By David Gilbert

I wrote a poem once about the lack of flowers on psychiatric wards. We who are unwell in the world of feeling are doubly unrecognised. The hill we climb back to wellness is jagged and steep with zig-zag turns.

The summer was scary. Symptoms I thought buried, returned. A Patient Director who had relapsed to patient-hood. Ironic. Fitting perhaps?

Post-recovery in the 90s, I lied on my CV about the time I was ‘away’. I called it ‘freelance consultancy’ (boy, was I ‘freelance’!). Disclosure was an impossibility for my career. Like it is for many others. Stigma was (and arguably still is) prevalent. But during a more recent bout, I did not lie. I had an employer who supported my recovery into wellbeing and my role.

That difficult step back into the office

Recovery is a dangerous time. When you get back on your feet, they are wobbly, like a baby gazelle. The echo of stifling thoughts and uncomfortable feelings have not disappeared. The narrative you have told about what happened – the usual bulls**t (I am no good, a failure, can’t do the job, etc) are rocking around. You may ‘look’ better. The scars are invisible and still sore.

When I got back, I was hugged. I was bowled over by affection. One friend who had been away with a physical problem asked: ‘Did you get a card from the office?’. I said, yes of course. And flowers. And wonderful chocolates. ‘And weren’t those messages from everybody amazing?’ she went on.

‘What messages?’ I said.

Then I realised what had happened. The organisation, rightly in terms of confidentiality, had not disclosed my illness to others. I had not had the conversation with someone to say ‘you can tell people XYZ about what happened to me’. Hence I got a card, but not one signed by everyone.

Recovery is a dangerous time. You may ‘look’ better. The scars are invisible and still sore.

I remember that when I got that card, with a ‘love and support from all your friends’, it felt like I was disconnected from all those people who could have voiced their support explicitly. That extra layer of protection further isolated me. That lack of connection made the return to office more unknowing.

The touch on the arm

But here’s the main thing: one or two people came up to me and gently touched me on the arm and asked ‘are you OK?’ That touch said so much. It conveyed deep concern, love, kindness. And also uncertainty – not about how I was – but about how to open up a conversation about my mental wellbeing.

To me, it said ‘I am here for you, I am happy to listen, but I am unsure how much you want to share’. We needed a way of holding a safe conversation – on my terms of course, but also one that recognises the limits of what others are comfortable with.

In some ways, we who are suffering need to make it okay for others to show they care. This may seem like a lot of work when we are already going through so much pain. But the consequence of not doing so may be silence.

We needed a way of holding a safe conversation – on my terms of course, but also one that recognises the limits of what others are comfortable with.

During a more recent bout of awfulness, I made a point of writing a note to colleagues that it was OK, more than OK, to get in touch, to ask about things, to show they cared. And last week, I got a card that made me teary, signed by everybody. I didn’t feel quite so alone.

I talked to some people who, courageously, said ‘I don’t want to treat you with kid gloves, or patronise you’. We went on to talk about how to have a proper conversation about my unwellness and capacity to take on the refreshed workload. We agreed that if I was hurt or triggered by things they did or said, or if I felt that work was too much, it was my responsibility to say something. And that they would be open to challenge too. Can your organisation or the people within it do this?

So, if you are worried about a colleague struggling with their mental health… don’t be scared to show you care. Send a card, send flowers, send a little of what is in your heart. You may get it wrong. And if you do, use it to explore what you can do or say next time that helps. But in fact, your caring may help do a tiny bit to prevent a next time.

Opening up

There were also people who sidled up to me to talk about their own vulnerability. And it is in these sorts of encounters – furtive, gentle, open, adult – that I feel I have most been able to give of myself. By opening up, people have opened up to me.

Many reading this will have experienced this opening. It is one gift we bring from the cave-world. The touch on the arm is the beginning of something different – it is a strike of connection and light.

Thank you to all my work colleagues – friends. This is my touch on your arm.


David is Patient Director, Sussex MSK Partnership (Central). These are his own personal views. You can read more of his blogs on mental health, user and community engagement and poetry at www.futurepatientblog.com