Fiona Kennedy discusses the importance of not denying people appropriate treatment on the basis of cost
Over the last few months I’ve written quite a bit for this series on the subject of mental health and managing difficulties as they arise.
One thing keeps coming back to me again and again though – just how difficult it is for the vast majority to access the kind of help I’ve been receiving, and how incredibly frustrating that must be for those reading who need help, as well as for mental health professionals who want to help but are stymied by an out-dated, under-resourced and woefully inadequate system.
Actually, frustrating isn’t anywhere near a strong enough word. For those who need help, it’s soul-destroying and at its worst, life-threatening.
Trying to maintain mental well-being is something that we all need to work on, every single day. It takes time, effort, motivation and commitment. Yet how many of us are actually aware of this, of the fact that it’s as important as maintaining our physical well-being? How many of us know just how much our lives are controlled by our emotions, or how much our emotions are controlled by chemical responses in our brains to external events? How many of us know how to cope with and actively manage difficult emotions as they arise?
Despite years as a psychiatric patient, all of this knowledge is very, very new to me, so new in fact that I’m still marvelling at how much of our behaviour comes back to evolution and biology. Our brains and bodies are interacting all the time, reading and responding to cues that we’re not consciously aware of, although we may be painfully aware of the emotions that they cause. It seems so simple, and as it has been explained to me over the last few months, it makes so much sense. Why don’t we all know this? Why aren’t we all being told about it?
Instead, we often struggle on alone, believing that we deserve the difficulties we’re living with, or that we have brought them on ourselves. So many of us carry crippling guilt and shame and anxiety, and not only carry it, but hide it. We don’t know that these are normal responses to the simple experience of being human, and in possession of a brain most of us know virtually nothing about.
I can only write from my own experience, and I must emphasise that I’m not a mental health professional, so my grasp of how this works is rudimentary at best. What I do know is this – years of psychiatric medication helped to a degree. Years of psychotherapy helped me to manage (the many) crises as they arose. But it’s the last six months, and the knowledge I’ve gained about how we physically work and what I can do for myself to manage difficulties, that has had the greatest impact.
Here’s the thing though. In terms of what I can do to help myself, none of it is groundbreaking or new. It’s the same stuff I’ve been hearing for years, but resolutely ignoring – eat well, sleep well, exercise, practice mindfulness etc.
But the why was never made clear. I need to understand something before I can put it into practice. Yes, in theory self-compassion has always sounded lovely, but I didn’t know what it entailed. I quite literally didn’t know how to look after myself on anything other than the most basic level.
That is what’s missing from our public mental health service. Education. There’s fantastic work being done at the moment with school age children in terms of making mental health an everyday topic, but there’s a significant chunk of our population who don’t have access to that. People who find themselves in A&E after a suicide attempt don’t need to be sent home with a prescription and nothing else.
They need support, of the long-term variety. People who struggle with repeated episodes of depression, chronic anxiety, stress, people who like me are told they have a personality disorder – they need support. People who simply find themselves overwhelmed, for whatever reason, need support. I don’t know how to make it better, but I know that the system in its current form is failing us, badly. I’m able to access therapy privately because of the kindness of strangers, people who contributed to my crowdfunding effort. I should never have had to resort to that, but as the HSE proved unable to help, I’m beyond grateful that is was an option open to me.
The vast majority don’t have such an option. In six months, the change that knowledge has made to my life, and that of my family, is astounding. It hasn’t been cheap, but when weighed against the cost of the medication I’ve been taking for over four years (and that I expected to have to take for the rest of my life), as well as the cost to the public health system of treating me, I imagine it must be a drop in the ocean.
No one should be denied appropriate treatment because of cost. No one should have to struggle for years on end when support could be made available. Yes, ultimately maintaining our mental and emotional well-being is our own responsibility, but before we can take that on, we need to be taught how, and we need to be supported in putting it into action. Is that so much to ask?