Losing It: Our NHS on Mental Health

We all have mental health. We don’t all have a mental illness. we have not all experienced a mental health crisis. Sometimes you hear people talking, especially online, about how they had a crisis and sometimes I wonder if the term “mental health crisis” has become somewhat watered down and overused, much like the term “trauma”. Many now refer to trauma for anything a bit significant and overwhelming. The problem with this is that the reality and severity of trauma and mental health crisis become diluted the more they are overused or, alternatively, used out of context. This is why, although difficult viewing, I was really relieved when I saw ‘Losing It: Our Mental Health Emergency” listed on 4OD.

The show follows patients through a mental health trust in Nottinghamshire and shines a light on the extremes, the harsh, petrifying and heartbreaking reality of a mental health crisis. In episode 1 we met Laura and Briena. Laura was experiencing her first-ever episode of mental ill-health and was detained on Section 2 for post-partum psychosis – her illness nearly cost the lives of her entire family. Laura was super compliant with treatment in order to get better, however, experienced variations in her mood and energy states, which highlighted the subtlety that psychosis can have: the conviction in delusional thoughts, the not wanting to rest and agitation, the deadish eyes in a family photo that in hindsight give Laura a glimpse into how unwell she was, “I don’t particularly like this one behind me because I think you can see in my eyes that I’m still ill”.

Once she is well, she reflects on the experience and she really hit home. Having come out of a crisis and hospital admission, “we will never be the same people as we were before that day because of what I tried to do but it doesn’t make me feel any better by crying over it…I still regret it and I still live with the guilt” Reflecting she recalls how the realisation of how unwell you’ve been once you’ve recovered from an episode can be harder than being ill, “it’s mad how when you’re ill you don’t realise how serious it is, and then when you come out of it, it hits you even harder …it’s crazy how much… its just kind of come back”.

We are also introduced to Briena, an 11-year-old with deeply disturbing suicidal and intrusive thoughts. She sometimes struggles to articulate herself and has panic attacks so severe she looks to be in real agony. It’s heartbreaking and painful to watch. You can’t even imagine how her parents feel watching their daughter in so much pain and being essentially helpless.

The world of mental health has changed dramatically in the last decade, heck it has changed beyond recognition and even in the last 5 years everything just keeps changing. This can make navigating the system and services out there difficult. It can be more difficult when more people ask for help, because all of our campaigning has worked in de-stigmatising mental illness and mental health difficulties. Unfortunately, the system isn’t prepared for this influx of pleas for help, and so it is, in the words of my social worker yesterday, “they’re changing the system to be more streamlined, so people come in and go out very quickly in order to deal with the influx of need”. I’m sceptical; this sounds like a false economy, where people go in to the system at crisis point and come out just as quickly without the longer term input and support that helps people to get and stay well, “gone are the days when we could support someone for years, we just can’t now. We’re really looking at months”

With this new system I haven’t had a care coordinator allocated to me and I’m one of 70 in my team to have a named professional. This is apparently the worst it has ever been. I have now been told that I won’t be allocated someone new and will instead be discharged because I haven’t had a crisis for a while and although I still need medication adjustments and tweaks about twice a year, I am quite frankly not a priority. I understand this, and in hindsight despite being petrified for the future, I am so grateful I got unwell before Tory policies came into effect because a lot of the treatment and support I’ve had, the very treatment and support that has helped me to get to this point of relative stability and resilience is no longer available. So even though we have reduced the stigma of being open about mental health, and in asking for help we still have a lot more work to do in order to make sure the help and support is available to people who need it.

This is no longer a battle. This is a war. People have lost their lives, and more people will – and that’s just not acceptable. No one should be left alone to end it because the support isn’t there. I think the place to make the biggest impact is perhaps to contribute towards the charity sector who are plugging a lot of gaps as best they can – and maybe people of power with a real ability to influence legislation and funding, or perhaps help set up practical services beyond signposting to the Samaritans or an online chat forum would be good. There’s a lot of talking and celebrity endorsement going on, but for the people on the ground without privilege, where are they going to turn when they can’t get the help they need from the NHS? For as well intentioned as it has been , we have perhaps missed the mark in the context of this political fuckery we are currently in.

