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The "Mental" Health Service

The Truth Behind the Experience

By Karen PhilpottPublished 6 years ago 15 min read
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There are obviously many types of mental health people experience during their lifetime; Some short term and some longer term that may also need inpatient treatment of some kind at some point.

In no way can I pretend to understand all areas of the mental health services that are available currently and, in this story, I will not be including charities such as MIND who do a fantastic job in their field. I do, however, have much to say on services, particularly around suicide and depression to include the failings I have experienced over the last three years.

It leaves me perplexed to think that, with the technology, medical advances and resources we have today, so many people are still left feeling that their life has no value and that there is no one out there for them to turn to for help.

I half expect someone who calls into their doctors, either before a break down or during one, that they will be treated in the moment and put on the back burner because, lets face it, we all have periods of feeling over whelmed, sad or confused in our personal life direction. These people are the group that I feel would benefit from being mildly medicated and have an open telephone conversation and a little cognitive behavioural therapy (CBT).

My experience of this outwardly seemed positive to begin with after I asked my GP for advice about a panic attack I 'survived' for the first time following a bereavement. I was showing typical symptoms of depression with anxiety which was increased during this time as it coincided with other deaths within my job at the time, the long dark winter months, first Christmas without a loved one, a young child and other family I felt I needed to be strong for. I found it very difficult to find anything positive in life when everything around me felt so negative.

To add to everything else, a friend of the same age, dropped down dead without warning and another old school friend went out one day with no warning and hung himself. To me, both of these people were perfectly healthy which led my already overwhelmed thinking to question my own mortality and that scared me. There was no way to know what was inside your body and even more scary, no one knows what triggers that ability to be so comfortable with death and ending your physical existence that you make a conscious effort to do it. I was terrified not knowing that trigger and fearing the fact that it could trigger in me at anytime.

This fear became a focus that diverted me away from my grief for, at that point, 6 people.

The assessment carried by my GP showed that I had depression and anxiety disorder. well, obviously! I was having a panic attack every day feared work and paranoid about my health constantly.

I was grateful then when I received my prescription for the mild antidepressant Citalopram and an email inviting me to agree to CBT over the phone. I did six sessions, one a week and an emailed review before the next one to check progress.

At the end of the six weeks the tablets had kicked in but had been yawning solidly for two weeks (which I later found out to be a side effect). The CBT reviews were showing signs of improvement and the talking about things did seem to relieve a little stress from my shoulders.

It wasn't until 4 months later I realised how the CBT had not even touched the edges of my issues but had covered up them up beautifully so I could continue to function. It had been so long since I really felt 'normal', the emptiness I still felt was my new 'normal'. I told the GP I felt better, the CBT reviews said I was back to normal ranges in their assessment areas. Perfect. They washed their hands, never heard from the GP again.

All it took was a stranger at work to tell me if I didn't agree to new contracted hours, despite the old ones being agreed to suit my child care arrangements 4 years previous, my contract would be terminated. That news pulled something away from me and caused the floor beneath me to vanish and I totally cracked. I had been living like a zombie day to day in a stressful job role that was chronically understaffed. I had a panic attack that was so bad I was taken to hospital with a suspected stroke. I was 29 years old! Thankfully it was a combination of aura migraine and panic attack.

I would just like to take a moment to praise the Ambulance service at this point who were amazing. The paramedic who stayed with me at work for an hour to help calm me, came to visit me in hospital to check on me. He didn't have to do that. I will never forget him for that.

Even at this point, I was not offered any help. I had a few days off to recover and during this time a brief thought of suicide crept in but not in the traditional sense. I was thinking about how much more I could take before that trigger kicked in. I didn't know if it would feel like an out-of-body experience or if I would do something unconsciously. I already felt horribly out of control so that made the possibility all the more real.

I called my GP. I have to say that I don't believe I would have been as comfortable calling that day if one of the receptionists wasn't my parents neighbour. That made it comfortable for me. I had a link in the surgery in my mind and it felt accessible.

Through that phone call I was able to get an appointment and my husband came with me. He really had no understanding of what I was going through and often said that 'everything will be fine' but after witnessing the break down he became more supportive. My drugs were increased and I was again offered CBT.

