“Why I’m no longer talking about mental health”

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Emily Reynolds
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Writer Emily Reynolds has spent years talking about mental health but now, she’s had enough. Because what’s the point of talking if the health service fails to support those in need?

It may sound slightly ridiculous, but mental health is pretty on trend right now. It’s not quite millennial pink, but columnists, celebrities and even politicians have all been making huge efforts to talk about the state of the nation’s minds.

And ‘talking’ is the key word here. From the government’s plans to “reduce stigma” to the coverage of Prince Harry’s bereavement, media focus is firmly on encouraging people to talk about mental health, particularly about common conditions like anxiety and depression.

You’d have thought this was good news for me. Growing up on LiveJournal and MySpace meant that writing about my mental health problems online came naturally to me, and I still regularly tweet about living with bipolar. I have a supportive network of friends and family who I can confide in about how I’m feeling, and who generally respond well when I pull them up on ignorant or misconceived ideas about mental health. I also wrote an entire book about it – a book that contained quite a few embarrassing (and sometimes disgusting) anecdotes about what it is to live with a mental illness. It’s safe to say that ‘talking about mental illness’ is not something I have a problem with.

So why, recently, when I attempted to get medication from a GP, was I denied any help at all? And why, when I tweeted about this experience, did I receive hundreds of replies from people who had experienced exactly the same thing?

It turns out that the process of ‘getting help’ is much harder than “just asking for it”. We’re told to visit our GPs to ask for medication or therapies, or to try to get a referral to specialist services: we’re also told that asking for help is the first step in ‘getting better’. But that’s simply not the case.

Visiting a GP can be a truly hit-or-miss experience, with no guarantee that you’ll leave the appointment any better off at all. Since the first onset of my mental health problems, I’ve been offered a series of ridiculous suggestions – quitting smoking, losing weight, quitting my job – when all I needed was medication.

This time, I was denied assistance because my depression “didn’t seem that severe”. I was up and about, going to work, and talking confidently about my mental health problems. So it couldn’t be that bad. It wasn’t “high priority”.

Others told me similar stories about doctors perceiving them to be “handling things well” and not giving them the help they need, or asking them to jump through impossible hoops. 

There are obviously thousands of doctors who are more than willing to help you – but others will offer no tangible help or even be downright dismissive. A few years ago, one GP even responded to a detailed description of my plans for suicide with the suggestion that I “come back in two or three weeks”. I might start feeling better, she offered, not even considering the idea that I might be dead by then. The ineptitude of such doctors seems faintly comical in hindsight. At the time, as you can imagine, it’s a distinctly unfunny experience.

Most recommendations that you visit your doctor end there, too, offering zero backup plan or advice for what to do if you don’t receive help. What this means in practice is that many people spend weeks – or even months – building up the courage to ask for help, fully expecting that once they’re over that barrier they’ll get it. When they don’t, it can be a devastating blow to confidence, self-esteem and mental health, making it almost impossible to summon the energy to ask for help again.

Funding cuts have made this problem worse: it’s harder to get referrals to specialist services, waiting lists are longer, and many experiencing crisis have to wait for hours in A&E just to be told that there are no available beds. Thousands of people are forced to live in limbo – ill, yes, but not “ill enough” to be admitted to hospital or to access immediate help. Many suffer for years; yet more die.

That’s not to say there’s no benefit in talking about mental health at all; there obviously is. Encouraging people to be open with friends, family and medical professionals can make a huge difference in the day-to-day management of mental illness, and steps to help marginalised groups access care are obviously incredibly valuable too.

Talking about less publicised and still heavily stigmatised conditions is also important for us to start breaking down the kinds of misconceptions that can have a tangibly negative impact on the lives of those diagnosed with them. Talking more about what it is to live with a personality disorder, for example, or what it’s really like to experience psychosis, can be a valuable way to negate negative media stereotypes about people with severe or chronic illnesses being ‘violent’, ‘dangerous’ or ‘mad’.

But acting as if ‘talking about mental health’ is the whole story is willfully misleading at best and actively dangerous at worst. I’m white, middle-class and work in mental health, putting me in the best possible position to navigate the complicated bureaucracy of accessing healthcare. Many people – who are asking for help, just like you want them to – don’t have these privileges, and are likely to have an even worse time. This just isn’t acceptable.

Talking about mental health, being open about it, does not stop someone from being depressed, anxious, manic or suicidal. Structured medical care does. Therapy does; medication does; being supported in a long-term treatment plan does. Picking up a newspaper and seeing yet another middle class columnist talk about the benefits of telling people about your depression? Not so much.

So please: stop telling mentally ill people that it’s time to talk. We are talking. Listen to us.

Images: iStock, Rex Features. Follow Emily on Twitter: @rey_z