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What Happens if You’re too Broken for the NHS?

By all accounts, a lot of the stigma that once existed around mental health has been eroded. Studies show that people’s knowledge of and attitude towards mental health issues has significantly improved in the past decade, with a Time to Change survey reporting that since 2007, 4.1 million people have improved attitudes towards mental health. So, these days, it is a lot easier to open up about your mental health.

But it’s not enough.

We’re sold this story of everything getting better if we only just speak up -– like the only thing holding us back from recovery is ourselves – but the reality is a lot more complicated than that. A lot of public discourse emphasises how so many people with mental health issues are ‘suffering in silence’ and that if they only reached out to get help, everything and everyone would be rosy. But that’s not the case.

The reason so many people are suffering and that the country is on the brink of a mental health crisis isn’t because of individual responsibility but because of a flawed system. The truth is, our mental health system is simply not fit for purpose and just does not work for people who have more than mild stress, anxiety, and depression.

Take it from me.

I’m somebody who has ‘spoken up’, gone through all the motions, and done everything that these glossy campaigns have told me to do. But it’s gotten me absolutely nowhere.

Time and time again, I’ve been to my GP, 111, and called every hospital or emailed any email address I can. I’m tired of letting depression and OCD rule my life. I don’t want to live like this forever. I honestly, truly, want to get better.

I’ve spent half a decade being fobbed off with a menagerie of SSRIs and surface-level CBT sessions. Whenever I finished my little block of sessions, the therapist would act shocked that I wasn’t miraculously cured of my afflictions despite my repeated insistence that this type of therapy was simply not enough to help me tackle my OCD.

It was almost like these therapists resented me for not being able to dissolve my OCD entirely by drawing a few circles.

When I finished my first block of CBT at 17, feeling no better than I did when I started, my therapist mumbled to his shoes that my issues were very “complex” and probably not suitable for the general therapy he (on the NHS) offered. And that was that.

No alternatives, no hope, just a letter discharging me from the service. It almost felt like I was being punished for not being a quick fix and not fitting the easy-to-treat mold they wanted me to.

For years, it would be the same old story of therapists discharging me from the IAPT conveyer belt in order to make room for the next person, despite us both knowing that I was no closer to getting better than I was when I started mental health treatment.

And so began a cycle of relying on medication, having a breakdown, going to my GP for help only for them to refer me to the very same CBT services that time and time again have proven to be unsuitable for my specific mental health issues.

But I’m far from the only person to have this problem when it comes to seeking NHS mental health treatment.

58 percent of people surveyed by mental health charity Mind said they weren’t offered a choice in the types of therapies they received. Only recently, after a significant amount of begging, my GP reluctantly referred me to their community mental health team.

I had done my research and knew of several specialist OCD outpatient treatment centres funded by the NHS that could help me, but once again, I was rejected. I was told that before I could access the treatment I actually needed, I had to once again go through generic CBT.

Unbeknownst to me, before I could access specialist help, I had to make sure I met a particular set of hidden ‘criteria’ regarding how many times I had tried the treatment options that I knew full well were useless.

The nurse reminded me how expensive it was to get funding for this treatment. She talked about how there would have to be a panel meeting to assess whether I really ‘needed’ specialist help, I was made to feel like a burden.

I was made to feel not like a person getting support and guidance for their mental health, but as a box that needed to be ticked and filed away so that everyone could get on with their day.

I’m glad I researched specialist OCD centres, but why was it up to me to do that? Why was it never presented to me as an option earlier down the line?

The answer is simple — the more complex your mental health issue is, the more paperwork and money it is for the NHS.

As those living with mental health issues like eating disorders, bipolar, and PTSD are left waiting for up to two years for treatment, our mental health system is built not on compassion but on bureaucracy.

With 75 per cent of people with diagnosable mental health issues receiving no form of treatment, it is clear that, especially when it comes to more complex mental health issues, our NHS is not fit for purpose. If it were, two-fifths of people waiting for mental health treatment wouldn’t end up contacting emergency or crisis services.

Many people like to push the narrative that the only reason the NHS isn’t fit for purpose is that it’s the victim of underfunding.

Although it is undoubtedly true that the NHS is not funded anywhere near as much as it should be, issues such as their lack of compassion and competence for those with more complex mental health issues run a lot deeper.

For example, a recent investigation by iNews revealed that 23 NHS mental health trusts had adopted something called Serenity Integrated Monitoring (SIM).

Targeted at those patients who frequently call emergency services and make attempts on their own life, if patients are tagged under SIM, they can be denied treatment, refused a psychiatrist, and sent home.

This, in turn, means that patients with more complex mental health issues, like mood disorders, are once again pushed away, denied treatment, and made to feel like a burden.

People with severe and complex mental health issues have a life expectancy 15-20 years shorter than the average person. But, as I can attest first-hand, this isn’t because they refuse treatment or want to get better.

There are so many people out there who are doing all the right things society tells them to in order to treat their mental health issues, only to be knocked back, blacklisted by emergency services, and told that they are ‘too broken’ by the very people who are meant to help them. 

Quite simply, telling people to ‘Be Kind’ and ‘open up’ isn’t enough anymore.

If the NHS wants to save more people’s lives, they need to look inwards rather than putting the onus of blame and responsibility on those who are on their knees, begging to be heard. 

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