By Jody Elford
Here in England we have the National Health Service, which I feel extremely lucky to benefit from. We’re privileged to be able to access healthcare services without worrying about how to foot the hospital bills. However, there tend to be long queuing periods for treatments.
Obviously the free-of-charge care patients receive isn’t really free. It all costs money, and all must be budgeted for. This can leave departments spread thinly, healthcare workers overworked and underpaid, and services and facilities being downsized or cut all together. Some areas of healthcare suffer more than others.
Mental health services seem always to have been one of the many areas to bear the brunt of corner-cutting and budget slashes. I’m not here to make a political post though. In all honesty I am not educated or intelligent enough to begin banging on about the government. All I can talk to you about is how it feels to occupy an unknown position in a queue of indiscernible length, trying to stay alive long enough to reach the front.
People dying in the queue
Of course I’m being a little dramatic. My experience with suicidality has been mild, if there is such a thing, but for many people the high mortality rate of mental illness is a very real daily risk.
In explaining to my Dad how the therapy referral works and about the waiting time involved, I said something that hadn’t really occurred to me until I said it out loud:
“Well, they assess your risk and stuff, and place you in a queue for help, and as people either get help, get better, or die, you move up the queue.”
It only occurred to me as those words left my lips that people are dying in this queue.
There were 5,668 registered deaths from suicide in 2016 in Great Britain, and around three-quarters of these were men. In England and Wales, suicide is the most common cause of death in men aged 20-49 years old.
Five thousand, six-hundred and sixty-eight people! Let’s also not forget that these are the recorded ones – there are bound to be many that are missed, such as people who deliberately crash their cars or appear to have overdosed accidentally. And this only includes those aged ten and up. I think it’s important to note that child suicide appears to be on the rise, yet most of the statistics discount younger children.
The statistics are alarming
The mortality rate of mental illness is staggering. And the statistics get increasingly alarming when you begin exploring how mental illness impacts on the ever-growing number of people who live with it – and its effect on the economy.
It’s unsurprising really that mental health has become such a hot topic in the media – it’s everywhere, isn’t it? We’ve reached a point where I’m not sure I know anyone who hasn’t experienced mental illness either directly or indirectly.
For someone who is mentally ill, three months may as well be three years. You can lose all hope in that time.
When the crisis team came out to visit me after my first relapse, they informed me that the wait for therapy was a long one. They explained that their primary function as a first response team was to assess and manage risk to outpatients awaiting treatment, and to undertake interventions as necessary to safeguard people.
A couple of weeks later, a very lovely lady telephoned me to perform my initial assessment with the therapy service (honestly you’ve never been assessed so much in your life until you’re bonkers). She informed me that the average waiting time for treatment is three months.
Let me tell you.
For someone who is suicidal, three months may as well be three decades. Time crawls by at less than a snail’s pace. The all-penetrating sense of hopelessness stretches that waiting time out in front of you so it feels like you’ll never get there. It’s like preparing to complete a marathon, through treacle, wearing a deep-sea diving suit like something from 20,000 Leagues Under the Sea.
The revolving door
Of course, it is true that some people awaiting help can find ways to get better on their own. So by the time their therapy finally arrives they feel that they have nothing left to resolve. Therapy then can feel like a waste of time to the patient so they either decline to go, or make no progress in it because by that point they’ve coped. They’ve packed it away and feel better. Sometimes this is fine and those patients go on to live their remaining days with no further incident.
In my first-hand experience though, it’s possible that all the shit that landed you in a dark well screaming for help last time has simply retreated, offering you a reprieve until your next relapse. By this point you have been discharged from mental health services and must begin the process all over again. I have been on this revolving door since the age of 16 and it’s only now, approaching my 28th birthday, that I am afforded the tools, support, determination and absolute pressing need to get off. In the past few months I have come to the realisation that if I don’t, it could, and probably will, kill me.
Still a ‘fruitcake’?
On Friday I received a letter from the NHS requesting that I telephone to confirm that, yes, I am still a fruitcake and still want to access their therapy services.
“If we do not hear from you within 10 working days from the date of this letter we will assume you no longer require this service and will discharge you.”
Diligently, I called them yesterday and noted to myself, with a shameful degree of cynicism not without humour, that these letters are probably also to prompt those of us remaining alive to get in touch. I wondered briefly whether, upon not hearing from you, they take any steps to establish whether you did off yourself after all.
I know waiting for treatment is like purgatory, but you’re far from alone. I feel obligated to reach out to anybody else who might find themselves in limbo like me, because it is purgatory. For some of us, it means tip-toeing along the knife-edge between everyday life and the morbid abyss. It’s like navigating a lego-strewn floor barefoot, with the lights off.
While I linger here in my personal state of limbo I’m waiting for the call to say that they’ve matched me up with a suitable therapist. (Like some sort of weird dating website – pimpmytherapy.com?) It’s as though someone has lowered a harness down into the darkness. I’ve navigated the straps and, after several failed attempts, figured out where the leg holes are and now I’m waiting at the bottom of this pit. I’m trying to keep my gaze firmly fixed on the slack rope extending high above me, waiting for it to grow taut and begin hauling me out.
How to survive
All I have to do?
Keep the harness on.
Just keep waiting.
