Overheard in the Emergency Room: Mental Health Crises and Provider Bias

It’s time to retire “jokes” made at the expense of those in crisis.

Sarah K Stricker


Once, while in the ER for a complication related to my chronic illness, I had a room situated next to the nurses' station. One of the nurses asked a resident standing nearby what specialty they were interested in. The young resident mentioned that they wanted to go into psychiatry. The nurse was surprised but said it was great to hear because they need more providers in that field.

Then she made a joke offhand: “You should’ve been here during the full moon this past weekend; the waiting room was full of crazies.”

Neither the nurse nor the resident was likely aware that I could hear that conversation, and the nurse probably wasn’t thinking about who might overhear her comment.

Neither of them knew that I was one of the “crazies.”

I wish I’d spoken up and called out the nurse on her bias. Since I didn’t have that opportunity, here are a few things I would want both her and the resident to consider:

Mental illnesses are serious chronic illnesses.

Due to the sometimes unpredictable nature of psychiatric crises, it’s not uncommon for people to comment that people with mental illness act “crazy.”

But these illnesses are not a joke. They can be debilitating, and people at a crisis point who present to the ER shouldn’t become the butt of jokes made by the very people who are supposed to help them navigate their crisis.

These beliefs perpetuate stigma against mentally ill people, drive mistrust of medical professionals, and reduce treatment seeking.

Neither of those outcomes is worth making “harmless” jokes or comments under the guise of blowing off steam in an inarguably stressful job.

Your brain is part of your body. Mental illness is just as valid as “physical” illness.

Just because an illness is behavioral doesn’t mean it’s any less real and valid than chronic physical illness.



Sarah K Stricker

Writing about disability, chronic illness, & mental health. MS in health communication from @NUHealthComm. Find my work in Invisible Illness & No End in Sight.