Recently I had a powerful illustration of the difference.
One of Kelli's coworkers started acting strangely last November. Normally a relatively quiet but extremely kind man with a great sense of humor, Ben (not his real name) began talking a mile-a-minute and being otherwise boisterous and emotional. He was quick to laugh inappropriately and quicker to get inappropriately angry about trivial matters. Everyone noticed this change of behavior and he acknowledged it himself, explaining to a few coworkers (Kelli included) that he was going through a rough patch. He also mentioned he had been buying Xanax off of the internet because his local doctor would not prescribe it for him anymore.
The way the internet thing works is this: you pay for a "doctor's appointment" and you pay full price (plus) for the drugs and they get express mailed to you. Being an online enterprise, it's extremely difficult for the DEA to shut these places down. If you look, you'll find them. You will probably be able to get drugs inappropriately (read: illegally) but you might get drugs which have not been stored appropriately, you might get fake drugs, or you might not get anything and be scammed out of your money completely. And if there's a problem who do you expect to complain to? It would be a little like calling the police to report you were sold poor quality crack cocaine.
Anyway, Ben was getting progressively worse and self-medicating to the point of being dangerous. The managers at work pulled him aside and steered him to their employee assistance program. He continued self-medicating and his behavior deteriorated to the point where he was having problems putting together complete thoughts, was slurring his words, and was having problems with coordination.
January 1st he was arrested for driving under the influence (of Xanax). He told his coworkers the next day that it had happened (and felt picked on by the police).
A few days of erratic behavior at work later he was put on involuntary leave so he could get some more intensive help.
While the whole picture (or at least the whole picture as of now) was not clear until everyone compared notes later, pretty much everyone he worked with knew he was headed off the rails. Given the erratic behavior and wild emotional swings, some coworkers were understandably concerned that he could become violent toward them. More were concerned he was a candidate for suicide. Pretty much everyone guessed it was going to get much worse before it got any better.
Every move he made was a "cry for help."
January 7th, 2007, he was found dead at his home of an apparently unintentional prescription drug overdose. He was 39.
What an incredible waste.
Ben had family and he had friends and he had a longtime (although not live-in) girlfriend and every one of them, to a greater or lesser degree, tried to help him. Kelli had recommended specific counselors and tried her best to let him know that self-medicating was not the answer. For a strictly coworker relationship, she tried her best to help him out.
If you are close friends with someone you might be able to grab them by the scruff of their neck and drag them in for a psych eval but maybe not and definitely not if you are just a coworker.
Plus it is an essential ingredient for Ben to have actually wanted to get help. Comparing notes with his workers, friends, and family lead to the discovery that his agenda with regard to treatment was almost exclusively drug-seeking. He wasn't very successful locally so that's where the internet came in.
Ben had rights. He had the right to refuse treatment. If the police had deemed him a danger to himself or others he have been taken for a psych eval and could have been involuntarily committed to a mental hospital for no longer than 72 hours. Ditto a physician.
Friends could not have forced him into treatment.
Family could not have forced him into treatment.
Had he committed a crime (or had he been convicted eventually of the DUI) he could have been ordered by a court to either complete a treatment program or go to jail.
That's it, folks.
The only one who had the power to change things was Ben himself. He might have being "crying for help" with his actions but he never properly requested help and actively denied it in some cases.
Maybe it was pride, maybe he was not thinking clearly enough to know he seriously needed help, maybe… maybe… maybe….
The night he died he had left messages on the answering machine of his girlfriend requesting that she call him back although he knew (or should have known) that she was out of the country. I wish he'd have called a crisis line. I wish he'd have called 911.
I wish he'd have asked for help.