How to access mental health services

When there aren't any?

by Rick Johansen

I’ve been trying to arrange my ‘Annual Health Check-Up’ with my local health centre, the place we used to refer to as ‘the doctor’s’ when I were a lad, and not without difficulty. These days, in the name of progress I assume, everything is online’ and with most things I welcome that. I do my weekly shopping online, if I need something I’ll buy that online, I message people online; in fact, I do loads of things online, so I am not totally computer illiterate, but after a mere six visits to the centre in order to set up fanctioning online facility itself I have finally managed to book an appointment. Naturally, I am pleased with that because I am increasingly old and cronky and need all the expert medical advice I can get as I hopefully become older and cronkier, but there is, as ever, a yawning gap in my health check: mental health.

In a few weeks, they will take my bloods, blood pressure, check my asthma levels and everything else they do every year. I will get advice on my consumption of alcohol, my diet in general and how much exercise I take. But, unless I raise the matter myself, there has never been, not ever, not once,  a question like, “How’s your severe clinical depression? How are you anxiety levels? How is life for you now that you finally have an ADHD diagnosis?” I always bring the subject up, but when I did so a couple of years ago, the GP called me a day or so later – imagine actually getting a phone call from a GP? – and he said he was reducing my antidepressants by 50% because “the amount you are on is bad for your physical health” or words to that effect. I protested, of course, because this depression malarkey is always here. It never goes away. It’s just bad or not quite so bad.

I explained that I was happy with the way that the surgery was dealing with my physical health, but there was nothing for my mental health. The reply, which did not include these actual words, indicated there was nothing else he could do, apart from sending me some links to various websites which were, frankly, useless. At least one of them was Samaritans, if things get dramatically worse, but the upshot is that in between clinical depression and being sectioned, there lies nothing. “Mind how you go,” he didn’t add. Luckily, suicide has rarely been an option for me. Maybe the doctor had worked that one out?

Why we separate mental and physical health, I do not know. It’s just health, isn’t it? If I am particularly low, then I don’t want to go out and take exercise and no number of doctors’ orders will change that. I know exercise is good for me, as it is for all mental folk, but just saying, “GO FOR A WALK!” isn’t going to make it happen. Real life ain’t that way. We need to walk before we can run. Some of us need help before we can walk. There’s none there, at least from the Tory ravaged NHS.

Note I brought politics back into it? Well, under the last Labour government from 1997 to 2010, I was able to see not just a common or garden psychiatrist, I saw an actual Mister, a consultant psychiatrist, and for a few years of seeing him and undergoing actual tailored therapy, I began to recover. Politicians, political parties; they are not all the same. I am, or rather was, living proof.

I know I am lucky my depression is not totally debilitating and in one curious way, I do not know what I’d do without him. But I wish I had the chance to manage without him. My latest health check will, I hope, treat my physical issues. The mental ones? No chance.

My advice to anyone with mental health problems is to be rich and perhaps famous, too. The stigma is not so bad with the great and the good these days and we rightly praise those who take action to address, and openly talk about, their mental health. And we should welcome it when they urge the rest of us to take action, too. The problem, though, is that there is precious little action we can take. The nearest most of us get to Talking Heads is by describing our health system the same as it ever was. Which is to say, virtually non existent.

Mind how you go. I really mean that. No one else will.

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