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.

The Human Interaction Conundrum in The Information Age

As humans we have evolved over the discourse of millions of years. There have been generation after generation before us through which we have evolved for the greater survival of our species. In recent years technology built the internet and made it accessible to most of us most of the time, introducing The Information Revolution. We are now more globally connected and informed than ever: we’re in group chats that are kind of like hanging out; we’re in Facebook groups of people with similar interests to us, most of whom we’ve never met; we follow people’s lives on social media, especially Instagram which is largely based on visuals that we come to feel like we know these people whose content we follow, comment on and share when we really don’t know them at all.

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Tea for One

In becoming more connected with others via technology we are less connected in reality as we use our smart phones to for more and more tasks. Gone are the days of asking someone for directions, of going in person into a cab reception and making conversation whilst waiting, and now coffee chains have even made it possible to order without talking to anyone via our phones without having to even speak or look at another human being, all of which allow for as little human interaction in person as possible (Kushlev, Proulx & Dunn, 2017). Unfortunately, this trend bucks our evolutionary DNA for healthy fulfillment; social interaction has long been an established an innate human need, and is central to Maslow’s hierarchy of needs ((Kushlev, Proulx & Dunn, 2017). Although originally considered to be related only to close relationships such as family, partners and close friends it has transpired over time that the little interactions with strangers as we go about our day are also important (Kushlev, Proulx & Dunn, 2017).

I am very good at spending a lot of time on my own. I can go a while without really seeing anyone and only realise on day 3 or so. The downside to this is that I am quite a socially anxious person. I wouldn’t go as far to suggest I have social anxiety but I get overwhelmed for sure. I get so much anxiety in my stomach when I need to leave the house to go somewhere where I may meet or talk with others so intense that I frequently freeze until it’s too late to go anymore. So when my psychiatrist says to me that I need to get out and interact with people more, in person and preferably doing activities that aren’t solitary, it feels like a the hardest of recommendations to accomplish. It’s a tall order when just being around others can make me cry even though I k now it’s irrational. Consequently, I miss many social plans. Each time gives me a short space of relief but in the long run my anxieties just deepen and grow. It’s fair to say that I’ve been letting anxiety physically stop me from giving myself a chance at getting my human needs met.

So here’s the challenge for the next year or so:

  • Go to more social activities, will opt for sports closer to home to begin with.
  • Use mindfulness and breathing exercises to remain calm
  • Try to scowl less when I am out and about. Apparently this makes me seem unapproachable.
  • Use mood monitoring app to record anxiety levels around social events, whether I succeeded in going or not, what went well and what didn’t.

 


Sources:

Kushlev, K., Proulx, J.D.E. & Dunn, E. (2017) Digitally connected, socially disconnected: The effects of relying on technology rather than other people. Computers in Human Behaviour. 76pp.68-74. (Link)