It’s okay to admit you need help: Overcoming the stigma of mental health treatment

by Elizabeth Payne-Maddalena

Broken bones. Whiplash. Concussions and TBIs. Slipped discs. Busted knees. Juries expect these kinds of injuries from a car crash or a slip and fall. These injuries are easy to diagnose: there are diagnostic tests for them, like x-rays and MRIs. Doctors can press on a muscle and feel it spasm, look at a person and see them limp.

But a person isn’t just a collection of body parts. That’s not what makes you you. When I ask people what drives them in life, they tell me about their families, friends, faith, work, passions, hobbies and dreams. Those are the important little pieces of a person that makes up a soul.

To pursue these things, these passions that make up a person, people have to be physically able to do them. When someone gets hurt in a car crash, it’s like throwing a stone into a calm pond – the ripples spread out and touch each part of their life. The outgoing PTA mom who’s always willing to help out suddenly withdraws, in too much pain to paste a smile on her face. The young accomplished athlete feels like a failure, struggling with frustration, anger at the recovery process. The office rockstar misses work, meetings, falls behind.

Juries aren’t surprised to hear about these kinds of damages from car crash or fall victims. After all, jurors are people too, and this makes sense to them that injuries do more than just hurt. But sadly, some attorneys choose to ignore these impacts on their clients’ lives, even when the emotions become so great that their client needs professional help to recover. These injuries, some say, are too “hard” to prove. After all, there’s no MRI to show depression. X-rays don’t show driving anxiety.

However, these are crucial losses that you’ve suffered because of someone else’s negligent choices, and you deserve to be compensated for them. So today, I’d like to talk to you about how to make sure all of you gets the healing you need after you’ve been injured. This is an important topic, and I know there are lots of stigmas around “mental health issues” that we’ll get into. Most importantly, remember that there’s nothing wrong with asking for help when you need it.

What kind of emotional or psychological injuries do you normally see in your cases?

First of all, I try not to call them “psychological injuries” because there’s a lot of baggage with that term, and I don’t want clients to feel judged or uncomfortable.

The situation I described above is very common with my clients. Injuries suck. I’ve had my fair share of them, and the healing process can be a long and arduous road. The pain alone can cause someone to want to isolate themselves or feel weak, humiliated. Clients may lash out unintentionally when they’re hurting, affecting their relationships with others. But some feel robbed when they miss out on important life events, or even everyday life events. When the injuries are life-changing, its a higher chance that they will never truly, fully recover. This makes some people very depressed. Some people get angry, as they did nothing wrong – after all, it was the defendant who made the choice that caused them to get hurt. Sometimes, these feelings of depression, anger, or anxiety become a festering wound that drags a person down.

Other times, the event itself may trigger anxiety or post-traumatic stress for a client. For example, imagine you’re sitting at a red traffic light, minding your own business when BAM! A drunk driver rear-ends you at full speed. You have to be taken to the ER from the scene by an ambulance. It’s out of nowhere. Next time you’re sitting at a red light, how do you think you’re feeling? Nervous? Anxious? You bet. Your sense of safety’s been completely shattered, and now, you trust no one. Many people confess to feeling like they’re just waiting for the next negligent driver to hit them – and they’re scared that the next one will be a lot worse. For a majority of people, this driving anxiety goes away after a few weeks. But for some, it clutches into their brain and refuses to let go. When those people get behind the wheel, they may start to feel their heart racing or have flashbacks. Nightmares might plague them. They avoid driving. When it starts to interfere with all the things you have to get done, that’s when you need to ask for help.

For assault and abuse survivors, the trauma surrounding the event itself leaves long lasting scars that require counseling to help them overcome their fears. Getting a client into immediate supportive treatment is necessary in these kinds of cases in order to help give the client the support they need to fully recover from their abusers.

What should I be doing to protect myself?

Again, each client is different – no two people are alike. Some people may recover without needing any professional help, but others will. It’s important that you’re talking to your medical doctors, physical therapists, and your attorney about your frustrations, anger and anxiety, so that way, if you do need help it is well documented. This means you’ll have an easier time getting treatment if you need it. This also helps build your case by having a third party that can back up your testimony if the case goes into litigation.

