Do you know how it feels to a vulnerable mental health patient when you tell them that they are on a “very long waiting list”?
by Matt Coot
The answer, at least for me, is that I am a burden or that maybe my problems aren’t thought of as important. It makes me feel worthless, more than I do already. It makes me feel like, maybe, just maybe, I should listen to the self-destructive voice in my head.
My self-destructive voice tells me that I want to cease to exist. It isn’t melodrama or exaggeration when I say that every second of every minute of every hour of every day is a struggle. I struggle to exist, I struggle to live, I struggle to belong.
Me: “Hi, I’m a risk to myself”
CMHT: “Excellent, excellent. Join the queue.”
*Looks around at the very long queue of people*
Me: “Uhh, that queue?”
CMHT: “That’s the one”
Me: “I can’t see where it ends”
CMHT: “Ah, yes, that is something we are working on. Just keep walking. Walk a bit further. Then just a tad bit more. Then you should be able to just about make out where the queue ends. Maybe. It might get bigger between now and then, we just don’t know. But do keep going until you reach the end of the queue. We will then see you as soon as we possibly can.”
Me: “I don’t think you understand, I am a risk to myself. I want to kill myself. I can’t function with day-to-day tasks. I need help.”
CMHT: “Excellent, excellent. Join the queue”
I’ve tried to take my own life. I was going to jump from a bridge into the River Avon in 2011. A different attempt, in 2017, saw me swallowing far too many ibuprofen pills. I’ve considered using knives from the kitchen to stab myself, or a Doctor Who sonic screwdriver, which is a real screwdriver, to slice open my skin. I’ve considered every possible way of using whatever is readily available to cause significant damage to end my life. This is called suicidal ideation.
“I don’t like standing near the edge of a platform when an express train is passing through. I like to stand right back and if possible get a pillar between me and the train. I don’t like to stand by the side of a ship and look down into the water. A second’s action would end everything. A few drops of desperation.”
I used to drink. I used to use alcohol to block out the thoughts in my mind. I used to use alcohol to block out life itself. If I reached oblivion, then I didn’t have to be existing. Of course, I also enjoyed drinking. I enjoyed the taste of Guinness, I enjoyed the taste of White Zinfandel wine, I enjoyed the taste of Jack Daniels and coke. I enjoyed being able to lose my inhibitions and being able to be friendly and chatty with everyone I came into contact with. I enjoyed the atmosphere in the pubs and clubs, especially when the alcohol inside me encouraged me to dance along to the beat or to drink more, and more, and more. But, I didn’t love waking up in the morning (or afternoon) with a killer hangover and no memory of what had happened the night before. I didn’t love finding out that I had spent the majority of my student loan on alcohol. I didn’t love the craving for more.
“Sometimes you can only find Heaven by slowly backing away from Hell.”
The Bipolar Rollercoaster
“When you get just a complete sense of blackness or void ahead of you, that somehow the future looks an impossible place to be, and the direction you are going seems to have no purpose, there is this word despair which is a very awful thing to feel”
I get highs and I get lows. These are not like any normal highs and lows. These are extreme and can hit me at random times with no apparent trigger. For a very long time now, I have been in a severe low. I have been struggling along through this low period with suicidal thoughts, self-harm compulsions, and self-hatred making my life hell. It has been like this for so long now, and I’m not even sure if I’ll be getting out of it. I don’t know how to get out of it. I’ve tried. I have tried every technique that I have ever been taught, but nothing is helping. I take my medication religiously, but it isn’t helping to break me out of this low. There is nothing that can help.
“It is an illness that ensures that those who have it will experience a frightening, chaotic and emotional ride. It is not a gentle or easy disease.”
Kay Redfield Jamison
When I get the highs, they are magnificent until they become dangerous. Over a couple of months in 2016, I spent thousands of pounds in several manic spending sprees. I obsess over facts and events that I find connections between – no matter how vague or imagined – and I can’t stop my obsession over the connections and coming up with conclusions as to why they are connected. I speak faster than normal and it is like the words in my head cannot come out fast enough, my lips just aren’t as fast as the words in my mind. Everything is brighter and faster. Everything. It goes so fast. I am creative, way more creative than normal. I write more. I make more. I plan more. I make rash decisions. I act on impulse. But, none of it seems unusual to me until I’m out of the high.
“If you hear a voice within you say ‘you cannot paint,’ then by all means paint and that voice will be silenced.”
Vincent Van Gogh
I struggle with anxiety. Sometimes, I cannot leave my bed. When the anxiety is at its worst, the simple act of throwing off the duvet and sliding out of bed is the most difficult thing in the world. Sometimes, I might be able to get out of bed but I might not be able to get to the living room, or the kitchen. Sometimes, moving around my house is okay, but the thought of going outside terrifies me. I’m stuck in that state quite often, especially lately. If I manage to leave the house, then it is often likely that I will be struggling with separation anxiety. This means that I cannot be without someone. I have to have that comfort of someone I trust being with me. They cannot leave my side. On the rare occasions when I can leave the house and not have someone with me, then it is quite normal for me to have a time limit to how long I can be out of the house before I start to panic. Not exactly ideal for a single, 29-year old, employed (part-time) and self-employed (the rest of the time) man.
