World Mental Health Day: An open letter to Jackie Doyle-Price

Dear Jackie Doyle-Price, Minister for mental health, inequalities and suicide prevention,

Today is World Mental Health Day. A day for stigma busting, frightening stats and well-meant declarations. But it’s also a day to highlight your Prime Minister’s failed promise to address the “burning injustice” of metal health provisions. How can she stand by as CAMs is overwhelmed with a generation of children and young adults seeking help, when teenage suicides have risen by 67% since 2010 and our NHS mental health services are enduring year after year of funding cuts and alarming numbers of clinical and support staff departures? Today on Mental Health Day I have to ask what does your government intend to do to address the ‘monumental suffering’ of this national and indeed global health crisis.

A crisis that whilst international is also very personal. A state of crisis I have often found myself in, at times barely existing, as I attempt to access the right care. Regardless of the shocking headlines of late, waiting lists years long are no surprise to those of us living with chronic mental health issues. It’s a daily reality thanks to your governments failure to protect and increase funding for mental health trusts, funding in real terms The Royal College of Psychiatrists analysis found was £105m lower in 2016-17 than five years ago. Funding failures that ensure our lives are harder and at risk. A risk you need to understand. As Minister for mental health, inequalities and suicide prevention I challenge you not only to spend time in the footsteps of those who have taken their own lives, but to examine how they came to take that final despairing decision and the process NHS mental health care provisions (or lack of) plays in that process.

As someone living with chronic depression I have very few choices when I become unwell. I can access mental health services but only through my GP. Accessing a GP in 2018 is, as so many of us know, a mission almost impossible. I then need to wait for a referral by my GP for a mental health service assessment. A 24 to 48 hour process that realistically takes up to three weeks to happen. Eventually I will be offered an appointment to see a young junior psychiatrist doctor or community nurse. I will be asked the same questions I’m asked at every assessment, each triggering more depressive and suicidal thoughts whilst sat in a cold clinical room with only a box of standard NHS tissues for comfort and a screwed to the wall generic ‘inspiring/ calming’ artwork to gaze at.

After a brief session on the assessment conveyor belt the head psychiatrist will pop in and based on his colleagues observations declare what the problem appears to be, how the long-term nature of my illness makes everything very complex and how we might address those issues. It usually involves a change of medication (with no support regarding the often debilitating side effects) and / or a list of therapies I could have. Could being the operative word. Show any interest in aforementioned therapies and the excuses come flooding out. Waiting lists months but usually years long, staff shortages, a CBT system not set up for those with different needs such as mine (there’s no 6 week short, sharp, cost effective fix for complex chronic mental health issues) or the suggestion of private therapy which, if you can’t keep down a full time job, are living on universal credit or have been sanctioned because of your continuing mental health issues, you can never afford. And then you leave. Triggered, depressed, despondent, despairing. But with leaflets. Always leaflets. You can never have enough of their useless sodding leaflets.

And then if your unlucky and the bloody leaflets get to you or the utter despair becomes life threatening as you realise you’d would have had more luck accessing care if you had a terminal illness (thoughts I’m not proud of), you get to try out the NHS mental health emergency care provisions. A police cell if you are being a danger to self or others, a service unsuited to either patient or officers but increasingly being relied upon across the UK. Or you can visit your local A&E department, your struggling, overcrowded, underfunded, understaffed A&E department, never meant to be the first port of call for a mental health emergency and never under so much strain as record numbers of people like me, young and old, arrive at their doors suicidal. Only to be greeted by overstretched psychiatric registrars and the ubiquitous box of NHS tissues. Naturally. Austerity seems to have missed those beauties.

So dear minister forgive me if I fail greet the news of your appointment this World Mental Health Day with delight. As a service user of a service that barely exists, I am sceptical your words will make any difference while your governments action continues to strip the NHS mental health services (and the charities and organisations it increasingly relies upon) of the funding they truly need to make a difference. I’m nearly 50 and I almost feel it’s too late for me find the support within the NHS to ever address the issues I live with daily. And that’s okay. Years of disappointment within your system have prepped me for this. The lack of parity of esteem between mental and physical care within the NHS is not breaking news, it’s always been there and its clever in a way. Why the need to provide parity of esteem to a group of people struggling with low or no self esteem? How do we challenge our poor treatment when most of us feel we deserve it? But as I sit here and read report after report about your government’s failure to protect young people, to provide them with the care they need, the therapies, interventions, treatments and support, that’s when I want to drag my self esteem off the floor and demand parity for a generation so let down by your government’s policies.

According to a recent study published in The Lancet I, as someone living with ASC and my resulting depressive episodes, have a significantly higher chance of contemplating or committing suicide than most within the general UK population. That’s something that early intervention in my mental health could of changed. That’s something too many young people live with but one you could make a difference to. That’s something we could all do with some help with. Supported lives rather than self medication, open arms rather than waiting lists, understanding rather than stigma, change rather than becoming another statistic.

So do us all a favour Minister and listen to every generation living with mental health issues, address the injustices of the benefit system and make it your mission to support and fund the health and therapeutic services we need. Heck even take a leaf out of the young royals book and put your heads together with all government departments to deliver true parity of care.  Because this World Mental Health Day it’s time you delivered more than words, it’s time for change. Because if you and your government don’t listen and work towards better mental health for all, we’re going to need a lot more than a box of NHS tissues to survive this crisis.


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