What are some of the major roadblocks that keep clients from getting treatment?

Stigma

Let’s face it: the US has a major problem when it comes to our views on mental health issues. The Association for Psychological Science cites this stigma as one of the main reasons why people don’t get or complete mental health treatment. Getting counseling or therapy is seen as something “crazy” or for people with serious psychological disorders. Some see it as an admission of weakness.

The simple truth is that the people I know who are willing to seek professional help when they need it are the strongest people I know. They’re anything but crazy. In fact, they’re some of the sanest people I’ve met. Think of it this way: you have a brain injury, you see a neurologist. But if your psyche is injured, you’re not gonna go see a doctor to heal that?

Insurance and money

The next big hurdle is finding a way to pay for treatment. Under the ACA, insurance companies must cover mental health treatments. This is great news, and something that hopefully Congress sees and keeps this requirement.

But many providers are out of network, meaning there are high copays or deductibles. Finding in-network providers can be time consuming, or worse, involve long waitlists. But there may be solutions you and your attorney can come up with if you ask and explain the issue with them. Let them be your ally! After all, we can’t help you if you don’t tell us what roadblocks you’re encountering.

Jagged little pill

With apologies to Alanis, medication is another big issue that makes many people shirk away from seeking help when they need it. There’s an additional stigma around taking psychiatric medications that’s pervasive. Some people fear they’ll become zombies or someone different on medication. Others worry that they’ll experience significant side effects. Still others fear addiction or dependency. But these feelings, while valid, shouldn’t stop you from getting the treatment you need.

First of all, medication is not always a requirement for treatment. It’s a tool that can be used as part of your treatment, yes, but it’s not a required one. Your mental health professional should be willing to work with you if you’re uncomfortable taking medication, and you should talk to them about your fears and concerns. You may also want to focus on treating with Licensed Professional Counselors (LPCs), Psychologists, and/or Licensed Social Workers (LSWs). These providers typically focus more on non-medication therapies versus psychiatrists. However, psychiatrists also offer therapies and methods that couple well with medication, or fall outside of it, and can be just as beneficial. They can be especially helpful if you do end up needing prescriptions to help manage your symptoms while you’re in treatment.

Additionally, your treating provider should work with you to find a medication that doesn’t result in significant or massive side effects or turn you into a zombie. While it may take a couple of adjustments or trying different drugs, your provider will work with you to find something that manages your symptoms while allowing you to still be you.

Finally, even if your provider recommends prescription medications as one of the tools to help you recover from your emotional injury, that doesn’t mean you’ll have to take that medication forever. It’s just like taking a course of antibiotics for a sinus infection: after you’re cured and you’ve completed your dose, you don’t keep taking them forever. Many people end up tapering off their medications completely once their treatment has resolved. Keep in mind that you should not just quit taking your medications, and stopping any psychiatric medications should be done at the recommendation and under the supervision of your treating provider.

Finding the right provider

The last big struggle I hear about when it comes to getting treatment for emotional injuries is finding the right provider. This boils down to two categories: experience/specialty and fit.

With experience and/or specialty, I mean finding a provider who’s treated people with the same trauma as you, and/or offers the kind of treatment you want. You don’t want to go to a counselor or therapist for driving anxiety whose never treated someone with post-crash driving fears before! When you’re calling around, ask your potential doctors, counselors or therapists if they’ve ever treated someone in your situation before. You should also ask what therapies they offer and prefer (including any concerns over medication, as I discussed above). If you’re not familiar with the therapies they offer, Google them! Google can be very helpful with explaining what therapies benefit what symptoms the best. For example:

By fit, I’m talking about finding a provider that you’re comfortable with. This is incredibly important when it comes to any medical provider that you’re seeing, case-related or not, but even more so for mental health treatment. You’re trusting and talking to someone about the thing that most people struggle opening up about: your feelings, your thoughts, your emotions, your fears. If you don’t feel comfortable (or like you can get comfortable) with a potential provider, your treatment won’t be as successful as it’ll be hard to open up. It’s not a bad thing, and a provider won’t take it personally. (As a lawyer, I tell potential clients all the time that they should feel comfortable talking to me, and if not, they shouldn’t choose me to be their attorney for the same reason).