Keep breathing and existing and functioning as well as possible until help arrives.
Or rather, fight against the need to gasp for air while I’m submerged until I finally break the surface, lest I take on great lungfuls of water and drown.
So I decided to put together my top tips for survival until Yes, rest. Rescue mission begins.
Yes rest, I mean really rest. It took me a while to agree to being signed off work for an extended period. Maybe this is because I am so in love with, and dedicated to my work that I couldn’t bear to be away from it? More likely, I just found it difficult to admit that work is simply too much right now.
I’m actually legitimately unwell and I’m not safe to be in my working environment. I appreciate not everybody is in a position where they’re able to take time off. If you’re in that position, try talking to your employers about adjusting your hours or duties to make work less challenging for you. Your GP can also back you up by providing a certificate to indicate you may be fit to work if adjustments are made.
It’s not just about work, though. Don’t burn yourself out. Take time away from people a bit. I don’t mean isolate yourself, but remove yourself from the party scene. Pursue quieter, more gentle pastimes. Lay off the alcohol for a while. Get early nights if possible. Nap if you’re tired. Restfulness is not all about taking time off work, sometimes it’s more about creating space for yourself to regenerate your reserves.
You’re unwell right now, so stop beating yourself over the head because you’re forgetful or flakey, or don’t give a shit about anyone else right now. Mental illness brings a heavy enough burden of guilt and shame without you piling more on top. Allow yourself to be unwell for now, and tell anybody who makes you feel bad for not being your usual self to take a hike.
Even people who know us really well are not psychic. It is up to you to let your support network, however large or small it may be, know how you are doing. Sharing honestly can feel alien, difficult and uncomfortable, especially if you’ve spent a long time hiding your issues from everyone. The real kicker is that being honest and opening up to bare your soul can, at first, seem to make you feel even worse.
Keep going; keep talking. Don’t worry so much about making sense, just articulate yourself as best you can. Don’t freak out if people don’t understand, they’re trying to, and they love you, that’s all that matters. Perhaps most importantly, make sure you have the support you need to revisit your doctor if things change or deteriorate.
Don’t be an idiot
Be sensible. Take your meds. Try your best to do as your told. When (and I mean when) you screw up, tell someone and start again. Eat enough. Drink water. Sleep. Let people help you. Pursue things that make you smile, make you calm, and help you get out a good cry.
Don’t be afraid to do things that make you laugh and smile. It’s so odd that people with mental illness often feel forbidden to take pleasure in things or experience joy and humour. “I’m sick though. I’m off work with depression. I can’t go around having a lovely time.” Yes, actually you can. That’s sort of the point. The whole point of your treatment (and time off, if you have it) is to regain your capacity for joy and hedonism. Pursue activities, environments and people who bring you slivers of sunshine and positive vibes. It’s all medicine, I promise.
Avoid unpacking too much, too soon
Talking openly and honestly is vital to recovery. It is also important, and totally acceptable, to acknowledge where there might be boundaries to what you want to, or should, discuss with loved ones. This will be different for everyone and you need to get a feel for your own limits. The point of this is that you are waiting for therapy. In therapy, a professional will help you unpack all the nasty shit making you ill. It’s up to you to decide how much of that you need to offload to family, friends and partners while you wait.
To help you decide, just bear in mind that part of a therapist’s job is to provide an impartial, non-emotive soundboard. Your loved ones are, most likely, going to struggle to provide that, and that’s OK. It’s not their job. They are there to love you, support you, feel for you and listen to you as best they can. A therapist won’t burden you with their feelings about things you have to say. Your loved ones might be limited in their ability to do the same.
Share as much as you can, but don’t unpack anything there’s a risk you will struggle to put away again or deal with. It will be painful for your loved ones, and unhelpful, even detrimental, to you. Some things are best to await therapy to deal with.
Look after yourself. Wear soft, comfy clothes. Take baths. Get a massage. Get your hair or nails done. Treat yourself to nice-smelling body products. Meditate. Get plenty of sleep. Watch films that you get lost in. Read, if you enjoy it. Listen to music that soothes you. Brush your hair and teeth twice a day. Shave, if it makes you feel nicer.
Get a friend to braid your hair. Go on a modest shopping trip. Download mental health apps, water reminder apps and health and wellbeing apps that help you develop healthy habits. Have people who love you round for tea. Change your clothing every day, even if you’re just in pyjamas. Eat fruit and vegetables. Ask for help doing any of these things if you can’t do it yourself.
Go for walks in nice places. My favourites are the seaside and the woods. Get moving. Jig about to music. Seriously. Just stretch or cycle your legs in mid-air in bed if you can do no more.
Develop a crisis plan
Work with your immediate support network to develop a crisis plan. This needn’t be complicated, but it should at least provide you with prompts should you find yourself in distress, and instructions for others should they need to help you. Who should be called? Do you have medication that will help? At what point should you be taken to the emergency room? How can people help you?
You’re not alone. Take things one day, one moment, one breath at a time. All you have to do right now, while queuing, is live. Then live another moment. Then keep living moment by moment until living isn’t so hard. Don’t give in to this terrible disease. You’re amongst friends. You have all of us on your team. People who don’t even know you, people who have never even met you, are rooting for you. We’re on your side.
Reproduced with permission, originally posted here