In recent times, there’s been a lot of voiced frustration about the government’s lack of support for our NHS, from complaints regarding excessive waiting room times to shortages of doctors and nurses. However, from the outset, I’d like to say that I have a lot of love for our national health service and all of it’s hard working staff. Privatisation reads to me like a dystopian nightmare, that would further exacerbate the problems faced by the mental health service. But in spite of this, its undeniable that the NHS’s mental health service is failing a large number of young people. While in some cases this comes down to human error, the issues faced in the handling of the mentally ill – particularly those in the younger demographic – largely come from pushing this crucial service to one side by providing improper training for staff and a lack of funding, essentially treating psychological ailments as secondary to physical ones at every stage of available treatment.
It’s impossible to overlook the fact that as little as 30 years ago, the system was much, much worse than this, though. Before the introduction of care in the community, the mentally ill were shunned and incarcerated in imposing Victorian asylums, with no promise of release; essentially receiving a life sentence as a result of their suffering. The ‘treatments’ available to them – which were their only means of getting back into society – were brutal and unsanctioned, including electroshock therapy, prefrontal lobotomies and insulin therapy, all of which caused many untimely deaths and actually worsened the conditions of countless individuals, some who still suffer today as a result.
The idea to shut down these asylums, and turn towards care in the community and talking therapies, was fundamentally a good one. The only problem is that to make this change successful, it required far more funding than the mental health service had ever been allocated, and we are still waiting for this funding today in order to bring the service to it’s full potential. Theresa May has promised a rise of 20 billion pounds in funding by 2023, and though this sounds monumental – and it is certainly welcomed – it is not enough, when the numbers are really crunched, and may indeed prove to be a hollow promise as power passes over to Boris Johnson.
To explore the impact that the problems with the service have had, I decided to personally reach out through social media to young people with first hand experience of mental health care in the UK, to align the cold hard facts about why the service needs drastic improvement with the human side of the problem; the teenagers and young adults who in spite of being told to seek help, felt failed when they did.
Mental health wards and facilities for those in crisis and under surveillance have seen a drastic shortage in beds over recent years, as well as a shortage in specialist staff trained to help a vast spectrum of psychological disorders beyond the most notable few. Tragically, this problem can lead to completely avoidable deaths. Between 2012 and 2017, 271 patients in England and Wales died following failings in their NHS mental health care, and in spite of this there has been little to no renovation or accountability.
“The people who worked at my closest mental health institute diagnosed me wrongly with EUPD in spite of me actually being bipolar, after a very short appointment, and denied me a bed when I was in true crisis and truly needed the support they offered. I was shouted at and told off for the way I was feeling. The home treatment team also never listened and refused to believe I was in crisis when I was in a very dark place, and were rude and disrespectful to my mum and me. I actually came off worse at the end of their treatment.”
Being misdiagnosed and not taken seriously can be extremely common among young people, who are often written off and treated with blatant disrespect when they seek out help for valid problems. This, undoubtedly, comes from a lack of training, which routes right back to an absence of funding for it, and stretching limited staff too thin. From my own experience, my doctors now believe that I have suffered with chronic anxiety (GAD) from as early as 8 years old, although I went years believing I was simply suffering with a heart murmur. It was after my mum rushed me to hospital believing I was having a potential heart attack that a doctor realised there was nothing wrong with my heart, and that I was actually having a severe panic attack. I had in fact had an undiagnosed panic disorder for 5+ years at this stage despite frequently seeking help. I was unsurprised to hear others report this same story; of being misdiagnosed or discarded by the system intended to provide support.
“My partner was in an abusive relationship for years, and was essentially just told to man up. He was told that his panic attacks were heart palpitations due to his weight. He attempted suicide six months ago and only then was he taken more seriously. He’s been diagnosed with depression and anxiety so bad he’s been told not to work or drive.”
“The last counsellor I had asked me why I even bother to show up when all I do is smile.”
“I took an online CBT course for my anxiety which made no difference to my wellbeing, so I went to my first one to one therapy and she was horrid. She wouldn’t listen to me, and kept assuming the problem. I often fear about even going outside but she assumed again and again that my anxiety was all over academic pressure, and when I corrected her, she just said ‘oh, I guess you know more about anxiety therapy than me.’ Several times she actually laughed in my face, and would act smug and rude if she thought she’d been able to prove her point. I can’t change counsellor, though, without being put back on the waiting list.”
“I suffer from anxiety, gender dysphoria and suicidal ideation. I expressed a desire to my GP to be referred to Tavistock (a gender identity clinic) but was instead referred to CAHMS. In my first appointment, I repeated that I felt I needed a referral to Tavistock and confessed to having thought about killing myself. He wrote however in my notes that I had ‘no suicidal thoughts and was unsure about a referral to Tavistock’. Instead I was passed to a counsellor who was uneducated on gender issues, and wasted thirty hours of my life discussing how I chose to dress instead of my mental health. Upon turning 18, the CAHMS system spat me out. Three years later I am still suffering with anxiety that prevents me from leaving my house, and fighting to get referred to a gender clinic.”
