The following words are written, not by me, but from Jonathan Gabay a friend and business associate, who has granted me permission to share his first-hand experience of what it’s like to be suffering a mental health crisis. Jonathan has chosen to waive his anonymity and speak up for those whose voices are unheard. On behalf of those who society chooses not to hear – as you will read, the reality of our broken mental health system is frankly jaw-dropping!
“Harry, the Duke of Sussex, has recently achieved more to raise awareness for mental health issues than anyone else in the public arena. That should be commended rather than vilified.“
Yet, whilst celebrities and Corporately Responsible brands urge people to be brave and seek help for mental health issues, without a person having the means to pay for treatment, many are finding that just like in space, when it comes to anguish, no one can hear them scream – or by the time cries are heard – it could be too late.
Why is it so hard to access help regarding mental health?
Contrary to the ‘feel-good’ propaganda of the UK government, in truth, its mental health services are grossly under-resourced with staff barely coping with the backlog of people on the verge of a total breakdown.
When people do what the slogans suggest and reach for help, they enter a disconnected riddle of mazes that relies heavily on under-funded independent charities to hobble along. The result is often a horrendous journey into a black hole of no return.
As the official care system is shattered into so many discordant pieces, no matter what sufferers or families and friends do, help is either not forthcoming or comes too late.
Lives and families are destroyed.
Assuming someone can get through (rare) to the NHS mental health Crisis Line. The NHS will advise them that resources are sparse after COVID-19, so instead they should drink some water and breathe deeply. Other than that, they could dial 999.
So, they try the local GP. Anxious, desperate and shaking, they are presented with a series of tick-box questions to scale out of 1-10 how suicidal they feel. Scores higher than seven are rewarded with a line of Diazepam or SSRIs such as sertraline, escitalopram, or paroxetine.
They are pointed to a data collection website where they can order a card featuring the telephone numbers of the regional mental health Crisis Line or an organization like The Samaritans, MIND, or CALM, whose good-hearted volunteers struggle to keep up with the calls.
The medication’s side effects intensify the anguish. Suicidal thoughts increase. Meanwhile, friends and family can only watch, worry, and wait.
If they get through the first three weeks, the dose is increased. Next comes tremors, sweats, confusion… (See the back of the pack for the complete program of potential highlights).
Assuming the family (if they have one) can afford the highest level of health insurance covering all things that 2021 life can throw at you, the family approaches a private psychiatrist or psychotherapist.
The psychiatrist kindly prescribes a ‘suck it and see’ platter of different pills, each with its own cruelly debilitating proviso.
The sufferer may be left chemically numbed or chronically confused. Their only remaining road to redemption being the NHS Crisis Line numbers on the now crumpled card on the bedside table.
Maybe they could try cognitive behavior therapy or other forms of psychotherapy? They will have to be able to afford 45-minute Zoom sessions (no face-to-face meetings because of post lockdown) at between £60 – £120 a pop.
They must be willing to invest in at least six months of investigations into uncovering the actual trigger behind the gun that fired the first shot in the dark.
What to do when funds are not available?
If funds are not available, the options are:
1) Call the Crisis Line – yet again – and have a supply of bottled water.
2) Call an independent charity line and speak to a kind and sympathetic ear who can only do that – listen.
3) Contact the local mental health care facility.
4) Call 999.
Option 1: Call the Crisis Line – yet again – and have a supply of bottled water.
The exasperated family discovers that due to the lack of resources post-COVID-19, services are even more overstretched. Lines are blocked, so they reach option #4 (dial 999 – more on that coming up).
Option 2: Call an independent charity line and speak to a kind and sympathetic ear who can only do that – listen.
Despite kind volunteers, when someone is on the very last edge of giving up, they may not be open to a chat. Or, giving it a go, they may become so agitated by the endless stream of open questions that their anguish spins faster around their head. Don’t get me wrong, mental health charities are superb and certainly help increase awareness. But without further government support, there is only so much they can achieve.
Option 3: Contact the local mental health care facility.
The situation is now critical. Families are frantic. Again, with the excuse of catching up after COVID-19, it’s almost impossible to talk to anyone. Finally, after 20 minutes of ‘hold music,’ a voice comes on. Then the line is abruptly cut.
If they do get connected, a voice suggests trying The Crisis Line – option #1. And so it all starts again. (The system advises people that doing the same thing over and over again and expecting a different result is not madness).
If the family is persistent, they can demand to see a professional mental health consultant. To do that, they must first approach the local GP.
Again, with the excuse of COVID-19, the local surgery no longer accepts face-to-face appointments. So, assuming the sufferer can navigate an online form and that the technology doesn’t crash, they get online to the GP.
