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Action not words: Why mental health care needs to change

23 August 2018

‘Mental health should be treated no differently to physical health’; ‘there’s no difference between mental illness and a broken leg’; phrases that are often said in the context of mental illness and breaking down stigma, along with the standard black and white image of an adolescent with her head in her hands, or a glossy coloured photo of some smiling woman having overcome the demons that once captured her. I get it, I get the meaning behind the words, the images that are so commonly associated with mental health and combatting the stigma. But has any of it really helped those whose reality is a chronic mental illness? 

Despite the rhetoric on parity of esteem, mental illness is different to physical illness; as Hannah Jane Parkinson wrote earlier this year, it is nothing like having a broken leg. Yes, they both hurt, and yes, victims can be anyone from your daughter to your neighbour, from your doctor to your friend; but that’s almost where the similarity stops.

Despite the rhetoric on parity of esteem, mental illness is different to physical illness

Mental illness is ugly like you wouldn’t believe, and the treatment of it even more so. But then, how do you ‘treat’ someone set on taking their own life, someone emotionally so unstable, someone who doesn’t know their own identity? That’s not something that will ever be solved by a plaster cast, nor a course of antibiotics or operations. In fact, often the problem itself is so elusive and unnameable: a scan doesn’t highlight a past of trauma, a struggle with society’s pressures, a chemical imbalance. Mental illness can’t and in fact shouldn’t be treated like physical health, no matter how much we talk about it.

Every election, more funding is promised to improve services, with politicians and commissioners stating that mental health care will no longer be the ‘Cinderella’ service. Campaigns nationally tell people not to feel afraid to talk, to ask for help. The thing is though, that day in and day out people are talking; they are crying out for help, but there is no service for them, Cinderella or otherwise. Treatment only starts when your life pretty much stops, and that treatment isn’t really a ‘treatment’ at all.

A scan doesn’t highlight a past of trauma, a struggle with society’s pressures, a chemical imbalance

It’s being restrained by four male police officers despite having a history of trauma; being shouted at to stop moving as if trying to break free is completely irrational. It’s handcuffs and being forced into the back of a police van, the door shut, lonely tears your only companion. It’s spending hours in a 136 ‘suite’, which for reference is nothing like a ‘suite’ in the normal world; and it’s losing your freedom, your choices, your rights.

It’s being securely transported to a psychiatric ward hundreds of miles from home because there are no beds in the county, to a place where your fellow ‘inmates’ are just as lost as you.

People are talking; they are crying out for help, but there is no service for them, Cinderella or otherwise

It’s days spent sitting in corridors because what else can you do within the confines of four walls? It’s being watched around the clock as you sleep, shower and exist by a staff member who barely knows your name let alone your struggles. It’s being covered in bruises as you’re restrained, the irony being that it’s deemed necessary to prevent harm to yourself. It’s being brought back into area at the drop of a hat because suddenly a bed becomes free and you’re not worth the expense of an out of county one anymore, despite relationships and trust being central to the recovery of any mental health patient.

And then it’s being discharged; dropped into a world that has moved on since your departure, too well for the hospital but too unwell for work; the therapy you’ve been assessed to need months maybe years away.

The stigma of mental illness isn’t the real issue here. It’s the reality of a service in crisis

We can all say the words about what should happen regarding mental health care, we can all campaign, strive for equality and tell people this is not ok. We can share stories, insights into mental illness experiences; but actually, what is the real need for patients who are suffering because they can’t access good support? It’s not stories, selfies, quotes; it’s not special days where everyone retweets a celebrity’s endorsement of the cause. The stigma and silence of mental illness isn’t the real issue here. It’s the reality of a service in crisis; where you become unemployable because help turned you away at the point where you still had a job, a career, and some hope; and where people are driven to extremes before their distress can be acknowledged.

Mental illness can’t be normalised at the moment and perhaps it shouldn’t be, because in doing so we are diluting the urgency with which mental health care needs to change.

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