Content note: This first-person essay discusses suicidal thoughts, a suicide attempt, mental health crisis, emergency care and psychiatric medication.
In fall 2023, I tied a scarf around my neck, tighter than scarves should be tied. I was born with spina bifida occulta and was further paralyzed in a surgery gone wrong. For decades, I diligently cared for my physical health while giving minimal attention to my mental health. I started therapy shortly after starting my PhD, believing that two sessions a month would be enough to heal my anxiety and depression. I supported colleagues through their crises. I conducted research on the factors that affect disabled university students’ exclusion, including the impact higher education can have on disabled people’s mental health. I ignored invitations to workshops on burnout. I saw the signs but did not interpret them as warnings. I reasoned that I was immune to the stressors of a doctoral degree, that the nonstop work would be worth it, that ruminating over my mistakes was a feature of adulthood, and that high blood pressure and teeth-grinding were side effects of academia. I told myself I just had to take things one day at a time. In hindsight, I was spiralling downward, one day at a time.
I heard my body’s internal alarms before the burnout fully struck. I emailed my supervisors, contemplating whether I needed to take a break. I did not take a break. One week later, I was curled in a fetal position in my university residence. Eyes wide, voice hollow, I wheeled myself to the emergency room, searching for a safe space to sit. I was told that I was not in enough of a crisis to warrant staying at the hospital. I remember wondering if I had to take action in front of the medical staff for them to listen. Instead, I took a ride-share back to my dark residence in the middle of the night, my damaged wheelchair wedged in the driver’s open trunk. I didn’t fall asleep. I did fall into a routine: call a crisis hotline, talk for the fifteen allocated minutes, sit in silence until I no longer felt safe, call another crisis hotline, talk for another fifteen allocated minutes, and so on. I remained in my residence for several blurred days, experiencing crying spells, panic attacks, moments of lucidity, moments of confusion and moments of utter helplessness. I eventually filled a prescription for antidepressants, listening to the warning that my mental health could get worse before it got better. I was still unprepared when my mental health got worse before it got better. Hence, scarf. As I began to tighten the fabric, a thought occurred: it would be terribly inconvenient to those who would have to find and retrieve my body. This morbid belief saved me in the short term. My family, friends and support network saved me in the long term.
Becoming the peer support specialist I needed
Nine months later, in summer 2024, I began working as a Peer Support Specialist for a crisis-diversion agency. The Substance Abuse and Mental Health Services Administration (SAMHSA) describes peer support as recovery-oriented, person-centered, voluntary, relationship-focused and trauma-informed. Peer-run crisis respites can also offer a voluntary, community-based alternative to emergency departments or inpatient hospitalization for some people, depending on the setting and level of acuity. I frequently relate this approach to the disability-rights principle: “Nothing About Us Without Us.”
Working at the crisis-diversion center allowed me to be the person I needed when I was going through my own crisis. For fourteen months, I provided peer support by listening to and affirming our guests’ challenges and concerns. I cannot share the specifics of what we discussed because I am committed to protecting our guests’ confidentiality. I can broadly share that our conversations were always uncomfortable revolutions. We discussed mobility aids and medical supplies, surgeries and scars, breakups and breakdowns, regrets and ruminations, tragedies and traumas. We swap stories about being excluded by strangers and loved ones. We share our journeys of navigating ableism and disablism. We name moments of intersecting oppression: racism, classism, sexism, xenophobia, homophobia and transphobia. We share our journeys of regression and recovery, of hopelessness and hope.
What access intimacy can mean in peer support
We share our truth. In doing so, we expose and embrace the most uncomfortable parts of our lives so that others may find comfort in theirs. My coworkers and I often heard comments such as, “You understand!”, “Finally, someone who gets it!” and “I knew I came to the right place!” This is solidarity. This is why I connect peer support to access intimacy.
Disability justice activist Mia Mingus coined the term “access intimacy” in 2011. She described it as “that elusive, hard to describe feeling when someone else ‘gets’ your access needs.” Mingus also writes about the physical and emotional relief that can come when access needs are understood without repeated explanation or justification.
I see access intimacy in complimenting each other’s mobility aids, celebrating each other’s milestones and sympathising with each other’s grief. Importantly, access intimacy is not automatic; it is cultivated. Connection is not instantaneous, even when two people share the same disability or impairment. Disabled people are not a homogeneous group with a single hivemind. We all have different personalities, opinions, perspectives and approaches. Another wheelchair user and I won’t immediately connect just because we both sit. It takes time and communication to build a connection: intimacy created from both our commonalities and the respect we have for our differences. Access intimacy is built through open minds and personal commitments to supporting our communities. I encourage peer support professionals to commit to cultivating access intimacy as one way to build solidarity and support.
Sources and support
Peer support: SAMHSA’s Core Competencies for Peer Workers in Behavioral Health Services.
Access intimacy: Mia Mingus, “Access Intimacy: The Missing Link”.
Crisis support: If you are in the United States or a U.S. territory and need emotional support, call or text 988 or use 988lifeline.org. If you are elsewhere and you are in immediate danger, contact your local emergency service or a local crisis service.