I, in that diminished mental state, had to be the one to highlight the fact that I had done a course recently and asked him if I looked like someone who was treated positively by CBT. He agreed it hadn't worked and suggested face to face counselling for which I had to wait eight weeks for initial contact! That was that. The caring medical profession had washed their hands of me and I had to struggle through life for eight weeks. I was surrounded by family but felt totally alone.

Proper counselling proved to be the best treatment to start with. My issues were far deeper seated that what had happened in the past year and it was good to talk as they say. I eventually changed jobs, talked more about the right things to the right people and found myself again. I came off the tablets without GP input and basically picked myself up.

I was a lucky one.

My case never went further than the local doctors and yet I felt dead inside. I had innocently expected that those who end up in A&E services would receive better, swifter care for their mental health simply based on the concentration of resources they have access to on premises. Would you agree? Well it seems that, in fact, the service and resource pool was poor.

One NHS contact story I can share thankfully has a positive outcome where a very old friend from school contacted me after they called themselves an ambulance whilst mentally planning their own death, down to detail. Not even thoughts of their children came into this decision they had made.

I was so pleased that they had called for an ambulance (who again were amazing) and asked them to call me for support. The outcome to this story could have been much worse but the service we call a national HEALTH service, which includes mental health, completed a tick box exercise followed by a 'are you going to try it again?' question and sent my friend on their merry way with a leaflet and advised them to call their GP. See ya! Passed the buck.

Now as I say this was a happy ending and my friend is now engaged and living happily with their family and children. The following example of how our services are failing people at key critical points has a painful outcome.

Now, there is a big media campaign about getting mental health out there to be understood and have the stigma removed from admitting mental health issues. Price Harry himself, on a BBC interview, openly admitted that despite the awareness he was involved with raising, he was not oblivious to the lack of resources and funding out there for people who need help of this kind at the moment.

When you consider 6,188 suicides were registered in the UK (according to the key trends from the Samaritans Suicide Statistics Report 2017) and the highest rate was among middle aged men 40+ you might expect that two failed suicide attempts by a man in his 40's with an outwardly normal and stable life should ring some bells for professionals.

The police or ambulance service are often first to respond to suicide reports and my final story is no exception.

Call one: male, mid 40's found in car, attempted suicide, butane gas. Not taken to hospital as he was still conscious and refused to go. They were not able to take him against his will despite his obviously unstable condition. Treated as a cry for help, no further action.

Call two: male, mid 40's, missing person considered vulnerable due to history of attempted suicide. On this occasion he was found alive but intoxicated with a cocktail of illegal drugs and high levels of alcohol in his system. He had hidden himself in the loft. No fear of what was happening to his body or the outcome if left untreated and was disappointed he had been found. For a man to be so emotionless when his wife and child where downstairs should clearly show some kind of diminished capability where custody is in their best interest to prevent further harm to themselves. That might just be my opinion but is also common sense surely!

Because so many of his friends and family had been involved with his search multitudes of facts and troubles began to come out through what he had said to different people over the last few months. There were also some alarming snippets of information his policeman friend had picked up on.

At this point there were now four different services involved in his care, The police, under funded anyway, minimal mental health training, no medical training. The ambulance service, under pressure, medical knowledge and increasing attendance at mental health related call outs and believe that once they stabilise a person and hand them over to the hospitals the best treatment will be offered. So then the hospital staff were involved this time to make service number three. This is, in many opinions, the hub of services. If you need treatment, a hospital can arrange it, refer it, book it, do it!

The hospital this man was taken to had a mental health unit for outpatients and also catered for varying levels of mental health treatments for inpatients on site. It was a well known unit in the area and, as family, we felt secure in the knowledge that this facility was on our doorstep and in reassuring his wife, truly believed that he would be held under a section and admitted for his own safety.

Service number four joined in where a psychologist visited him in A&E and did their necessary tick box exercise.

Two hours after his second suicide attempt, he was home again. He was given a leaflet and advised to call his GP. Out the door. Hands washed.

He seemed 'normal' again for a couple of weeks. He looked very withdrawn in the face and thin. He was contacting people he hadn't spoken with for some time and even came to our moving party which was only unusual as he didn't come to anything!

