Photo ops in hard hats during a behavioral health crisis that won’t let up

Psychological distress can transmit and implant itself into our physical bodies, and for me, anxiety roils under my navel into a balled-up fist capable of squeezing life out of me— or at least anything well-ordered and reasonable I’ve cobbled together. It smashes plans to leave the house on time, sucks time into the anxiety’s gasping for breath. 

I’m learning new ways to manage it, but it’s a problem that showed up the morning of an event Sept. 21 to mark the construction phase of a long-promised Behavioral Health Crisis Center. It was funded by people who’d voted in 2014 to be taxed more, seeking adequate care options after Albuquerque police killed James Boyd, an unsheltered person living in the Foothills of the Sandias. 

The event was labeled a groundbreaking celebration for the center that’s set to open in 2024 at the University of New Mexico’s main hospital campus. Officials from the state, Bernalillo County and UNMH gathered around a P.A. system, with iced drinks and foldable chairs under a couple of tents, along with construction hardhats and shovels arrayed for photo opportunities. 

I’d meant to wake up in time to change into neutrally professional clothes, but the night before was rough with little rest. I’d thrown on sneakers and run out the door in what I’d finally crashed out in: shorts and a T-shirt with a block-lettered horror film reference: WHO WILL SURVIVE AND WHAT WILL BE LEFT OF THEM? Hasty attire at least posed a valid question. 

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

She also sounded tired. “And are we pushing a little pedal bike up against a big boulder?” 

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

They’d tried checking him in to detox services at Bernalillo County’s existing treatment center but got turned away at the front desk. Someone decided Michael, who at that point was exhausted, stressed and chemically imbalanced, “wasn’t ambulatory enough” for treatment.

So then they were back to the first private hospital, in the middle of the night, to plead for help. They happened upon one nurse who took the time to look up Michael’s medical history and advocate for him, finally securing him placement for appropriate detox.

My friend spoke of a pedal bike against a boulder, but the behavioral health crises in New Mexico at this point reminds me of the anger slime accumulating under New York City in “Ghostbusters II.” In recent years here, historical sorrows have been boiled down by further deprivations, dislocations and political polarization, while everyone watches our wan watersheds running empty, our stressed forests dying out and burning around us. 

We are all more agitated and at minimum seeking emotional shelter. Gov. Michelle Lujan Grisham spoke about impatience — her own, and others’. 

“I spent an hour with a dad whose own daughter presented to an emergency room in behavioral health crisis. Twenty hours later, she walked out, and we don’t know where she is. These are the kind of occurrences happening in our communities and across the country. … There’s not a single one of us who hasn’t had a family member affected by this … or a neighbor or a friend or a church member or co-worker.”

While she acknowledged this most painful part of “the underbelly of behavioral health” in New Mexico exists, its reek is more of desperation than impatience, followed by poisonous waves of desperation’s more hopeless and terrifying primo, dire resignation. The celebratory framing of the event was a gross distortion of reality, hard hat or no. 

We need to be more honest with ourselves about how grave people’s living conditions continue to be here, whether we feel their grip intimately or not. Far too many of us were swimming in loss and trauma before coronavirus added further disruptions, additional griefs, new forms of mass death. 

We were already too accustomed to rampant familial and community fragmentations, to both shared and personal violence.

No one I know is emotionally well these days. People who are coping have better protective coatings, ways to insulate or even dissociate emotionally and materially from the most severe sources of suffering. Most of them know they are among the lucky ones, a kind of survivor’s guilt that causes its own dislocations and moral injuries. 

We know this place where we live is, at this moment, overwhelmed by risk factors for the accumulation of still more permanent harms. One of our local think tanks, New Mexico First, said it plainly earlier this year: 

Before taking shovels to dirt alongside other policymakers in front of assembled cameras, Gov. Lujan Grisham handed out commendations, one to state senator and retired Albuquerque social worker Jerry Ortiz y Pino. 

When he and I caught up over the phone days after the event, he told me that the most urgent work ahead of New Mexicans is about fundamentals: We’ve got to increase the number of professionals who specialize in effective treatments. And this is not a drill. It’s an ongoing emergency. 

Back in May, when Ortiz y Pino spoke to the director of Turquoise Lodge in Albuquerque, the city’s one inpatient substance use treatment facility was operating at half its patient capacity simply because they were short-staffed. He said the state psychiatric hospital in Las Vegas, surrounded all summer by the largest wildfire in New Mexico history, has an entire wing that closed earlier this year because of inadequate staffing. And a rehab center in Roswell is licensed for substance abuse detox and wraparound treatments but hasn’t admitted patients yet, 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 needed in the state

We need drastically more behavioral health professionals statewide, said Ortiz y Pino, and while he’s encouraged that the state has released funding to educate more local people in this field, providers relocating to New Mexico from out-of-state face daunting bureaucratic barriers. 

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

The governor said during her remarks that she  “doesn’t want to have another hour-long conversation with a parent who’s devastated.” But it’s going to take much more than a new crisis triage center to make that happen. Once someone’s in crisis, help after that is reaction — not solution.

When I asked my friend last week how Michael was doing now, she had a story much like the parent who’d spoken to the governor: He’d disappeared. My friend doesn’t know yet if he’s OK and is starting to get really worried. 

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

That list of basics is apparently daunting or even unreasonable to most people in positions of power. And that itself is a call to mass anti-celebration. It’s call not for digging more holes but for proper burial and mourning of our wounded, missing and departed, before we break into relentless and effective lamenting.