“I started to suffer from anxiety and depressive episodes from the later years of primary school to the early years of high school. I was referred to a counsellor at a children’s hospital, who simply said ‘I can see that you have stress induced anxiety’ and sent me on my way, with no real idea of how to seek help, or how to understand what that meant. I was shoved back into school with no support, which was really limiting. I started to feel immense amounts of loneliness at a young age, and when I talked to the school counsellor she seemed to focus solely on herself. My high school never informed my college when I moved up, so they assumed I was fine, and I continued to receive no support.”
“Over the GCSE period I started to experience really bad anxiety. I cried almost every day and would be sent home from school because of that regularly. I finally got a place in counselling after being on the waiting list for months, so I went to the appointment and filled in a 1-5 rating questionnaire on my day to day feelings and was asked to describe my life so they could gain a picture of it. I described I had no boyfriend but was happy, had loyal friends and practically two seemingly perfect families (as my parents are split) but as I finished the doctor told me my life seemed pretty good and he didn’t understand why all through my life I’ve had underlying anxiety. Since being a child I feel like I’ve worried more than others around me, so maybe some would suggest I have a mental health issue, but this doctor decided to brush me off without support or a diagnosis, and proceed to remove me from the camhs/mental health service.”
A further problem frequently reported but largely unaddressed is the waiting lists that stand as a barrier to recieving help. With the dawn of new information about mental health comes a subsequent rise in diagnoses, of people who previously would have gone unnoticed and unsupported now being found to be mentally ill. However, with government funding not rising to meet this new demand, much like the over-filled crisis wards; the counselling system is drastically over-burdened. Many young people considered high risk may be kept in triage for months just awaiting evaluation, in a fashion eerily reminiscent of the Victorian asylums where patients would be kept contained and blindly medicated indefinitely. On the other hand, those considered low priority are put on waiting lists of up to 9 months just to get a chance to talk to a counsellor who – as you will have read – may be completely unspecialised in their area of concern, or have no idea how to approach young people specifically.
“After one appointment with CAHMS opening up about gender dysphoria, I was sent a letter saying they suspected I had social anxiety, so I had to book another; a process which took months. The process was so slow and unsupportive that it’s concerning to me for those people who rely on CAHMS for their sole support.”
“The waiting lists are ridiculous. I had to complete a 6 week online course which didn’t help me one bit before I was even considered for one-to-one therapy. The therapy in person only helped temporarily. I’d leave feeling lighter for a short while but the depressive episodes would come right back and I’d have no idea how to help myself.”
“My brother visited CAHMS 5 years ago after becoming violent at school. He has never been discharged, although he has never seen the same psychiastrist twice. 2 years ago he was sectioned under the mental health act and kept in a maximum security ward for ‘assessments’ as to what type of ward he needed. He ended up there for 6 months before he was placed in a minimum security ward. There, he received little real help. He was just dosed on antipsychotics, which continued into respite care. Now, he is still with CAHMS, lacking a diagnosis and not getting any better.”
“I had four counsellors in one year as everyone kept leaving, due to the conditions at the facility being so poor.”
“I had to go to group therapy due to waiting times, but it was just a group of adults talking about paying bills and quitting work, when I was just a teenager with completely different problems; it was completely useless to me.”
Fundamentally, it seems that at each step of the service available to young people, not only are they treated as unimportant and as though they are not the primary expert on their own mental state, but they will be handed off to somebody else at the earliest opportunity. There is no holistic service. They’ll spend time thinking that it’s all in their head, doubting themselves as others tell them to just calm down, smile, drink more water, exercise. Should they reach out to a GP, they’ll often be given this usual recital of half baked advice and a survey to determine whether they’re likely to kill themselves. If no, they’ll be given a course of resoundingly unhelpful online therapy clearly designed to help someone in a neurotypical frame of mind only, before having to wait 6 months to see a vaguely specialised counsellor who may or may not respect them at all. During this time they can either attend an unhelpful and daunting group therapy of a mixed demographic, or are left to manage their own brain, trying to rationalise their symptoms and get on with the pressures of an ever intensifying education system. If, however, they are suicidal or suffering from a severe eating disorder, perhaps they’ll be given a bed in a ward for monitoring, or perhaps they won’t. That depends on what month of the year it is. If the hospital is overburdened, they can prepare for questions like “are you really in crisis? Have you tried counselling?”
Frankly, not everybody has 6 months to wait. The 271 individuals who passed away between 2012 and 2017 because of the failures of this system certainly didn’t.
All of the quotes I have included are from real young people who have asked to remain anonymous, who bravely came forward with their accounts of life in the mental health system, at my request. Unfortunately, many people aren’t here anymore to tell their stories, and that number cannot be allowed to get any higher. These people are the real, human reasons for increasing NHS funding. We need more beds in crisis, more specially trained counsellors, more group therapies aimed specifically at young people, more money invested into online programs, more education in schools, and overall we need more compassion. We are here, we exist, and our mental health concerns are valid. We are told to ask for help, and here we are, asking for a help that doesn’t yet exist.