We had reservations moving away at this time and though we should stay a bit longer but everything was booked. Two weeks later we got the phone call. This time he managed it successfully, found by his wife in his daughters bedroom.

This raised so many questions for me. I had met people who had been admitted for an over reliance on sleeping tablets. They were taking knowingly and taken a safe amount daily and yet a double failed suicide attempts warranted nothing but a leaflet and a good luck!

Rather than fall back into my own depression at a time I was needed for support I flew into researching areas I felt had failed the three of us in this article.

Firstly it was clear, well documented and highlighted in the media that the demand and need for mental health service support was growing rapidly. A BBC news report this year by Rowan Bridge states that out of 39 mental health trusts that provided figures for their crisis teams in the UK, 27 had seen their workload increase - 70% and some had seen referrals rise by as much as 60% - but without a comparable rise in funding.

The report also says that in 2014, a report for NHS England acknowledged the system was "stacked against" mental health. Last year a further report for NHS England said the majority of crisis teams "are not currently sufficiently resourced to operate 24/7, with case loads above levels that allow teams to fulfil their core functions".

Well no surprises there.

The worrying thing for me is that all three of us, whether it be me with depression, my friend with suicidal thoughts and a cry for help before attempting or the latter eventual death, none of us even made it to the struggling under funded crisis teams in the first place! Did postcode lottery play a part in this I wonder?

The rate of self-harm hospital, in my mid range depravity area in Surrey, was 168 in the 2017 report, better than the average for England. This represents 1,939 stays per year. Well they would be good seeing as so many were returned home same day.

I then looked in to stigma and assumptions made around mental health such as those where people say they tried but are just saying it to be manipulative or those who look like they could attempt it but because they make these attempts regularly, they lose their punch.

I have come to terms with the fact that those who genuinely feel that ending their life is the only option will do it regardless and are not willing to let on that it is something they are even considering. These people will never be helped because no one knows they need it and they certainly wouldn't ask for it no matter how many services at available. The after care for those left behind trying to make sense of something difficult for anyone to understand, in this instance, is where improvement is needed.

We bang on about person centred care in my industry as well as the mental capacity act. I found it very hard to believe that, in the last story, they found that man to have capacity. I have been in a dark place and felt unable to make decisions in my own best interests so for someone so calm about dying that they wanted to speed up the process begs the question, are they able to make decisions? It can't have been put down to him being allowed to leave making an unwise decision. Why would anyone think that someone in that frame of mind who was disappointed their suicide attempt had failed twice pick up the phone to call their GP. What could the GP do to ease their money problems, their long term health problems, their physical pain? How could a GP provide for the family where they could not or keep their family safe?

There are so many answers and solutions to all of these but when you are not thinking straight nothing is as simple as getting a loan or calling on your friends to help you out of a sticky situation. There was also the unfortunate truth that, as a middle aged man who was life and soul, admitting faults and failings to people around him was painful in itself. Why would he call the GP.

I can tell you that I was the only person to involve my GP. Neither of the other two stories contacted the GP after agreeing to at the hospital. Coincidently (or maybe not) both of the other cases where those of men.

There are many different reasons why people choose suicide as a route to escape what ever is going on they can't see a way out of but, even if the services were not under funded and over stretched, if the basic services are not taking this seriously and making those referrals before it is too late we will consistently be inundated with news stories and Facebook updates about people we know and love dying unnecessarily before their time.

I am but one person with a story or two to share with opinions of where things went wrong but I am in no position to fix them! It is frustrating and sad to have an insight into how it feels to be depressed, wrapped in darkness and out of control and also understand how it feels to experience life after loosing someone through suicide. Neither are pleasant for anyone and yet neither seem to have the attention of medical professionals that they need at crisis stage or prior despite red flags.

It's not good enough UK!

Statistic sources:

BBC News 2017 - http://www.bbc.co.uk/news/health-40732632

Samaritans.org - https://www.samaritans.org/about-us/our-research/facts-and-figures-about-suicide

Surrey health profile 2017 - http://fingertipsreports.phe.org.uk/health-profiles/2017/e10000030.pdf

(Stories are genuine stories and occurred in the Surrey area, other counties may have superior mental health and crisis teams)

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About the Creator

Karen Philpott

Just a human with experiences of things not everyone has experience of and I have a lot to say about it

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