More important than reducing stigma — #MHAW17
This post was written for my 7 day mental health blog takeover, in support of #MHAW17.
Over the past 7 days we have all worked hard to raise awareness and fight the stigma that still exists surrounding mental illness in the UK. We have assured you, as we do every year, that it’s okay to be unwell. We’ve shared our own stories, and those of others. But there is one thing more important than than any of that; pinpointing the issues and improvements that need to be made within our country’s mental health system moving forward.
In January, Theresa May outlined plans for a number of mental health care reforms in the UK. We need to ensure that significant changes are made in order to reduce the number of deaths caused every year as a result of the current difficulties in accessing adequate support and treatment for sufferers.
It is often said that the Mental Health system here is ‘fragmented’, and that is a statement I have had first-hand experience of.
Currently, those with a combined mental and physical illness are able to access better long-term care than those with an isolated mental health condition.
Two years ago, I was receiving treatment for CFS/ME in a specialised clinic under the NHS. Alongside the physiological treatment, there was a CBT (Cognitive Behavioural Therapy) service within the clinic. When deciding with my GP that I needed help with my mental health, I had a choice between self-referring myself to the local IAPT (Improving Access to Psychological Therapies) service or requesting a referral to receive CBT within the CFS/ME clinic. Ideally, there should be little difference between the two. Unfortunately, IAPT offered a limited amount of total treatment hours before i’d have to leave the service for a specified period of time and refer myself for further treatment if I felt that’s what I required. The CBT on offer at the CFS/ME clinic, however, was unlimited. I could go as often as I needed for as long as I needed until I had experienced a significant improvement.
The fact that IAPT stands for Improving Access to Psychological Therapies makes me question the quality of the service before it improved. Yes, it's fantastic that anyone can go online and refer themselves for treatment without visiting their GP, but spare a thought for the therapists working at IAPT services. They have to treat patients with a wide range of complex conditions requiring specialist care with a one-size-fits-all type approach in order to see an improvement for their patient within the limited amount of weeks they have available.
The theory is that short bursts of treatment allow patients to take a break and use the tools given to them by their therapist in practice. In my experience of therapy, it took months before I felt comfortable enough to open up and take on board suggestions given to me.
Within the limited number of weeks on offer to those using IAPT services, it’s possible they could still be coming to terms with therapy and find it an unpleasant experience. When you discharge these people at this stage, even if you give them the option of another referral at a later date, it’s highly likely they might decline and put themselves at risk of relapse.
And what if you’re worried about someone you know? What if you are seriously concerned for their state of mind and therefore their safety? The recommended steps you need to take are not clearly defined by the NHS. A friend of mine recently rang 101 in a bid to get urgent support for a vulnerable person. They were told that the vulnerable person had to go and see their GP and request help themselves as there was nothing anyone could do without their permission. If anyone has ever seen anyone at crisis point mentally, they will know that it’s incredibly difficult to persuade the person to request help.
And then there are the locations of the outpatient clinics. I’ve yet to visit one myself that hasn’t been in an obscure, ageing office block down a random side-street with tatty decor and a slightly off smell. My old clinic shared its space with three other businesses, and there were often awkward moments between employees and me, the person in the lift clearly getting out at ‘the crazy floor’.
I thought it was bad there, but a few months ago the clinic I attended merged with a number of other random clinics for other things, and relocated to an old social services building. I’m a fan of Brutalist architecture, but even this place was too depressing for me. It was clinical, intimidating and due to its location in a dark industrial area felt unsafe to leave in the dark.
I sent a letter of complaint to the service regarding my concerns and was met with the response that the clinic would be staying put due to pressure from those higher up demanding cuts.
I do not have a comprehensive solution to the problems we are currently facing regarding the mental health service in this country, and nor are my personal experiences necessarily an accurate reflection of the overall picture, but I know that a lot of money could be saved and deaths prevented if there was a better support system in place for those in the early stages of mental illness. If people are given the right long term care, they are much less likely to reach a point of crisis. We have a wealth of fantastic psychological talent in the UK, and already a number of specialist clinics within the NHS offering an invaluable service to people like me. I would hate to see a reduction in these specialisms, and would welcome more organisation surrounding the best methods of treatment for those with differing conditions rather than lumping us all in the same clinic.
When the reality is laid out bare, it can be easy to lose faith in our mental health service, but we must not forget those who work tirelessly to help people feel better. Those who work day in day out amongst a constantly changing, fragile service with doubts and concerns for the future.
I hope one day, events like Mental Health Awareness Week will achieve more substantial changes beyond those of social attitudes. After all, what is the point of raising awareness and potentially helping someone towards seeking psychological support if the support on offer is inadequate?