A personal guide to accessing mental health services
Sometimes it feels like accessing mental health services is like trying to please Goldilocks. Sometimes you’re too unwell; sometimes you’re not unwell enough. You must jump through hoops to prove you are as badly in need of help as you say you are; but if you’re well enough to jump through them, are you really in need of help? Here’s a short guide on how to navigate that tricky dilemma, and access the help to which you’re entitled.
It’s the dilemma that many of us have faced – me included. The fluctuating nature of many mental health conditions means that when you’re at your lowest, it’s hard to perform even basic tasks, let alone face the outside world. To give an example: even leaving the house or communicating by telephone can be beyond the capabilities of someone who is undergoing a crisis. I’ve been there, sitting by the phone, looking at it in my hand, for hours, unable to press the buttons, or dialling and then feeling sick straight away, then waiting until it rings and hanging up. How can you even begin to help yourself when simply reaching out is so hard in the first place?
It might sound straightforward, then, to ride out the worst parts of a mental health crisis, then seek help when you’re feeling better. But it’s not that simple, for several reasons. You might not want to think about mental health, let alone talk about times when you’ve been at your worst, when things are finally coming together. You may hope that it was a temporary blip that has been overcome.
But it gets worse. Attempt to seek help for a long-term problem when you’re feeling well, and some people will tell you that they aren’t fully understood by health professionals, up to and including GPs and mental health professionals. If you’ve got back to the part where you’ve managed to leave the house, go to work and even book an appointment, everything’s all right again, isn’t it?
Well, no. It isn’t. But the irony is painful: you can only be in a place where you’re able to discuss your symptoms at the very point at which they are least visible and least present. To the outside world, you are presenting the face you would like them to see: they are not seeing you in a crisis, because the person you are in a crisis is one who might hide away and not even be able to speak to them at all.
Make a plan
It might seem counterintuitive to get help when you feel least symptomatic, but it can be a good idea. You can be lucid enough to make sense of what has been happening. Additionally, you are in a place where you’re most able to make use of your access to the outside world. And you’re also capable of talking and listening without being as highly stressed by these activities as you might otherwise be.
You might think that, when you’re well, it’s exactly the wrong time to make a plan about what to do when things get worse – after all, you hope against hope that they aren’t. But… suppose they do. You’ll thank yourself for having done that hard work when you were able to. So get a plan in place. Who will you speak to? How will you find help? Do you have everything to hand, in a place where you can find it? Do it, if you can. Just in case. It’s always just in case. A good place to start is the Rethink website, which has plenty of links and information. If it’s a crisis, you can speak to the Samaritans in person, on the phone or via email.
Write it down
That said, it might not be easy to access the rawness of the highs and lows you are able to experience at other times, so how can you get across how they feel? One way, if you can, and if you feel safe enough to do so, is to write it down. There’s something about putting feelings into words that touches a different part of yourself to just talking. It makes you think a little more deeply; at the very least you have to confront the reality of what happens, or happened. As I’ve alluded to, that is only something that should be done if you feel ready, but if you do, do it.
It might seem artificial to “perform” reading from a series of notes when you finally get in a room with someone, or on a telephone. But a script or a set of bullet points can help. There’s a chance that the sheer emotion of finally saying what you’ve been dying to say might make you trip over and forget your words. For some of us, we end up sounding like we’re speaking so slowly that there’s a lifetime between every single syllable. But those moments will pass. Someone who will help you will let the words come out.
Jump through those hoops
Sometimes it feels like there’s no help. That dread of the phone call to the GP receptionist, who tells you there’s no appointments until next month if it isn’t “urgent”, might lead you to put it off. But don’t put it off. And you might not even have to deal with the usual gatekeepers.
Now, this doesn’t apply everywhere, and it’s very much a postcode lottery, but in some enlightened parts of the country you can access mental health help by self-referring – you can even do it by email or via a website, if you find the telephone a problem. I was amazed to find out I could do it where I live. It’s not as well known as perhaps it should be, but you can do it. Find out if your area offers a system where you can self-refer, and if it does, take advantage of that. You’ll be dealing with people who understand the process of accessing mental health services.
You will probably have to go through a consultation lasting 45-50 minutes, but that will give you the chance to explain how you feel and put across the issues you’re facing. You might find you have to jump through more hoops – for example, go through a six-week course of cognitive behavioural therapy before you’re considered for anything else – but the good news is, you’re on the path. Once you’re on it, stay on it. And even if one course of therapy ends, you can self refer again as soon as you want. It’s really in your control, which might be a huge relief.
Remember: you’re entitled to help
Perhaps the most important thing to remember if you can, no matter what your feelings are about yourself, is this: you are entitled to get help if you need it. You’re not getting in the way. You’re not taking someone else’s place. You’re not so insignificant that no one can help. You’re not a problem that can’t be solved. You’re not so insignificant, or small, or easily forgotten. There is a way for you to be heard, and be listened to, and helped. However much it might seem that the system is set up to reject you, you are entitled to help. So if you need it, get it. And if you aren’t happy with the first attempt, try again: you’re entitled to a second opinion too.
Written by Steve