Remember This

No matter what, people deserve to be compensated for the emotional damages they’ve incurred as a result of someone else’s negligent choices. Even if they don’t end up needing psychological treatment, as those damages still matter. Make sure you’re talking to your treating providers in order to build a record of these damages and ensure you get the treatment you need. Find an attorney who cares about all of you, not just your bones, muscles or organs. And don’t let the stigmas keep you from being compensated for all of your injuries. After all, it’s what you’re entitled to and what you deserve.


Beyond the Criminal Case: How Civil Lawsuits Help Sexual Assault Survivors Find Justice

by Elizabeth Payne-Maddalena

Trigger warning: the following discusses sexual assault and rape issues

“He stood there in a robe, and then opened it.”

“He grabbed my breasts as I walked by, every time.”

“I complained to my bosses about it. They never did anything, and it kept getting worse.”

“I tried to avoid him, find ways around seeing him. But he kept cornering me.”

“I trusted my doctor. I thought she was there to help me. Instead, she fondled me while I was under.”

“He told me if I wanted the job, I’d have to prove it. And then he whipped it out.”

“I kept saying no. Begging him to stop. He didn’t.”

Words like these have dominated the headlines recently. Victims of sexual assault are finally standing up and speaking out about the abuse they suffered at the hands of someone else – often someone they’ve trusted. It’s sparked criminal investigations, a national conversation, and even lawsuits.

As a personal injury attorney, I’ve been entrusted by sexual assault victims to handle civil suits on their behalf. Many people don’t immediately think that there’s any recourse other than a criminal case for sexual assault victims. Others don’t see why victims file personal injury or civil lawsuits. Today, I want to help explain what the civil options are for victims, and why it can be equally important in achieving justice and helping victims recover. I also want to help give victims some idea of the process, and what they should do as they take their lives back and weigh their options.

Because of this, there are 3 parts to this blog post, which I’m linking to directly here if you want to go straight to one section:

  1. Why pursue a civil lawsuit?
  2. I’ve just been the victim of a sexual assault. What do I do?
  3. How do I find the right lawyer for me?

Before I get started, I do want to state that if you have been victimized by someone you trust, I am so, so sorry that you are going through this. And I want you to know that it is not your fault. The most important thing you can do is take care of yourself right now. If this post is too hard for you to read at this time, that’s okay. Save it to read in a few weeks, when you are ready. And if you need to talk to someone now, I’ve included some links below to national hotlines for counseling after a sexual assault or rape case under section 2.

Why pursue a civil lawsuit?

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I hear this question, or some variation of it, all of the time. I think it’s honestly one of the most important questions there is on this topic. After all, people think, rape and sexual assault, those are criminal cases. That’s for the police to handle. The criminal system will take care of this, right? And that is partially true. Rape and sexual assault cases are criminal cases. The only way that a Defendant goes to jail for those things is if a jury finds him guilty of those criminal charges in a criminal case. But, those cases focus mostly on the punishment of the Defendant instead of helping to make a victim whole again. After the criminal case is over, a victim is left to pick up the pieces on their own. This can require expensive treatment, counseling, and financial losses, as well as the psychological costs to a victim’s psyche. The feeling of shame and humiliation. The fear of being a victim again. The loss of their sense of self, of safety. The criminal system usually doesn’t consider these kinds of things. These things are the domain of a civil case, where a jury made up of everyday people from your community awards the victim damages to help make up for what they’ve gone through.

Additionally, criminal cases and the prosecution of them are outside of the victim’s control once they report it to the police. The prosecuting attorney and their team decides whether or not to pursue the case in a criminal court. For victims, the criminal case itself can cause a whole new round of trauma. And because the standard of proof—or the evidence required—is so high, the chances of losing are higher too. Nevermind what happens if the verdict rendered is one like the infamous Brock Turner case, where the Defendant received a sentence many consider too light to even be called a slap on the wrist.

