“The resources to help seem to be non-existent.”
I recently moved from the Midlands to the South of the UK, and I wanted to share my story of how my mental health care has been a bit of a postcode lottery.
My main diagnosis was mixed personality disorder. My secondary mental health care team was keen to assess me further with the belief I may fit into the criteria of Schizotypal Personality Disorder due to the nature of my hallucinations and paranoia. My symptoms are mostly depersonalisation, hallucinations (typically in my peripheral view) and voices, as well as self harm, body dysmorphia and depression, amongst others.
In the Midlands I could call about a symptom to the crisis team and expect help on the spot or call 111 and see someone that day if I felt I needed it. If I needed an appointment, I could get that within a week to two weeks. My medication review was monthly. Currently, since returning to my more rural hometown, I have had no face to face appointments since coming back after uni.
I can summarise it by saying the main differences I’ve had have been that in the city, I had a fortnightly session with a mental health nurse who would even go so far as to book my blood tests and arrange for counselling with other departments. I also had help as a crisis phone number and a huge walk in centre that would take me in temporarily when I felt I was a risk to myself. They gave me authority and provision for allowing me to change medication and checked on that often.
The countryside however demanded a re-evaluation once I moved and made me send them photocopies of my own medical files, such as proof I’d been sectioned. Then they (without having met me and after a 50 minute phone call) denied me secondary mental health care services as I was holding down a job and not currently experiencing psychosis. Changing medication down here has been futile. As such, I’m no longer on anything. Thank goodness for the fresh air though, right?
The referral process in the Midlands was fast except for diagnostic purposes, as they only had one specialist for the area. I had lots of help below that level, but diagnosis took years and years.
The teams I deal with at present are very quick to refer to non NHS sectors like Samaritans or private healthcare, unless you are an immediate danger. Any substance misuse in your records means they will immediately refer you to addiction services even if the problem is nothing to do with that. I have tried multiple times to get referred to secondary and have ended up in tears because I am not being taken seriously here, since I can work and haven’t tried to end my life lately it seems.
I tried multiple medications when under my mental health nurse in the Midlands. We had settled on Fluoxetine and Quetiapine predominantly, but when I moved back to my parents in the South I was questioned a lot about whether I should be on Quetiapine. I had to call back after my assessors- who I had never met and spoke to on the phone once- told me I can’t be on it if I’m not psychotic.
I ended up buying my medication online ultimately. I buy one drug and only use it occasionally. I am still prescribed the same pills but don’t refill them. I only get given a month’s dose of each due to overdose risk, so it’s not worth the price and I never get medication reviews unless I pester my GP for them.
It’s not easy to find trustworthy businesses for medication online, but it’s definitely doable. Some medications are a lot easier to find that others. I do worry about how safe it is. I would like to have a relationship with my doctor where I can tell them what I’m taking in case of side effects, but they always jump to substance abuse when you buy your own medication. I’ve tried CBD but felt no difference.
Where I live now, the views tend to be that if you aren’t actively self harming or endangering yourself, such as having a step by step plan of suicide, then they simply don’t have the time for you. The resources to help seem to be non-existent. I feel like there’s no mental health net here at all. I don’t really have much of a social aspect down here still, so I’m not sure if my experience is reflective of everyone.
The private sector is almost as bad. At the very cheapest, it is £40 for half an hour of therapy. They rarely have experience in anything outside of depression, anxiety and eating disorders and many are reluctant to work around difficult schedules. If you work nights or evenings, then there is no chance of getting appointments.
The phone call assessments can be dehumanising, they act as if they know your condition better than you. The immediate reaction to any substance use or misuse in your past or present will throw any progress away, as this is an easy ‘Found the problem!” for doctors here it seems. The rehabilitation clinics have told me I have no need to see them, yet my GP has referred me twice when I no longer have any addictions. I can’t be referred back to the Midlands team, so as of right now I feel stuck. I can’t see a way forward.
I feel like the older the populous is in an area, the more physical medical issues are prioritised (In my opinion, this is valid to put first, but not to ignore mental health entirely) so doctors are busier dealing with things like heart conditions, arthritis, dementia, cancer etc, and perhaps mental health- because it doesn’t manifest particularly strongly visually- gets put on the back burner of importance.
I’d like to see us have a separate entity to the GP entirely. I’d like to see a mental health unit in every county as a minimum that only deals with mental health patients. I’d also want easier access to a database of medication so you can swap medication with doctor approval by using an NHS database to check side effects, rather than asking your GP and hoping number five of 13 of all the drugs available works out.
