On improving mental health support

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My first mental health diagnosis is by far the most comfortable for people to engage with. It made sense – I was diagnosed with depression during a year which has since received responses such as “oh God!”, “bloody hell!” and “that’s awful!” from friends and acquaintances. People still don’t know what to say to me if I explain it but they do at least understand why I might have struggled at that time.

You see, in the space of one year I went from having an achingly ordinary childhood to being a grief-stricken, housebound teenager. The longer version includes a particularly bad case of glandular fever, coupled with a 9 month long chest infection, but that’s all prologue. The real story begins in December 2004 with the sudden death of my Mum. What we all thought was a migraine, something she had struggled with her whole life, turned out to be a brain haemorrhage. The pain started on Sunday, she was rushed to hospital on Tuesday and gone by Thursday. (One of the coping mechanisms I’ve developed over the years is a rather dark sense of humour, so please note how hard I’m having to try not to make a Craig David joke right now).

It was the worst week of my life by far and just a month later I began complaining of worsening health – like my initial glandular fever symptoms, I wrote in my diary at the time, except ten times worse. I somehow struggled through the rest of the school year but only two weeks into the following autumn term my body crashed. I had been diagnosed with M.E that spring, told there was nothing to be done, and sent on my way. All of a sudden I could barely walk, struggled to talk, think, move. Some people describe M.E as a living death and that was truly what it felt like. I was sixteen years old and my entire life became about grieving my health, my dreams and my mum. My world reduced to four walls.

My dad was the one who noticed that something was badly wrong, that I was in a darker place than I should have been, even with everything that had happened. He was the one who insisted on going to the GP, who insisted they had to help me. I accessed child and adolescent mental health services a short while afterwards, where they prescribed anti-depressants (which I have been on for 8 of the last 12 years) and insisted I come in for weekly counselling. I hadn’t dealt with my grief and I needed support to work my way through it, they said. I went every week for a year and alongside my medication began to emerge as myself again. It’s a nice, neat mental health story, really. There’s a logical cause, there was a solution, a happy ending. As I said, it makes sense.

It’s much more difficult to discuss the two further diagnoses I went on to receive at 22 and 27. Harder to pinpoint the start, harder to explain the why, the path back to a healthier mind more murky than it was the first time with no traumatic series of events to dissect. I’m not sure many people know how much more likely you are to relapse after that first diagnosis – I didn’t until I had some mental health awareness training a long time after my first two experiences. As it happens, you run a 50% risk of a second depressive episode after your first diagnosis, and if you fall into the unlucky half, your risk of a third rises to 70%. So, my mental health story is difficult but in no way improbable.

Now, if you’re reading this I’m sure you know it’s Mental Health Awareness Week and I’m sure you’re seeing a lot of posts saying how we all need to talk more, but that’s not the post I’m writing. I fully believe that breaking down stigma and raising awareness is vital – that for too many people having those conversations and being open are a huge problem. That too many people don’t know how to hear and respond to these conversations if someone does open up. Believe me, I’ve experienced it. The thing is that this isn’t the only problem in the mental health arena, and we need to stop letting our discomfort with difficult conversations keep eating up all of the headlines. We need to stop only focusing on the first step to recovery, as though there aren’t so many after. What is the use in asking for help if there’s no practical help to be offered? The most consistent part of every one of my diagnoses was that recognising and articulating the problem were a small part of the picture – there were always next steps that led me to a resolution.

I actually count myself lucky for getting a diagnosis so young and for having such a clear cut case that left my doctors in no doubt over their course of action. I have no doubt that it has improved my access to care and support ever since – it has enabled me to walk into a GP’s office and be taken seriously when I talk about mental health because they know I’ve been there before. They know the medication that works for me, that I can be trusted with it. I imagine it’s far more difficult to go in for the first time as an adult, to go in without the obvious narrative, to have to explain what often feels entirely inexplicable.

I was also extremely fortunate that when I accessed CAMHS I didn’t have a long wait to access support and that I didn’t have to be at crisis point to be offered help. If I was in the same situation today I would not have been so lucky and I honestly believe that a lengthy wait for an appointment could have had serious consequences. I wrote a piece on the CAMHS crisis for Marbles Magazine just last year and the situation today isn’t any better. Sadly the picture across mental health services as a whole is the same – there is too much demand and not enough support available.

In addition to all of this, I had no choice but to get comfortable with talking about my mental health. I spent about a year working through my issues on a weekly basis, coming up with coping strategies and reflecting on my mental state. It has certainly made it easier for me as an adult, where I immediately turned to talk therapy for help at 27 I don’t know many people my age who would have done so as easily. The thing is, that shouldn’t be the case – you shouldn’t have to go through hell to have simple mental health literacy.

I am incredibly passionate about mental health awareness and support and would love to hear other people’s thoughts on what needs to change to really improve the picture. For me, the top three things I would love to see would be:

1) A focus on campaigning for better funding and improved mental health services – balancing out the narrative that we need to talk.

2) Mental health and wellbeing becoming core elements of the curriculum so that young people at all ages acquire the language to explain how they feel and the tools and understanding to look after their mental health. We need to move beyond a sole focus on crisis management and prioritise prevention too.

3) The media being held to higher standards in how they report on mental health – accepting their role in promoting negative stigma and actively seeking to do better, listening to mental health charities who offer guidance on mindful, safe reporting.

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