The Myths That Shape Our Approach
So many myths about mental health keep us silent. Beliefs like “therapy is only for people in crisis,” or “medication is a shortcut,” or even “hospitals are always the safest option.” These assumptions not only reinforce stigma but also create barriers to care. As therapists, we’re often in the position of confronting these myths—not just in our clients, but in ourselves.
Elyn Saks, a law scholar living with schizophrenia, has described what happened when she was taken to the ER while experiencing psychosis. She recalls doctors and nurses “lifting me high in the air and slamming me down on a metal bed so hard that I began to see stars.” She was then strapped down with thick leather restraints, sometimes for months at a time, despite never harming or threatening anyone. Saks has pointed out that in the United States, every week one to three people die in restraints. Her story forces us to question: are hospitals always safe? And who do they really serve?
When ‘Safety’ Isn’t Simple
I think back to one of my own early jobs at an inpatient psychiatric facility for children and adolescents. Every few weeks, I was assigned “room checks.” That meant going through every item of clothing and every belonging—no sheets, no towels, no mirrors, nothing sharp. I remember the dread in my stomach, terrified that if I missed something, it could cost a child their life.
As a therapist, those fears don’t vanish. I still remember a particular client who struggled with chronic suicidality. She was often late to her sessions, and with every passing minute my mind raced to the worst possibilities. More often than not, she eventually arrived—iced latte in hand, having simply stopped on the way—but the panic was real.
We often discuss inpatient hospitalization as the “safest option” when clients are at high risk of suicide. But research paints a more complicated picture. One of the most dangerous windows for suicide is actually the week immediately following a psychiatric hospitalization. In that short window, suicide risk increases by 200–300% compared to the general population. That doesn’t mean hospital stays cause suicides, but it does raise hard questions: are we truly guiding clients toward healing and hope, or sometimes adding to the trauma that brought them there in the first place?
Moving Forward With Nuance
That’s why we need to keep naming and challenging these myths. Therapy isn’t just for people in crisis. Medications aren’t “shortcuts”—they’re tools, sometimes essential ones. And hospitalization isn’t automatically the safest or most healing option.
Going forward lets challenge these myths when you hear them. In your families, in your workplaces, in your circles of friends and in your practices. Listen closely to the people in your life who are struggling. And remember, what helps one person may harm another. Our job is to replace myths with nuanced understanding, and to keep choosing connection over silence.
