Emergency rooms are overwhelmed, in South Carolina and around the nation, with mental health emergencies.  It seems that every day I’m asking someone about their suicidal thoughts, exploring their mental health history, trying to discern if their behavior is due to drugs, alcohol, underlying mental illness or simple acting out.

I can’t remember the last shift when our emergency department wasn’t 1) holding a psychiatric commitment or 2) watching the ambulance roll up with  yet another person thinking of suicide or acting on their thoughts.

Like many facilities, like many communities, we don’t have a psychiatrist. And thanks to budget cuts, we don’t even have much access to counselors.  Consequently (and also like many hospitals) we find ourselves boarding the mentally ill, either in the emergency room or on the hospital floor.

Where is it all coming from? I mean, most of these folks couldn’t have afforded a psychiatrist to begin with, and wouldn’t have gone if they could have.  Why are we unraveling so rapidly?

Is it purely the economy?  If there are jobs, nobody feels depressed or suicidal?  Is it the culture?  Before reality television, people were happier?  (I can accept that!)  Is it transience?  Methamphetamine?  Divorce?  Is it lack of connection and loneliness?  Is it lack of insurance?

The causes, like so many things, are probably multi-factorial.  But as I see patients crying, punching walls, raging against…everything; as I see them cut and use and hear the descriptions of voices that tell them they are worthless, the replay of their memories of abuse, I have to believe that maybe, just maybe, our national rejection of faith, of truth, of certainty, has finally borne its fruit.

We reject the idea of guilt, and laugh at confession and repentance.  But guilt remains.  We reject any hope of eternity, or eternal meaning, and medicate hopelessness (with nearly hopeless results).  We deny God, and the love of God, and scoff at communities of faith, but there aren’t enough counselors to  comfort the lonely and broken.

We deny evil and leave the raped and broken, the victimized and lost wondering:  if there is no evil, how did this happen to me?  And why am I upset about it?  And did I make it happen?

We have sown the wind, and reaped the whirlwind.  And the victims of the windstorm lie in the hallways and side-rooms of our hospitals, waiting for comfort from psychiatrists and pills and hospitals (which discharge them as soon as possible).  And none of them will offer the comfort of this:

‘Come unto me all yet that labor and are heavy laden, and I will give you rest.’


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