Leading up to a severe mental health crisis, and at its peak, a patient ideally receives intensive support from their spouse, immediate family, close friends, and a core team of medical professionals. Those closest to the patient often bear the brunt of the trauma. They take on tasks such as hiding knives in the family home, ensuring medication compliance, minimizing substance abuse, and even contacting the police if necessary. This level of intervention can be overwhelming, as it focuses solely on keeping the patient alive. The patient may express the desire for everyone to give up on them and leave them alone.
However, our heavy reliance on the nuclear family means that we overlook an invaluable source of support: the periphery. The periphery refers to individuals who are one, two, or even three steps removed from the patient’s immediate circle and may not have a full understanding of the turmoil the patient is experiencing. Nonetheless, their distance and representation of normalcy make them powerful sources of support.
During one of my initial mental health crises, when I was in and out of inpatient care, returning to a sense of “normalcy” seemed impossible. The ward psychologist suggested that I reach out to one of my former English professors and ask if I could sit in on one of his classes. This simple routine and distraction proved to be tremendously helpful. Attending a crime fiction class gave me something to occupy my time during the day and provided a glimpse of ordinary life. Sitting in the lecture theater, surrounded by students my age, allowed me to engage my mind in something other than chaos. My professor never acknowledged that I wasn’t a true student, and he never mentioned my illness. He treated me like any other student, which was immensely comforting.
The periphery can also include work colleagues who reach out to check on the patient during their hospital stays, even if they haven’t socialized outside of work. It could be a beauty editor who sends magazines and self-care products despite never having had lunch together. It might be a neighbor who invites the patient over for morning coffee a few times a week, knowing they have little to do. Even though conversations may be minimal, the neighbor may play the piano, creating a calming atmosphere. The periphery can even extend to an ex-boyfriend visiting the patient while they are in a locked ward, or someone the patient’s brother is dating, who bakes them a comforting treat. These individuals may not seem like significant figures during a crisis, but they truly matter. While family and spouses can feel overwhelming when one is severely ill, the periphery can offer support without being directly responsible for the patient’s survival. They can treat the patient as they were before the crisis and provide comfort through phone calls, gifts, practical help, and other gestures of kindness.
In many cases, individuals on the periphery may feel uncertain about how to approach someone in crisis. They may fear intruding or worry that their actions will be seen as excessive. Sometimes, people feel like they shouldn’t reach out because they are not close enough. However, setting such strict boundaries prevents the periphery from participating in the patient’s recovery. It’s essential to open up to the periphery and appreciate the good they offer. While they cannot save someone, their presence and kindness can bring a smile to the patient’s face.
In my own experience, taking the class reminded me of better times and reconnected me with my intellectual capabilities. Listening to my neighbor play piano gave me a sense of joy and culture during a difficult period. Sharing a delicious cake on the ward made me feel like a hero for a day, and it brought happiness to other patients who were also struggling. It is important to remember that support is available for mental health issues, such as Beyond Blue and Lifeline in Australia, Mind and ChildLine in the UK, and Mental Health America in the US.
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