The GP promises to arrange an appointment with the local mental health facility. It will have to be a phone call (COVID-19). It takes months for the phone to ring. In the meantime, with nowhere else to turn, following the guidance of the person on the other end of the NHS Crisis Line, lots of breaths and even more liters of water are swallowed.
The date eventually arrives for the telephone consultation with the facility’s psychiatrist. More mind-altering concoctions are offered. Sufferers could be promised up to four sessions of talking therapy. (No more because of post COVID pressures).
The date for the first session could take as long as… (well, nobody knows).
If the psychiatrist concludes too much time and resources on the Crisis Line or other services have been wasted and the sufferer has reached a nine on the “will they do it or not” scale, a section order will be sanctioned.
The family tearfully wave goodbye to their loved one, who stares blankly out of a window of a nondescript white van.
Once behind three sets of locked doors at the facility, the sufferer sits in a room next to other terrified people. Many are homeless. Some no longer have space on their bodies to jab out pain. All are bewildered. They pray that the ‘big angry guy’ sucking on his icicle stick who shoves staff against the wall – setting off alarms – won’t carry out his whispered threat.
So, everyone keeps their eyes fixed on the cracks in the floor and remains quiet. The monotony is occasionally broken by filling in a colouring book with broken stubs of worn-out crayons handed out by kindly retired volunteer care worker.
They ask to visit the walled outside garden but are told resources are tight, “so maybe tomorrow.”
As with talks with a consultant, tomorrow never comes.
Eventually, should they remain quiet and take the medication without fuss, for long enough, they are released. (There are never enough beds, so unless a person is deemed unsafe or literally has nowhere else to go, the facility will want them out).
Once outside, the sufferer is promised a follow-up in the community and sent away with a card featuring the NHS Crisis Line number. (The follow-up call never comes – again, too few resources due to COVID-19).
Option 4: Call 999.
The ambulance arrives. Depending on whether the skin has been sliced, bags wrapped around the face, or blister-sheets of pills burst, the paramedics switch on the blue lights or, if the call came at the start, rather than the end of a shift, the paramedics would take 30 minutes to chat with the sufferer gently. The hope is that they will save the sufferer the agony of waiting in A&E for ten hours (because of post- COVID).
Eventually a wearied member of the psyche team asks where on a scale of one to ten, the sufferer is in terms of killing themselves, and what are their plans to get the job done.
If the suicide scale is under 9, a diazepam and offer of a follow-up call is given.
The next day the sufferer will receive one call over a badly connected line. They can barely hear the advice that if things get too much, they should drink water and take a deep breath – or call 999.
If on arriving at hospital an attempt has been made, depending on the damage, the sufferer will spend up to a week in the hospital.
Providing they have been quiet, the psyche team will advise that there are not enough beds because of pressure on the system. So they are released from the ward.
If they are deemed too mentally unwell, they will be directed back to option #3 – the facility – to restart the process from scratch.
If there are no family and friends, they will be endless shuffled from one facility to the next, wearing clothes donated by Oxfam.
Our Mental Health’s System Cold Hard Truth
So, there you have it—the cold hard truth.
Whenever people reach out, the system promises to catch them.
More likely, they will be forgotten.
Meanwhile, the Duke and Duchess of Sussex, footballers, celebrities… will all repeat the message to be brave and reach out for help or maybe call a bot- automated Crisis Line printed on the label of a product from Proctor and Gambol which is doing its bit to whitewash the brand portfolio.
The post-COVID-19 world turns.
In today’s networked world of aphoristic soundbites, empty slogans and symbols, rather than actions, count.
Our cybernetic ideology of a kind, globally connected community has become the new religious creed.
Empty messages to be brave created on Canva go viral in a virtual world of good intentions and thumbs up likes.
In the real world, woke mantras are either totally impractical: “defund the police” or naively well-intentioned but false promises: “reach for help”.
Just out of sight of Zoom and beyond posting confident Instagram selfies, people fumble with worn-out NHS Crisis cards carrying a help line number.
They swallow their breaths and take another sip of water.
The rest complete yet another satisfaction survey on a scale of 1-10 or online resume that wants to know everything from their binary sexual ID and erogenous preferences to faith, so data can be fed and the future efficiently automated and organised.
They revere just how far society has progressed. They rejoice how everything from the economy to moods will be levelled up by the caring system of the kinder new normal.
They keep going; maintaining their public social media presence whilst cautiously ignoring the backdrop of screams that rebound endlessly somewhere out in the deep virtual space of our magnificently connected universe.
This article has been reprinted with permission from Steve Phillip’s LinkedIn article.