One other issue with the criminal process is that sometimes, those who were responsible escape any kind of charges at all, because the criminal laws don’t apply to them. This baffles people. Sometimes, they have no idea what I mean by this. Let me explain:

Let’s say that an employer – a private school, for example, hires a teacher. And this teacher has some holes in his background that they don’t discover. Maybe the school doesn’t properly vet him for some reason. During the teacher’s time at the school, red flags start to appear showing that he’s a danger to the students he’s supposed to protect. Maybe other teachers notice he is far too friendly with his students. Maybe someone sees that he meets with kids alone, with the door shut. Maybe a teacher hears a complaint from a student that he said something inappropriate. And all of these things are reported up the chain, but the people in charge do nothing. They pretend to be ostriches, stick their heads in the sand, and ignore all of these red flags.

Until one day, the police come to the school and arrest the teacher. He’s molested a child – one of his students. More students come forward. Parents are enraged, especially when they learn that the school knew he was a risk and did nothing. They didn’t investigate. They didn’t reprimand the teacher. Nothing. They trusted their children in the school’s care and the school turned around and handed their little ones right to the wolf. The parents of the victims are furious. They demand justice. But the police, the prosecutors, they say there’s really no criminal charges that can be filed against the school. There’s nothing they can do.

This is when the civil system steps in and fills the void. Under the civil laws, there are a few ways the (hypothetical) private school and the people running it for a pretty profit can be held accountable for their role in these sickening attacks. After all, they were the ones who allowed this to happen. They were the ones who could’ve stopped it from the get go.

We see this in all sorts of situations. Businesses hire employees that may sometimes even seem fine, at first. Then the red flags start popping up and the people in charge decide to bury their heads in the sand and ignore those red flags, despite that they know that their employee is becoming a bigger and bigger danger to not only their other employees, but their customers. They think that in the end, they’ll get away with it. It’s easier this way. Sometimes, the culture of the company itself is toxic, and the people in charge are doing the same things. We’ve heard this story a thousand times recently: from churches, to children’s groups, to schools, to colleges, to multi-million dollar businesses, to newspapers and media companies, and in restaurants and hotels. Too often, businesses and institutions think they will get away with it because they didn’t do the foul acts themselves. But when they allow predators to continue to prey on people who are trusting them, they should and can be held accountable.

Now, I am not saying that civil lawsuits are guaranteed wins. They’re far from it. Nor am I saying the criminal process is not important. The criminal process and system is very important in these cases, but it is not the only avenue for justice to be served. Both a civil case and a criminal case play important, yet separate roles.

There are also some cases where a civil case just isn’t appropriate. Since these cases can only award money damages (again, no jail time here), it is not worth it to a victim to pursue a case against someone who won’t ever be able to pay a verdict. But, in those cases where a victim has been severely traumatized and where the Defendant—or the Defendant’s employers—have financial resources, they should be held accountable to pay all of the costs from their choices. That’s what a tort case is and what a tort case does.

If a victim thinks they may want to pursue a civil case, they should absolutely talk to an experienced attorney who has handled these matters before. But I’m getting ahead of myself. More on that in a bit.

I’ve just been the victim of a sexual assault. What do I do?

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Many victims of sexual assault struggle with knowing what to do in the hours, days, weeks, and months following the attack. Their entire world is shattered. They’ve been stripped of their control of their own bodies. It is hard to function at all for some victims. My hope is that this part helps someone in this terrible moment see a path forward.

