Posted by Commander Roman Alden (First Officer & Chief Science Officer) in En Route- Mental Health Priorities

Posted by Lieutenant Junior Grade Leah Hart (Nurse Practitioner/Counseling) in En Route- Mental Health Priorities

Posted by Commander Roman Alden (First Officer & Chief Science Officer) in En Route- Mental Health Priorities
Posted by… suppressed (2) by the Post Ghost! 👻

(snip)

“I’m sure you have that there as well,” Roman said, not wanting to talk about it. Initially, he’d wanted to do everything off the books. In the end, he’d agreed to do it right. But he would not talk about his nightmares willingly.

~ Roman

Leah set her stylus down and silently took in Alden for several long moments. [o]Alright, we’re going to pause for a moment and I’m going to do a bit of talking and I would appreciate you truly listening and not tuning me out, because this is important.[o]

She inhaled deeply, a pensive expression sweeping over her face. [o]I started out as a registered nurse working the emergency room at a hospital on Aldebaran. I saw all kinds of patients, with all kinds of injuries and illnesses, and the ones that always got me the most were the ones that were avoidable. And this became no less true after I joined Starfleet. I’ve spent the last eight years primarily working with patients who for a variety of reasons aren’t able to stay on their duty assignments in order to receive treatment. Some had milder issues that they just needed a bit of guidance through, and other were quite severe to the point of debilitation. And the one thing they all had in common was that they had hit hurdles that they couldn’t get past on their own. And rare is a cognizant patient who ends up in those more severe situations who isn’t embarrassed to be there, or in fear of judgement. It’s normal.

[o]My job is to help each person evaluate that hurdle and figure out what to do. Sometimes just trying to leap over it doesn’t work, so we come up with different strategies to go around, under or even through. Whatever that looks like is unique to each person and their situation. And the one thing you have to understand about me is that I don’t believe that mental health struggles are an automatic boot from service, or removal from duty. Much depends on the exact issues, the severity of symptoms, and the willingness of the patient to be helped.[o]

Leah paused and considered him. [o]I get it, more than you might believe. This eval has been forced upon you and it might even feeling like I’m holding a weapon to you head while asking you all sorts of things you believe will take away something you love. It’s not a negligible fear, but nor do I make snap judgements with such high stakes involved. I’m used to patients withholding information or outright lying. It’s a part of the job. But while this eval is about you, this situation is about more than just you, Commander. You are the first officer of a starship with a hundred some-odd people you are responsible for. If I turn in a report with a ton of holes, or am not as thorough as I should have been, I would be negligent. Because let’s consider the hypothetical situation where I clear a patient for duty when they were struggling with something they were avoiding talking about and I didn’t push hard enough. They keep going until something triggers them badly. What if that happens in a crisis, or when there is a situation with high stakes? What if lives are lost as a result? That’s on me, because I didn’t fulfill my duty-of-care to the patient, their shipmates, and Starfleet.

[o]I refuse to let that happen here![o] she said adamantly, her accent thickening as she infused more emotion into her words. [o]I told you we can play games if you want to, but if you stop fighting me so hard, I actually might be able to keep you in your job on the Sentinel. But I’m going to be really frank here, Commander Alden, that if things are so bad that I can’t get more than a few words out of you at a time over some fairly basic questions, then you shouldn’t be there. But if we can show the powers that be that whatever you are dealing with is something you are willing to work on and be an active participant in finding the way around your hurdles, then I can help you and make things happen. I’m not out to get you, truly. I want you to be the best officer you can be, whatever that looks like. And if you’re having mental health struggles and need support? What of it? It says nothing about you as a person. You’re just dealing with an issue the same way you’d deal with a broken arm or a bout of the flu. But this is up to you. I can’t help someone who doesn’t want to be helped.[o]

~Leah Hart, NP

That was just it though, he didn’t want to be helped, he didn’t want to talk about it. He wanted to keep going how he had been. He was fine. He could do just fine. He didn’t think he was going to be ‘triggered badly’.

That was, of course, him ignoring the obvious, again. That he gripped whatever was closest to him at the slightest shake of the ship, that he would probably have a panic attack if ever he faced a Klingon cruiser again. That without Rand making him get medical care and treatment, he’d either already have been pulled from duty, or be dead. Either his leg, which had been hurt and he’d had surgery on two years ago, or the very nightmares he was avoiding talking about, would’ve caused him to lose his position.

He gave a long sigh and looked at Leah, still guarded but also just scared. “I just don’t want to lose my job. But… I… I’ve never been able to talk about this.” His hands, resting on his knees out of view, clenched into fists. “I can’t.”

He hadn’t received mental health care after the attack on the Ardent, and he had been able to avoid all reminders of it and of what happened, what he lost, allowing his avoidance, his fears, to grow, until they became something unmanageable. Something untouchable, yet threatening to take away everything he cared about, with far reaching effects on his behaviour and actions.

Roman glanced down with a frown, not meeting her gaze through the screen. “It’s embarrassing.” Not to mention too hard for him to talk about. He and Randy had barely breeched the subject, and they had worked for some time towards it.

~ Roman

She gave him a soft smile. [o]That is the first truly honest thing I think you’ve said to me, so thank you. I appreciate you going out on this limb with me. And I will also say you were right earlier, that today is not the day for a proper therapy session. I fully believe you when you say that you feel you can’t talk about it. And I also understand that all this can bring up feelings of shame. My goal isn’t to tackle that right now. My goal is to see that you’re not so disconnected from everything that you’re a liability on that ship.[o] Hart leaned in closer, her eyes unwavering in their belief. [o]You’re not broken, Roman, you’ve hit a hurdle and it’s a big one. I can see it in your face, you body language, your avoidance. And that’s okay… for now, for the moment. But it won’t be for long. So here’s what we’re going to do. I’m going to ask the rest of my questions, of which there are only a couple, and then we will be done for today. At the end, depending on the rest of your answers, I might have homework for you that is non-negotiable. We will meet after I get to the Sentinel and we will discuss that homework, figure out the plan to get you moving forward and go from there. Yes, sessions will be mandatory. No, I will not tolerate the disrespect of missed appointments and having me chase you about the ship. We are adults and Starfleet officers. Yes, things come up on a ship, but you can make this a priority. Short of an emergency, you can be spared for an hour at a time. You’re the first officer, delegate. And if something is that important that we have to reschedule, you will talk to me about it, but the next time we meet will be close in time to original appointment, not days later.

[o]Can you agree to these terms? All of them?[o] She felt she was being reasonable under the circumstances, but only he could make this happen. His future was truly in his own hands.

~Leah Hart, NP

“Why not? What’s changed? I’ve been fine the least several years. I don’t know why all of a sudden I have to do this.” Roman said and then sighed. “I suppose I don’t have a choice so yes.”

~ Roman

She weighed her options. Would she prefer he agree that things couldn’t go on as they were? Absolutely. But the depth of his denial was such that it overrode everything but his sense of survival. This was fight or flight in action, even if it looked different than others might expect. He wasn’t fine, not by a long shot.[o]What’s changed, Commander Alden, is that your well being is being made a priority and we’re not willing to let you slip through the cracks anymore. You matter, and it’s time for you to learn to believe that as well.[o]

Leah grabbed her PADD again. [o]Okay, next question is pretty simple. What sort of activities or hobbies do you engage in when you’re not working, and how often would you say you take part in them?[o]

~Leah Hart, NP