Help at the point of need

Have you ever woken up and thought: “I really don’t want to get up today”? And, then you hide under the covers and you try to go to sleep again. But you keep waking up anyway. Yet, still – you just cannot face the thought of going to work, or college, or signing on for benefits, or any of the other things we are expected to do as adults, and if we don’t do them, we know there are consequences which will probably make us feel worse. So, eventually, as slowly as possible without actually becoming a slow-motion clip in a movie, you drag yourself out of bed and groan so loudly you petrify the cat/ dog/ goldfish (do fish hear things?), and you get ready for another day. Another day of doing stuff you really don’t want to do but you know you have to.

Sometimes, we feel like that, and then get up and get washed and dressed and eat something, and after apologising to the cat or partner or whoever else we scared by groaning too loudly, we go out and things aren’t quite so bad as we thought. It’s freezing cold, but the autumn leaves are an incredible blend of gold and yellows, and the air is fresh, and we start to remember that life itself is good.

Mental health is rarely like being in one state now and forever: good or bad. Our moods and mental health can change a lot in our lives: I wrote about that not long ago in another post here. And last week, I posted a short story about what happens when a person’s mood gets stuck, because of some loss or trauma, and they become ill, depressed, and suicidal. It’s not an easy thing to think about, talk about, or write about. But sometimes we have to face it – because it creeps up on us as individuals, families, and as workers who help people in crisis.

The other week a report about mental health services in Tayside came out. It’s got a snappy title: ‘Living Life Well’. It is a first draft of an NHS strategy document. The big challenges facing the mental health of our population are noted. ‘There is increasing evidence that emotional disorders, particularly anxiety and depression are on the rise..’ And, it also says: ‘People who experience financial strain are at greater risk of common health problems than those without financial worries.’ In these difficult times, I suspect the former group is the larger one, and growing.   

These points ring a whole belfry of bells within me. As a Welfare Rights Officer, I worked with hundreds of people who were struggling to get by on benefits, pensions, or low wages. I’d try to help them as best as I and the rest of the team could. Getting benefits won back after they had been unfairly cut; stopping evictions; dealing with debts. I remember one very thin and very shaky man, who was so weak from hunger, that I had to go and get him some food before I could speak with him about his issues. He was literally on the verge of collapsing. And I remember another man who spoke to me months after I’d helped him, and he told me: “Harvey, I don’t think I’d still be alive if you hadn’t helped me.” And I wasn’t the only one helping people that way – in foodbanks, in various services, including hospitals, frontline workers come across people every day who are struggling so much to survive that it’s harming their mental health. And, of course, it gets to the workers too. We are only human.

When people become mentally ill, it’s not pre-determined that’s how they will always be. A lot depends on the quality of health care and support a person can access. Waiting lists are very important: any failure of the NHS to see people quickly enough can have devastating consequences for a vulnerable person. There are a few pages in the report devoted to one of those consequences: suicides in Tayside. As is the case with other issues in mental health, the report suggests ways to provide a better service for those most at risk. Things like – better training for staff, and quicker lines of communication between services. These are fine, but there’s a slightly circular argument to go along with the strategy: ‘Suicide prevention is a national priority that requires to be supported and promoted at a local level with a strong emphasis on prevention and early intervention.’ So, in suicide prevention there needs to be a strong emphasis on suicide prevention. Okay.

The report came about due to a lot of public anger about the effects of NHS cuts and failures to respond to people with mental health problems who had asked for help, sometimes for years, but got nowhere. This included people who felt they had no alternative but to end their lives. The report states that it’s strategy ‘has been developed primarily to respond to the needs expressed by families, carers and the people with lived experience to re-instate confidence in the mental health services in Tayside’.

One man who was let down by the system was Lee Welsh, who took his own life on 8^th August 2017. He was 27 years old, a dad, a talented musician, and a loved person. For years, he had struggled with mental health problems, but never received the diagnosis and mental health treatment he needed. His devastated family led a brave campaign to try to ensure that no others had to suffer as they had. The family fought, and are fighting, for the creation of a place where individuals in crisis could go, at any time, to get the care they need.

I remember going to one of the consultation events leading up to the report. I listened to Lee’s mum Lesley argue powerfully for a 24-hour centre for people with mental health issues. Others who had ‘lived experience’ nodded enthusiastically and spoke in support of the idea. None of the health professionals there disagreed. Then, the report came out a few days ago, and Lesley commented about it on social media: “So still not any care then, when they need it, sounds like we are back to square 1. When people are at the brink they need to go somewhere safe that have 24/7 care, stop this roundabout I want to get off, feels like we’re going around in circles, what is it they don’t understand???”

I wondered the same thing. I read the recent news story, where Phil Welsh, Lee’s dad, publicly stated – as he has done many times – his disappointment at the lack of action. He said of the report: “There seems very little here in regard to people at the pinnacle of crisis.” I wondered: how can a report, which claims to be based on consultations with 300 people, get it so wrong? The report says that NHS Tayside wants to “improve how we work as a health and social care system to ensure people in crisis and distress get to the right place first time.” And I thought – how do you get to a 24/7 centre if there isn’t one?

I’ve read the report: it is 96 pages long. Now, some of it is a bit dull, so I may have nodded off here and there when reading it, but I’m fairly sure that it doesn’t mention a 24/7 centre; and it certainly doesn’t argue for one. And the question must be asked: why not? I’m going to be very generous to the report’s authors, and I’ll guess – in all the consultation events where the idea of a 24/7 centre was so powerfully raised, and despite dozens of news reports where the idea was also raised, and despite sympathy for the idea from local politicians, health professionals, people with mental health problems, families and carers, despite all of that, the report’s authors just forgot about the idea. Okay, maybe that’s not likely, but let’s pretend that’s what happened – to explain the black hole at the centre of this report. How do we get the idea of a 24/7 centre placed firmly into the report – bearing in mind, the report is only a first draft. And, bearing in mind – that the final report can be different – because the NHS website where it is placed asks for comments and suggestions. All you need to do is click and answer 10 short questions; and there’s very helpfully a box or two where you can write your own comment. You could, if you wanted to, write something like: ‘The need for a 24 hour crisis centre should be an NHS priority so that people in crisis have, for the first time, support available at the pinnacle of crisis.’

So, what are you waiting for? Please make a comment on the NHS site. Encourage others to do the same. Let’s remind the NHS, our NHS, as Phil and Lesley have done so many times, and others have done too, our views matter and we cannot and will not be ignored or forgotten.

This post is dedicated to all the inspirational campaigners for social justice who should be supported by us all.       

The NHS Report: Living Life Well and Consultation can be found HERE

The Not in Vain For Lee website can be found HERE

 

Harvey Duke