  1. Take care of yourself first.
  2. Once you’re safe, breathe. Remember, you did not deserve this. And you have control of what you, personally, do from this point.
  3. If it is the same day as the attack and you have been raped or physically injured, go to the hospital. Many victims don’t want to have to deal with anyone after an assault. They especially don’t want to be poked and prodded by doctors when they’ve just been physically violated. However, getting immediate medical treatment doesn’t just allow access to medications that will protect a victim from sexually transmitted diseases or an unwanted pregnancy; it’s incredibly important if you decide, at a later date, to pursue a criminal and/or a civil case against the Defendant.
  4. If you don’t require medical treatment, take photos. Write down what happened, who saw what. Make a record for yourself. If you are bruised, take the photos immediately. Same thing for scratches or other marks. If your clothes were torn, take photos, bag up the clothes and put them in a safe place. Write down everything that happened. Put names of any potential witnesses in there. Put all these things in a safe place. Back up anything you write down and any photos you take. Remember: phones break all the time. Computers die. Make multiple copies and put them in different places.
  5. Call the police. This one is a hard one for many victims. It is the hardest part. I am not going to sit here and judge you and make you feel guilty for not calling the police. I am not going to tell someone who decides the criminal system is not for them, that they want to let this go and move on, that they are wrong. This is a personal choice and it is your choice. But, if you think you may want justice, if you think you’ll want to pursue legal action, calling the police is a good first step. In a civil case, it helps us build the case and get the evidence we need to give you the best chance of winning. (That’s not to say there’s no hope if you didn’t call the police.) Ask for a victim advocate, if one is available. These are people who provide support to victims during the lifetime of a criminal investigation and case.
  6. Keep taking care of yourself. Again, your first priority is you. If you need to talk to someone, find a therapist that you’re comfortable with. Give yourself the time and space to process what has happened. A great resource for sexual assault victims is RAINN, a national hotline that helps victims navigate these first steps of the process. They even have an online chat feature if you’re more comfortable talking that way. If you’re thinking about suicide, please, please call the National Suicide Prevention Lifeline ASAP. Their number is 1-800-273-8255, or you can also use their online Lifeline chat. They have people standing by to help you and talk to you. Don’t let the Defendant steal your entire life from you. You deserve better.
  7. If you decide that you want to pursue a civil lawsuit, find an attorney who is experienced with these kinds of cases and whom you feel comfortable with. A quick, but important reminder here: in many jurisdictions, you only have a couple of years to pursue a civil case for sexual assault and rape cases. Sometimes, it is even less than a year, depending on the kind of case. Getting in touch with an attorney quickly is definitely important in order to protect your rights. Even if you’re not sure if you want to go through with a civil case, there’s no harm in reaching out to an attorney who practices in your state to see what your options are.

Why You Want an Experienced Lawyer Who Cares

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This brings me to my last point. A recurring theme, you may have noticed, is that you want an attorney who has handled these kinds of cases before. Depending on the kind of case, the facts of your case, and where you live, different kind of attorneys may be more appropriate to handle your civil lawsuit. No matter what, you not only want someone who knows what they’re doing, but someone you are comfortable with. Someone you can talk to. Someone you feel like you could grow to trust over time.

In my experience, these kinds of cases take years to reach a final resolution. During that time, you need to know that you can get in touch with your law firm – and your attorney. Your attorney should listen to you: your pain, your fears, your frustration, your anger. All of these are valid. Your attorney should answer your questions and explain the process to you. Even if it’s a “well, this is a unique situation, let me look into it and I’ll get back to you.” (And they should get back to you!). During the life of your case, you’ll have to relive some of the worst moments of your life with them. If you can’t trust them, you’ll never feel safe in doing that. That’s why it’s important to find an attorney who cares about you – not just your case, but you, the human being.

In the end, the decision to pursue any kind of action is yours and yours only. If you’re a victim of sexual assault or rape (or the parent of a minor child who has been victimized) who lives in DC, Maryland or Virginia, and you want to talk about the possibility of pursuing a civil case, I hope you’ll give ChasenBoscolo a call. Our experienced attorneys are happy to talk about your options and your personal case during a free initial consultation that is private and confidential. You can reach us via phone at 1-800-322-3380 or by going to our website and clicking on the live chat button.

No matter what, you deserve justice, and if you so choose, you deserve to have someone in your corner fighting for you.