"I didn't go to school all week... the depression is killing me. And my mom just doesn't understand. She thinks all meds are bad." My seventeen year old client sighed, slumped in her seat, looking so disconnected from herself. "But nothing else is helping. My friend gave me edibles, but after last time..." when she took too many and had a psychotic meltdown... "I don't want to do that again. Is that the only thing I can do though?" She looked up at me, eyes stony, reminding me of myself. "If my mom refuses meds... is my only option getting illegal drugs?"
My heart broke for her. I had tried everything — talking to her mom, sending psychiatrist referrals, getting my supervisor involved, even calling child services (who didn't do anything). In my client's community, there was such a denial of mental health services, including therapy. Anti-depressants were seen as giving into the weakness, a character flaw even. They were old school... the "pull yourself up by your bootstraps" type. It was so ingrained in their culture that all of my pleas were useless.
"It just makes me want to die."
"Isabel, no." I leaned forward in my chair, showing the deep compassion I felt for her situation. "I know it feels like too much right now, but we are going to get through this, I promise." I let out a breath, lip quivering as I imagined the worst case scenario. Then I was just honest with her: "I'm worried about you."
She nodded, looking away. "Me too."
There was a tense silence as I racked my brain of what to do. My inner-Violet side was on full blast: how DARE our system fail these teens in this way! It's not fair that she couldn't get meds without parental consent. For god's sake, she's almost eighteen anyway!
But she couldn't wait the extra month for this. Especially with how intense the depression was becoming.
But it wasn't bad enough to send her to the emergency room, and with her shitty government insurance, they would send her to what my clients deemed the "scary hospital," which would probably do more harm than good.
I finally broke the stillness. "I'll do anything I can to help you."
She shook her head. "Unless you can get me meds, I'm not sure what else you can do. Talking to my mom is like talking to a brick wall. She won't budge. We've tried everything."
A lightbulb went off in my head. Maybe I could get her a prescription. Just a low dose of an anti depressant... something I'd taken in college which helped me tremendously.
"Let me see what I can do... What's the pharmacy that you would use?" I scribbled the information down on my notebook, wheels still turning about how I could make this a reality for my client.
x-x-x-x
The next day in the Central Park office, I knocked on Toby's door. It was closed, but did not have the "in session" sign up, so I let myself in. His light was off and computer asleep, and I wondered where he was. This put a damper on my idea to ask for his help with this client, but the butterflies in my tummy told me it's better to ask for forgiveness than permission anyway.
Gently easing the door shut behind me, I turned on the light and made my way towards his computer, shaking it awake. My heart thumped in my chest as I entered the password I'd seen him type in thousands of times. The desktop sprung to life, several windows left open under the guise of being password protected.
An outside noise stopped me dead in my tracks for a moment as I feared my friend would come in and catch me in the act, but then I realized it was just noise from the street.
Taking a deep breath I clicked on his web browser, then the button that read "EHR." I'd seen him do this a handful of times, when I joined in on sessions he had with the clients we shared. But the system was fairly user friendly and almost too easy.
Toby's password was automatically filled in, so I entered with ease. My fingers shook as I typed my client's information, then clicked on the medication and lowest dosage. Last was finding the pharmacy in question, and just like that, the prescription was sent.
I felt lightheaded as I logged back out of Toby's accounts and his computer, praying that his screensaver would come on quickly and he'd never find out what I did.
Guilt crept through my body, slimy and heavy as I pushed away from the desk, tucking my notebook under my arm and slipping away.
It's worth it for Isabel.
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