Losing It is a great documentary opening the doors to providing a platform for people in crisis talk about what they’re going through, but without real action and funding, it seems you have to nearly die or kill someone to get help – and if you ask me, that’s just too risky a system. I don’t have the answers, I’m just a bit petrified for my own situation and for those who have it much worse than me any time from 2017 and into the foreseeable future. We’re talking, but the conversation is bleak.

Wake Me When September Ends

For anyone who knows me well, they know that September/October is a hard time of year and has been throughout the past decade. For a long time the underlying cause was assumed to be situational stress, with something always assumed to have been bothering me: an argument with my other half; studying was difficult; work was stressful; my routine had been disrupted; this had happened and that had happened, historically speaking, like an anniversary of shite; it rained too much or it was too sunny. To be frank there’s always someone in your life that is doing your head in a bit, and in the UK there’s always always the weather, regardless of how good or bad said weather patterns are being, no matter the time of day, week or year, there is always an angle to take from which you can blame the weather for life’s woes.

This ‘something must be going on’ approach is understandable; when things go awry with your mood and mental state it seems that the most logical first step is to try and pinpoint a cause, and from there you can theoretically hatch a plan. The thing is, there is always something external to blame whether or not there is validity or truth in the reason. For ten years we’ve been fine-comb picking my life apart to figure what it is that has set me off this time. After about a decade, a pattern has emerged. I am always looking for an explanation in september and october. The chicken or the egg, the mood or the thoughts, the cognitive or the behavoural?

Now we have pinned it on the changing seasons: autumn saddens, and spring quite literally springs. I have tried to go on as if to not expect the wobble. I have tried to distract myself out of the habitual mood change with hoildays, festivals and exciting events to look forward to, just in case it was a subconscious pattern. I have tried ignoring it just in case I was placebo affecting it into effect, and I have tried to go on as if everything is just as fine and stable as it was mid-August. None of this has worked.

A breakdown in Berlin, a meltdown in Morocco, a face like a slapped arse, and difficulties in not to lashing out ensued from getting into confrontations with mates and strangers alike, particularly on public transport, inextricably blaming everyone but me for being so goddamn unreasonable. I mean sometimes they are but my patience is tissue paper thin right now, so instead of not rising to the occasion or ignoring something annoying, I snap, crackle and pop.

The difference between now and a decade ago is that I have a decades’ worth of experience up my sleeve at managing these episodes, it that CV worthy? I feel like managing this is a transferable skill? At least these episodes are no longer scary for me because they are in fact incredibly familar. I recognise and feel familiar with the feelings and the irrational thoughts of “I should just kill myself” – spoiler alert, I shouldn’t. The intrusive thoughts of just pushing, shoving or tripping people up for having the audacity to be near me in the street street are just that, intrusive thoughts. I can choose to act on them with varying degrees of self control – and if I’m really struggling to control them then I just stay close to home. I take it easy. I grab coffee and reply ever more inconsistently to my phone. I watch shit TV and let myself be. Sometimes I’ll fall into mentally beating myself up for being so useless and lazy, and then I remember that this is in fact why I am studying part-time, this is in fact why I get the financial aid that I do and this is in fact a much better option than pushing on even more so, only to absolutely lose my fucking shit completely. Top tip: prevention is always better than cure, or picking up the pieces.

This is all familiar now. When it happens I have the confidence to manage it and that it will pass. It always passes. It is never like this forever. All I need to do is call my CPN and tell her. She is arranging zopiclone for me at tomorrows meeting from a single phone call today. It’s predictable and routine. I reflect to figure out the root cause and I’m not particularly confused. I’ve got through it for my entire life, and I know that with time it will settle and pass, if I do the right things to help myself. I know what helps and what really realy does not help. So if you’re struggling with the mood shifts that are so frequently triggered at this time of year for anyone with a mood disorder, hear me out. It passes. IT ALWAYS PASSES. Sometimes it takes a really long time, and sometimes it doesn’t. Look after yourself, take your meds, and get them looked at if you can if you’re struggling an unreasonable amount.

Give alcohol a miss and sleep is a priority. Solitude in times of feeling short fused is OK and seeing people when you’re feeling alright is a necessity for our sanity. It’s OK to watch shit TV. Doing small things helps, and not having major comitments also helps. Balance. Balance. Balance and perseverence. You’ve got this, I’ve got this, we’ve got this.

N.B. Fuck that ending was cheesy!!!!! Grab a cracker.