentle. I’m asleep.”
M.Y. said she is thankful for her doctor and the treatments.
“He has really saved me — me and my daughter both,” she said. “It reboots my brain, and that makes a difference. Without the treatments, I could not cope with even the little things.”
M.Y. said the ECT keeps the thought of killing herself at bay. Nguyen also said the treatment seems to reset the brain in some way.
“We do not know exactly how it works,” he said. “We know changes in the biochemistry in the brain lead to depression. The ECT sends electricity through the brain and signals and resets the works.
“Without being invasive, it can trigger electrical change in the brain, just like a drug is used to regulate the electrical pulses that set the heart rate for someone who has atrial fibrillation. ECT works 95 percent of the time. It is no cure, but a form of medicine to treat the cause.”
Information from the staff of the Mayo Clinic and published by the Mayo Foundation for Medical Education and Research notes that ECT often “works when other treatments are unsuccessful.”
According a statement published by the foundation, “Much of the stigma attached to ECT is based on early treatments in which high doses of electricity were administered without anesthesia, leading to memory loss, fractured bones and other serious side effects.”
Dr. Nguyen, at Saline Memorial, said ECT is safer today because it is given to people while they’re under general anesthesia, and the electrical currents are smaller and better controlled to achieve the most benefit with the fewest risks.
“I go home as soon as I can after the treatment,” M.Y. explained. “I’ll sleep until lunchtime and then watch the soap operas and take a nap before dinner. I’ll be lazy tomorrow, but by noon, I’ll be fine.”
Like her doctor, she can’t explain how she feels better after the ECT, but she said she does.
“I just know that I feel more involved with the world and life, and I’ll even want to go places,” M.Y. said.
She said that within a few days, she hopes she will feel good enough to visit the unemployment office and begin looking for a job.
“The thoughts of suicide started when I was a moody teenager sitting in my black-painted bedroom, but I kept it hidden. I wore a mask and learned to say what made people comfortable,” M.Y. said. “My first attempt was in my late 20s, and I was taken to the hospital. I was offered help, but I was in denial. I put the mask on and said, ‘This is not me. I’m not one of those people to try to kill themselves. I am an educated person.’”
With her education, M.Y. was able to build a professional career, but the depression also complicated her life. She said thoughts of killing herself grew worse after menopause.
“I got to where I said, ‘I don’t care,’ but because of my child, I do care more, and I’m more aware when the feelings start. If I don’t recognize it, she will,” M.Y said. “Now there is no more mask. This is who I am. You either get me or your don’t.”
Tears formed when M.Y. talked about her daughter and how her support has helped M.Y. through some tough times.
Nguyen also said the daughter has been great support for her mother. He said the daughter is in counseling with a social worker, helping her to cope with her mother’s mental illness. He said he wishes M.Y. would consent to more counseling, especially if she tries going back to work.
M.Y. said she needs to find a job for the income and for insurance. She said she is ready to go back into the workforce. The doctor said it will depend on the job.
“Her last job was stressful,” Nguyen said. “She has skills, but it will depend on how stressful the job will be.”
He said his patient has a lot going on in her life.
“She has a lot of health problems, and day to day, she is struggling,” Nguyen said. “She is better, but she doesn’t feel good, which is typical with someone with chronic illnesses. If you ask me, her prognosis is guarded.”
When it comes to M.Y.’s treatment, her doctor said ECT is not for every patient. He said that nationally, only about 1 percent of those under psychiatric health care receive the therapy.
However, that 1 percent can be a significant number. The National Institute of Mental Health states that around 38,000 people die by suicide each year in the United States, more than those killed in homicides. In 2011, that number was almost 40,000, according to the Centers for Disease Control and Prevention. The CDC states that someone in America dies by suicide every 13 minutes.
According to information from Saline Memorial Hospital, the hospital’s ambulance service has answered almost one call a day this year for mental-health emergencies with patients reporting suicidal thoughts, intentions or attempts.
Jim Gregory of Counseling Clinic Inc. in Benton said more than 700 people are screened annually for mental-health concerns by the counselors who work at the hospital, and that from 55 to 60 percent are hospitalized. The clinic provides some of the personnel for the hospital’s behavioral-health department.
“We admit about one a day that we think are serious enough not to be allowed to go home,” Gregory said.
Nguyen said he would like to see a dedicated suicide help line in the county, with trained volunteers who can talk with those who call with thoughts of taking their own lives.
“That kind of immediate help, even just someone to talk to, would be a start,” he said.
The counseling center maintains a help line, with counselors taking calls from individuals, along with calls from Saline Memorial’s emergency department, the Saline County Jail and police departments in the county. The counselors and social workers take callers through a mental-health screening process.
To find out more about ECT and combating suicide, call the Counseling Clinic at (501) 315-4224 or Saline Memorial Behavioral Health Department at (501) 776-6600.
Staff writer Wayne Bryan can be reached at (501) 244-4460 or wbryan@arkansasonline.com.