Onward Ever

Back in May this year I wrote of my battle against the system to get treatment for high-functioning anxiety disorder. In August I wrote another piece further eluding to the struggle. Well today, over four months after initial referral for psychological services, I finally have an appointment with a consultant. The letter states that there will be a further wait following the consult before therapy/treatment begins (of course) but I nervously look forward to the meeting. Nervously and anxiously..

I recently acquired a copy of my entire medical file from my G.P. The nature of the journey into my long and complex history of mental ill-health warranted getting as full a picture as I could of each and every intervention, or lack thereof, by the medical professionals charged with my care over the years. It was a cathartic experience, to say the least. Particularly shocking was my discovery that I was all but diagnosed with bipolar disorder 10 years prior to my actual diagnosis. This was simply never followed up on, and effectively ignored, but worst of all I was never even told about the existence of the extensive psychiatric report. You can imagine my dismay. I can't say it hasn't further eroded my faith in the medical profession.

Out of disappointment and disillusionment with the system does, however, come something very positive. I have never felt more empowered in dealing with my mental health. I have gone from pillar to post trying to get answers over the years. From a humble and fairly aimless starting point in my teens, as my experience has widened and my knowledge has grown, I have become an expert patient. Gone are the days when I will allow anybody, be they a top consultant, counsellor, G.P. or surgery receptionist, to act on decisions regarding my care with anything less than an absolutely true and accurate picture of the nature of my mental health. Put simply, I know far better than them what it is to survive mental illness, and try to thrive in spite of it.

Sadly though, my experience of the creaks and cracks in the system have taught me that as the years go by it gets harder and harder to get treatment at all, let alone the right treatment. To some extent I can forgive medical professionals for not giving me a full picture, back when I was a teenager. My problems were so huge, the road so long and my mental health so fragile that I can imagine a scenario in which it was felt not to be in my best interests to 'lay it all bare' so to speak. I can even understand how it came about that symptomatic treatment was deemed better than addressing the root of my problems. Papering over the cracks may well have seemed like the easiest option in most of those allotted 10-minute G.P. consultations.

What I cannot accept though is the evidence that lies before me, in the pages of notes I have sifted through - that at almost every single stage of my mental ill-health, over the course of decades, those charged with my care - the people to whom I summoned up the courage to go to for help, who's very job it is to do their best to help make me better, failed me royally. One could be forgiven for thinking that their lack of care was systematic and intentional. I don't think that, but only because I've had so many years of experience at trying to get better in a system that is fundamentally mismanaged, underfunded, under-resourced and ultimately falling apart at the seams. Even that system is not truly at fault. It is those charged with the care and governance of the NHS itself who are really responsible for its sad decline..

There were occasional exceptions to the shower of fools involved in my case over the years. I recall a kindly registrar at an Accident & Emergency department who told me, off the record, that I might not have the full picture as to long term treatment options for the issues which had led me to the particular crisis that had brought me there that day. I fondly remember an amazing CPN (Community Psychiatric Nurse) who counselled me when I was in my early 20's, teaching me mindfulness techniques and guiding me in the direction of some of the best self-help books and psychology literature I have ever read.

I also remember a dedicated patient advocate who saved me from a particularly horrible hospital experience by informing me of my rights and supporting me in exercising them, when I was in a state of panic and being virtually held against my will. Most recently, I am thankful for a very patient CBT (Cognitive Behavioural Therapy) counsellor, who tried his best to keep working with me despite getting tied up by the limitations and inflexibility of the system. These wonderful few embodied everything it means to be a true medical professional. They went above and beyond the call of duty. At times they truly extended themselves for the benefit of my growth. The leaps and bounds I made in getting better because of the care and support they gave me cuts through the lost years of medical impotence and downright lack of care I experienced like sun rays through the murkiest fog.

My personal struggle has led me to learning about the troubles of others in this failing mental healthcare system. Incredibly, it would seem that I have actually been relatively fortunate. I have relatives and friends who have found it even harder than I to access effective treatment for a range of mental health issues. I have met plenty of people who have been in the system longer than me, with far more complex and difficult conditions, who struggle to get even basic outreach or crisis response. For those unfortunate enough to have very little or no support outside of the system, the tendency towards self-medication with all the inherent dangers of illicit drug use is very high. Rates of self-harm and suicide inevitably rise alongside cuts to mental healthcare provision. The sadness of this totally avoidable set of circumstances is overwhelming.

When I write about this topic I almost feel like a busker, banging an old drum under some bridge whilst people walk around and past. Maybe banging on about this sad state of affairs is old news and perhaps people are oblivious, but I can't stop. Too many are being failed because of the insane ideology and badly-disguised greed of a bunch of morally bankrupt politicians. Who really knows the true scale of just how many people's lives could be made so much better if mental healthcare provision was given parity with that of physical health? What kind of legacy is being left for our children and subsequent generations, if the current system is allowed to continue sliding into collapse and backdoor privatisation?

Whatever the future holds for us, brave warriors of mental health must continue to fight for the treatment they need. I shall be doing just that, and while I'm doing it I will gladly help others to fight too. Nothing is more important than ensuring we have the best chance at treating mental illness effectively, so that we can use all we learn to raise a generation of children who's emotional well being is actually improving. Perhaps together we can raise awareness of the terrible price to be paid if we don't completely rethink mental healthcare provision in the UK, and halt the terminal decline in our collective mental health.

Copyright ©2018 Richard C. Greenlow. All rights reserved.