“Everyone has inside of him a piece of good news. The good news is that you don’t know how great you can be! How much you can love! What you can accomplish! And what your potential is!”
Community Mental Health Team
I have been in the care of the Community Mental Health Team (CMHT) in Liskeard,
Cornwall, for a rather long time. I was referred by my GP when I realised that depression was striking again. This was in the late-Spring/early-Summer of 2016. A few days before my first assessment with an on-duty Community Psychiatric Nurse (CPN), a sixth form student at the school I was working at committed suicide in the same manner that I was considering to take my own life. I had to manage holding my own feelings inside as I helped many of the students come to terms with what had happened. I sat with colleagues in silence, as we didn’t know what to say, occasionally trying to put our feelings into words. I couldn’t tell anyone what I was really feeling inside. I couldn’t tell them that it should have been me. It shouldn’t have been that young man. He should have been able to live and receive the help he needed. I should have been the one jumping from the bridge, not him. I couldn’t tell anyone that.
After the first assessment, I was put on a waiting list for a Community Psychiatric Nurse (CPN) to act as my care co-ordnator, and I was referred to a psychiatrist. I was also referred to some talking therapy with a service called BeMe, but this was cancelled when the service run by BeMe was no longer in partnership with the CMHT. I wasn’t given any other form of therapy.
Eventually, I was contacted by a Community Psychiatric Nurse (CPN) called Neil. Neil supported me through many turbulent months. He would be my advocate to make sure that things happened. For example, when I needed a re-assessment with the psychiatrist, Neil would make sure that this would happen. When he could tell that I was becoming more intent on self-destruction, he made sure that I was visited frequently by the crisis home treatment team. Unfortunately, Neil left his job in December 2017. I was told that I would be reassigned another CPN “very soon”. In March 2018, I am still waiting.
I have had a few appointments with my psychiatrist. However, I cannot remember when the last one was – before the cancelled appointment in December 2017. Yes, she cancelled an appointment after my CPN had abandoned me, but the reason was that my uncle had just passed away and she didn’t think it was the right time for an appointment. Surely, when someone very close to me dies – and when I feel abandoned by the mental health team already – then an appointment with my psychiatrist is a good idea? Anyway, that appointment was going to be rearranged ASAP. In March 2018, I am still waiting.
As I mentioned earlier, I tried to commit suicide in August 2017. I took too many pills in an attempt to die. When I went to the Accident and Emergency Department at Derriford Hospital, the consultant who was dealing with me explained that it was important that I get medical help before rather than after I make an attempt on my life. The consultant explained that he would rather see me there, in the A&E department declaring that I was a risk to myself, rather than dealing with the aftermath of an attempt.
On 2nd January 2018, I took the advice of the consultant and went to the A&E department at Derriford Hospital declaring that I was a risk to myself. Coincidentally, I was seen by the same consultant who reinforced what he said previously by saying that it was good that I attended before trying anything. I was in the department until around 3am when the on-duty psychiatrist assessed me. He was shocked and saddened to hear that I felt abandoned by the mental health team and felt it was important that I be given another care co-ordinator ASAP.
A week later, I was given an appointment with the on-duty CPN at the CMHT. The appointment was an assessment to find out what I needed to support me so that I wouldn’t be in a similar situation again. It was decided that I was a “high priority” to be assigned a CPN, that I was “high priority” to be assigned to the Emotional Coping Skills therapy group, and that it was important that the psychiatrist reschedule our cancelled appointment ASAP.
Two months later, nothing has happened. I do not have a care co-ordinator. I have not had a rescheduled appointment with the psychiatrist. I have not been given the therapy that was advised.
In January, and when I called them in February, I was told that I was a high priority patient. When I called on Monday 12th March, I was told that I was on a very long waiting list. I feel like I have been abandoned by the mental health team.
It seems that there is only one of two ways to receive any form of mental health treatment in the UK: you have to either threaten to harm yourself or you actually have to attempt to take your own life. I do not use my words lightly when I say that I am seriously considering doing one or the other.
Of course, I do not blame the members of staff who work hard in the Community Mental Health Team. They are trying their best. It is not the fault of those who work in the mental health services that they are faced with staff shortages, insufficient funding, and insufficient resources. I blame the politicians.
The Tories will try to tell you that their funding of the NHS is at “record levels”, but what they fail to explain to you is that when you account for inflation, 62% of mental health trusts have less funding than they did 10 years ago (according to the Royal College of Psychiatrists). Theresa May will try to tell you that her government is responsible for 13,900 more nurses on the wards, but what she fails to explain is that numbers of community, mental health, and specialist learning disability nurses have all dropped dramatically. What the Tories continue to neglect to mention is the 271 deaths of highly vulnerable mental health patients between 2012 and 2017.
The Conservative Party have blood on their hands. If I don’t get the sufficient care that I need soon, it will be my blood.