It's really not what you think.

It's been a while since my last blog post. I've been busy working from home and have found it pretty difficult to motivate myself to write anything that I'm not being paid for. It obviously takes up free time and effort, so the absence of any kind of tangible reward makes motivation hard to find at times.

This time, I'd like to talk about Mental Health services. Since moving to Manchester I've been on a waiting list for high intensity psychological therapy. After around 15 months I've finally spoken to a qualified psychologist who explained that I will need to wait another six months before I can begin the complex work that I need to do. In the interim, I've been referred to a mindfulness service. Something I feel quite positive about as my own experiences of using mindfulness to assess my moods has been quite effective. The psychologist I spoke to was brilliantly empathetic, extremely well qualified and listened carefully to my previous experiences of therapy and how I felt about them.

For those unfamiliar with talking therapy, there are a lot of different types. I've been through Cognitive Behavioural Therapy, Transactional Analysis, Person Centred and probably other types. Depending on a person's needs, each type of therapy can be extremely effective but can also create further problems if the main issues a patient needs to discuss are not addressed.

My experience of being assessed and referred to services might be helpful or at least interesting to anybody experiencing a similar situation.

Assessments often take place over the phone. You will be asked about how you feel each day in specific terms and usually to rate your experiences on a numbered scale. So for example, do you feel as if you would be better off dead or hurting yourself in some way. 1 being not at all, 9 being all the time.

This can be a very effective way of obtaining an overall picture of how a person may be feeling, however, the prescriptive nature of the process and the increase in the use of lower level practitioners can often lead to a dehumanised, impersonal and systematic approach to problems which are by their very nature, human and difficult to quantify.

Having suffered with severe depression and anxiety for over 7 years and having been through a range of different treatment options and still not, "fixed" I became very frustrated with the way things seemed to work. The services to help people with mental health issues do exist but unless your problem can be fixed by a short, six week block of sessions or an online tool, the chances are you will find them woefully inadequate to meet your needs.

The practitioners I've spoken to have been incredibly kind and well meaning. I've been told not to beat myself up so much, to be kinder to myself and to "lighten up." One of them even suggested I took a day trip to the seaside town of Whitby... (She was probably my least favourite.) The issue here is that after paying for some in depth psychological therapy, (transactional analysis) I have been able to ascertain some of the things that make me the way that I am. It was painful, difficult and exhausting, but it's also the reason I'm not dead and able to function in a job now, rather than lying in bed feeling numb or worse. The thing with that kind of therapy, is that it requires a practitioner who is very experienced or qualified to go in to a lot of depth with an individual. Most of the lesser qualified practitioners I have spoken to were very nice but some seemed to struggle with non standard English to such a degree, the process itself became almost as frustrating as the condition it was designed to treat.

One practitioner asked me; "So, how did you feel when you decided not to kill yourself." I replied with "indifferent." She said "different to what?" "No." I said. "Indifferent." "I don't know what you mean." She said. Now this isn't really anyone's fault, but that kind of situation shouldn't arise. Having the courage, patience and resilience to seek help and then go through the numerous assessment processes is a difficult enough experience for the individual involved without problems with communication from the practitioner who has been assigned to help  them.

So for now, I'm trying to keep up with mindfulness exercises and am looking forward to (that should probably read, nervously anticipating)  the day that my actual psychological therapy starts again. I know I shouldn't beat myself up and I know I shouldn't be so hard on myself, but if it was as simple as hearing somebody say that a few times, I'd have been "fixed" by my loving friends and family years ago. There is no easy solution to mental health issues, the fact is, it's a complicated and challenging area that requires an army of highly qualified medical professionals rather than lots of well meaning but less educated practitioners to tick some boxes and make it look as if something is being done.

 Kind words almost always help and probably more than you think, too. They aren't a substitute for actual medical treatment, though. That takes time, for the practitioner to understand the patient, money, to pay the wages of somebody who has a higher level (Masters or above) qualification in a relevant area and lastly, awareness. That's an ethereal word that doesn't mean very much to a lot of people. "Raising awareness" usually means wearing a ribbon or a bit of rubber around your wrist or maybe even not drinking for a while in return for sponsor money. Nobody seems especially "aware" of the cause they are campaigning for because the cause is usually a complex, difficult and nuanced entity that can't be reduced to a few simple words or phrases.  By "awareness" I mean a genuine, tacit understanding that mental health problems are as debilitating and as life threatening as physical ones and should therefore be given the same amount of money and time by our health service. If it seems unrealistic to assign a psychologist to everybody in the UK who has severe depression, I think you might begin to see the scale of the problem. I'm tired of feeling as if I should be grateful for inadequate treatment and I have a feeling I'm probably not the only one.

I'll probably write another one of these soon. As always, if you are going though any kind of mental health issue. I hope this has been helpful in some way. X