Q: What was your job?
A: My title was “mental health worker.” It was like a foot soldier type of thing.

I chose the job because I had just graduated with a B.A. in psychology, so I guess it seemed like the next step. Plus I had spent five years working in a homeless shelter so it just felt like a natural transition, I suppose.

Q: What did you do on a daily basis?
A: You get there, read the notes about what’s going on in people’s lives, get them to take showers… Then lead two groups a day, doing things like reading the news or doing crafts. We’d take turns at mealtimes, be hall monitors. We were mostly there just keeping things safe and stable.

Q: Do you remember the hiring process?
A: It was a group interview, there were four of us, and they brought us on a walkthrough. At that point I didn’t even know it was a mental institution. It was called a “special treatment center.” I thought maybe it was for drug rehab.

They took us on a walkthrough and it was quite alarming at first. You’re in a room with 50 people and all of them are doing something very weird. As you get to know the clients more, you get to know what’s normal for them.

Q: What were the people who lived there like?
A: They’re more sensitive than the average person. They might be doing something that can be strange for a normal person, but normal for that particular person.

When I first started working there I thought, “How did they manage to hire so many assholes?” because the staff was so callous. But then you learn. There are a couple of people who work there who are just paragons of sensitivity and patience, but there is really high turnover and it’s hard not to change. I remember after I’d been there for a while, a new staff member asked me where something was and I just pointed at it—I didn’t even make eye contact. And then I realized I was turning into one of them.

Q: Did you ever see One Flew Over the Cuckoo’s Nest?
A: I watched that movie when I was working there and I remember that it wasn’t too terribly off. Nurse Ratched probably got the job because she wanted to help people but she’s been there for 40 years.

Q: Was there anyone you specifically remember?
A: Each person was very different, but two stand in my head the most.

I don’t like the subtle unspoken message some movies give you that people with mental health issues have to also somehow be brilliant for their lives to matter, but there was a woman there who really was. She could speak four or five languages and I know she wasn’t making it up because she acted as a Russian translator for a new patient we had. And she could do watercolor paintings that looked exactly like the person, using just these dollar watercolor paints.

I never saw any symptoms from her and I was getting a bit skeptical, but a couple months after I left this job, I saw her at an adult daycare center and she was really getting delusional at that point. She was telling me a story about her little girl and how she threw her in a dumpster JUST THE ONE TIME but her family wouldn’t let her forget it, and she didn’t get why they wouldn’t let her have custody of her child after that.

The second person I remember was someone who had borderline personality disorder. She thought that her colon had died inside her and she was going to die. Every day was her last day to live, in her mind. The people who are there every day were telling her, “You’re not dying” but she didn’t believe them.

We would show her the records, like, “Here is what you did this morning.” But to her, she was dying and nobody was listening.

She would yell, “I’m dying and nobody gives a shit!” I remember one time, one of my co-workers said, “Can you just ‘not die’ in your room because I’m running a group over here.” It’s sad, because to her it’s real, but to us, we hear her say it every day and it gets tedious.

And then you do get a little bit of gallows humor over it. Like, I remember one time I overheard that woman gloat to someone, “You’re just jealous because I’m dying and you’re not.” And I remember thinking, “Wait…are you happy that you’re dying, or sad that you’re dying? Anyway it doesn’t matter because you’re not dying, but which is it?”

Q: What kind of illnesses did people have?
A: Almost everyone there was schizophrenic. It manifests in different ways, like they hear voices or they are catatonic.

Some people had the kind of thing you see in movies like “A Beautiful Mind” where the symptoms are self-contained and additive, like they can talk to you about their favorite book at the same time that they hear a voice telling them to kill themselves, and they know the voice isn’t real and can ignore it.

Most of the time people didn’t really talk to the voices in their head like they believed there was a person in there. They would either think that something supernatural was going on, like their boyfriend, or god, or their daughter, was talking to them through telepathy, or they would think that other people were talking.

If people were catatonic, like not responding to the outside world at all, it can be challenging to get them to do things they need to do, like eat or take a shower. Usually people were only like that when they first came in. Even if the meds didn’t work super well to get rid of persistent delusions or hallucinations, they could usually bring people out of that stage.

Q: Did people ever get better?
A: Some clients did get better—some people are able to find a pill with manageable side effects, but it can be difficult. Like incontinence is a side effect. Do I want to hear voices or wear diapers?

I once asked someone what it felt like and she said that when she first experienced symptoms, she thought someone was messing with her. She heard three different voices—one of which was a Jamaican guy. So she’d hear someone calling her name and look behind the bushes to see who was talking to her. Then before she knew it she was pulling her teeth out with pliers and had to go to the hospital. That moment has always really stood out to me because it was such a graphic thing to say, and she said it so casually, matter of factly. She was missing some teeth, but the whole time I knew her she was so lucid it’s hard for me to imagine that. But it’s what she said.

Q: Did you learn any life lessons by having this job?
A: People get this idea that the mentally ill are dangerous or scary, but most of the time the seriously mentally ill probably don’t know what’s going on, are more of a danger to themselves than others. They’re really quite vulnerable. You can joke with them, play music, play cards. It’s just a part of someone’s life, not everything about them. And the symptoms come and go, so even if someone is in their worst stage, they could be joking around and making beautiful art next month, if they get the right help.

The lesson is that it’s a lot more complicated than you think.