Our mental health service is crumbling

Big cracks

Big cracks

A quick update on where I am first – following my post last month regarding my depression. Truthfully? I have no idea where I’m at. When I first started this post a little over a week ago I really felt like I could be out of the other side of this particular episode – at least in terms of the darker feelings. But then? The next day gave me a good hard kick back to black. The self-doubt, the sadness, the tears, the anxiety, the confusion: it all came back. It sucks when that happens.

The last post helped a lot mind you – along with the very supportive comments both on here and facebook and the odd phone call. Thank you all – though I excuse you now from the responsibility or obligation to comment on future such posts. Oh. Did I not mention that depression doesn’t just go away like a bad mood? In many many cases it’s something that those who have it have to cope with for years if not the rest of their lives. I’m very much a learner at this – a learner depressive if you will – and I’ve not read up enough research to know the numbers. All I can talk about for sure is my own experience. And so far that has told me that I periodically suffer from very difficult depressive episodes and that right now I know that I will be on my current dose of medication (a combination of Venlafaxine and Pregabalin) for at least the next two years.

I say “right now” because there is every chance that this may change in the next month. I made the surprisingly very difficult decision to go and see my GP and discuss the option that I be referred back to my community mental health service. I say ‘surprisingly’ because although you would think it a bit of a no-brainer decision, I feel like it’s a step backwards. A massive step backwards. An admission that I’m not well. Still. And that’s a very difficult thing to admit – when you feel like you’re getting better and then have to face the fact that you’re not. I was close to tears in my GP’s surgery.

My referral, as such, wasn’t a quick process though. And that’s kind of the subject of this post – took a while to get here I know.

Now. I’m going to try really hard not to make this a rant post. I just want to highlight how difficult our health service makes it for anyone with mental health issues to be dealt with in a manner that doesn’t make them feel any less ‘well’ than they do already.

I was last discharged from my local community mental health centre (CMHC) in the Spring of this year. It was the second time I had been discharged from their care over the course of a year. When you’re discharged from their care, back to the care of your GP the ‘system’ intends to make it easier for you to be referred back into their care again should you need to be – the first time around you almost have to break into their care!

Anyway I rang up my mental health centre on the Friday after I had had my breakdown in the car. I left a message for my psychiatrist to ring me back. She didn’t ring me back that day or the following Monday. So I made myself ring again on the Tuesday. I was told that because I had been discharged previously I needed to see my GP in the first instance. No apology for not having rung back or indeed not telling me this the previous Friday of course. It’s of course too late to get an appointment at my GP that day because they obviously don’t have any left – you have to ring first thing in the morning. I don’t ring the following day though because I doubt my own illness. But I do the next day because I have had a bad night. I get an appointment and as I said above, agree a referral is the way forward. This is already almost a week since I first rang up to speak to someone about my mental wellbeing. Now because my then current mental state isn’t severe enough, I am not an urgent referral so that means I won’t get a quick response. Upshot is, I get a phonecall to tell me the earliest appointment is the 12th December – well over two weeks away. When I get that call there is a huge part of me that wants to say, “no, don’t worry, I don’t need it anymore” because at that moment I don’t hate myself; I don’t want the world to swallow me up; and I don’t feel like I’m incapable of doing anything. But I do have enough experience to know to take the appointment because days can go down as well as up. Today proves my point.

But if I had said ‘no thanks’ and then gone through what I did today I’d be regretting at best, and hating myself at worst, for not taking the appointment. I’m also well aware that any time between now and then, I may yet ring up and tell them to cancel it because I’m having a good day – and remember I don’t want to go backwards so I look for any reason to avoid admitting that fact to myself.

So you see. It isn’t made easy. It’s not my local CMHC’s fault. They’re having cuts forced on them – and at a time when demand for their services have become even greater. And of course I realise that cuts have to be made somewhere in this time of austerity – if not in this particular corner of the NHS (and it does feel like a corner: a darkened, out of the way corner without carpets or a fresh lick of paint) then elsewhere in healthcare or beyond that, elsewhere in public sector services.

But mental health care will never be the poster boy of government. It’s never going to be held aloft as a shining example of public sector success. It’s never going to be given respect (and therefore money). And this is despite the generally great work that is provided much of the time from the consultants, doctors, nurses, counsellors and all the others that work within this sector – and in spite of the lack in funding. My own experience of the care – once I’d proven myself to be a valid patient – was a good one. The combination of having a very good psychiatric doctor, receiving good therapies (both drug therapy and CBT) and support services enabled me to begin a recovery.

I learnt today that my local CMHC is struggling even more thanks to a very apparent shortage of staff – it’s the reason my appointment has taken so long. And I suspect that this is unlikely to be an exception across the country. What troubles me most is that there will undoubtedly be people who are suffering – most likely more than I have – who have not the strength to push to be seen by a mental health professional: who don’t have the strength to question and argue against the care they receive (like I had to at the start of my depression – that’s a whole other post). People who may end up spiralling to such a degree where they either drop out of society altogether or are caught, just in time, by lucky circumstance. That’s my concern. “Lucky circumstance” shouldn’t be the safety net. Our system of mental healthcare may not be broken but it is certainly fracturing.

Was that a rant? Probably. Sorry.

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2 Responses to Our mental health service is crumbling

  1. Stuart Brown says:

    A rant, but some rants are wholly justified.

  2. Stuart Brown says:

    This also reminds me of The Moral Maze last week, where they were talking about people “lifestyle” illnesses being refused NHS treatment; it got me really narky because in an hour’s discussion of self-damaging behaviour and “responsibility” (oh Melanie Philips, how you manage to make that word a giant “fuck you” to anyone who happens to be non-safe-white-middle-class) there was one, brief, mention of that maybe, just maybe, this whole idea that people should be refused treatment based on their own behaviour is appallingly prejudicial against anyone with any kind of mental health problem. In fact, now I think about it, I shall write me an email to the BBC about that. Not good enough, Auntie. Not good enough.

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