I’m delighted to share this article written by Julia Cresswell.
Julia is now largely retired, but spent her working life splitting her time between writing books, mainly reference books or books about the history of English, working on big projects as a lexicographer and teaching at University level. For the last twenty years this has had to be fitted round being a carer, initially for a parent with dementia; latterly of a son with severe depression and anxiety disorders. Julia could not have done this without the help of her wonderfully supportive and patient husband Philip.
I read a local paper and a national one weekdays, so usually give myself a rest on Sundays. However, the other Sunday my husband had a cold, so I thought he might like some distraction, and I bought a copy of the Observer. There I found a full-page article by Rachel Kelly headlined ‘Talking about mental illness helps – but we need money more than words’. No one caught up in the nightmare of trying to get quality care from mental health services could disagree. But what really caught my attention was reference to Professor Sir Simon Wessely, President of the Royal College of Psychiatrists warning that a lack of specialists means mental health patients are not being treated by people trained to deal with their condition.
This has certainly been our experience. Our local Mental Health Trust has no one with a specialist knowledge of treating Obsessive Compulsive Disorder (OCD), a condition that makes our son’s life a torment. Nor, so far as I can tell, do any of the neighbouring services, despite NICE guidelines saying that every trust should have one. All that is available locally is group Cognitive Behaviour Therapy (CBT) classes, only suitable for those in the early stages of the illness. These are a recent introduction and would not take on a case like my son. The nearest place for advanced treatment is 2 hours’ drive away. I did manage to bully the local trust into referring him there, in itself something of a miracle. Treatment would have had to be residential and as the unit is unstaffed outside working hours they cannot take people considered a danger to themselves. As suicidal thoughts are one of my son’s compulsions that put us back to square one.
It is not that he has not had treatment from the local trust, off and on, over many years. It is that he has not had properly qualified treatment. The people dealing with him have done their best, and it is not their fault that their training has not equipped them. It is always worth translating experiences in the mental health field into equivalents for physical health. Compare: ‘You need brain surgery, but I’m afraid we don’t have a neurosurgeon on our books, so we’re going to put you in the hands of a really good general surgeon who is brilliant with gall bladders.’ Another problem is that any improvement, however temporary, can be treated as job done – like telling an accident victim that the hospital has set some of the broken bones, but that they are being sent home to deal with the rest themselves.
The net result of this lack of specialist care is repeated failure. OCD is an anxiety disorder, so sufferers tend to have a poor self-image and low self-esteem. For us, the net result has been a hardening of his conviction that it is all his fault and that there is no cure for him with a steady increase in his problems. And this brings us back to the Observer headline about lack of money. Charities such as Rethink and Mind are brilliant at running events for Carers, and I remember one speaker talking about how difficult it was to fill training spaces for psychiatry. More glamorous disciplines could pick and choose the best; they took what they could get. Things may have improved now there is so much more publicity for mental health, but who is going to choose to be a specialist in a field where hours are long and demanding, tight resources getting ever rarer while demand increases, and you are constantly having to tell people the help they need is many months away (my son’s mantra: ‘If they are going to make me wait six months for treatment then I want the treatment I’ll need then, not what I need now’), or simply not available at all?
For more information about guest blogger Julia Cresswell visit www.juliacresswell.info