Mental health: what everyone needs to know

This post provides what can be best-described as a ‘thorough snapshot’ of the recent special “mental health debate”, which featured on the Victoria Derbyshire programme on BBC2.

The programme aired on Monday 20th July 2015, and is available to watch (in full) for a limited time on BBC iPlayer, here: http://www.bbc.co.uk/programmes/b0631kt8.

If you do not wish to have your viewing experience spoiled, it is advised that you watch the programme first prior to reading the account below. Watching the programme in full is highly recommended; no text can ever fully replace moving pictures and sound on a screen. For those of you unable to do so, for one reason or another, please do read on.

One of the advantages of taking an impromptu mini-sabbatical is that I have inevitably found myself with more free time on my hands, and thus more time which could be well-spent watching daytime television. Of course, it is a well-known fact that watching daytime television isn’t time spent well. Right?

Well, ‘mostly right’ as it turned out…

For, having woken up on Monday, I was fortunate enough — whilst still relatively dazed and bleary-eyed, to stumble across a tweet pointing to that morning’s Victoria Derbyshire programme, which Victoria later introduced as “discussing the state of the nation’s mental health”. Queue two and a half hours (including my pausing and note-taking) of some candid, thought-provoking and truly inspiring television.

Throughout the course of the programme, proceedings were chaired artfully and delicately by Victoria Derbyshire, with a panel consisting of:

· Ruby Wax — actress, comedian and mental health campaigner. With a history of depression, Ruby has been an inpatient of of psychiatric hospitals in the past. Awarded an OBE this April for services to mental health.

· Dr. Liam Fox — Conservative MP for North Somerset, former Shadow Health Secretary and a former GP. Liam has campaigned on mental health issues and wrote last year that “the neglect of mental health in the NHS is a national disgrace.”

· Dr. Adrian James — from the Royal College of Psychiatrists.

· Claire Murdoch — Chief Executive of the Central and North West London NHS Foundation Trust, also a registered mental health nurse.

· Dr. Liz England — a GP from the Royal College of General Practitioners.

Refreshingly, the discussion was largely audience-led and we heard from some truly brave and inspiring individuals, all of whom have experience with mental issues — whether it is their own illness, a relative of theirs or they currently work in the field.

This post covers contributions made by both Audience and Panel members. Before we look at those — the programme also showed some very interesting short videos:

‘Celebrities on their mental health problems’ — 2 minutes, 8 seconds long

(Featuring: Alastair Campbell, Lady Gaga, Stephen Fry, Zoe Sugg (Zoella), Freddie Flintoff, Miley Cyrus, David Walliams)

‘Mental health funding: Is enough being spent?’ — 1 minute, 11 seconds long

‘The impact of mental illness on Britain’s economy’ — 1 minute, 16 seconds long

Throughout the course of the programme we heard numerous brave and inspiring stories and contributions — here’s a brief roundup*:

(*Notes: Names of the individuals have been provided, and also ages in instances where these were disclosed. The following accounts were all given by the individuals themselves. Apologies in advance for any misspelt names — the names didn’t appear on the television set! — for any corrections/errors, please email: jshothi@gmail.com).

Hailey (28)

– Has suffered from mental health problems for about 11 years

– They started when he parents split up; she was 17 at the time

– She hid this for about 3 months, her mother had also been very ill. At this point, she thought that something wasn’t right and she needed to get it sorted

– She went to the GP, and told her that she was feeling suicidal and that she was crying all of the time. The GP gave her Prozac, and basically said “take these, see how you feel”

– Just 17 at this time, Hailey didn’t know anything about mental health; at that time, she thought Prozac would be a magic pill that would make her better

– However, it in fact made her worse — after about 3 months, everything she had initially felt had become heightened; she felt even more suicidal, she was angry and she was self-harming

– She ended up taking an overdose after being on the pills for about 6 months

– She was admitted to a psychiatric ward; she didn’t know what was going on, she was confused and vulnerable.

– After about 3 days there at the ward, she saw the psychiatrist; his exact words to her were “There’s nothing wrong, you’re just a little bit sad”. She was subsequently discharged

– She was then put on different pills and has been battling ever since

– It has taken 5 years to get a diagnosis of border personality disorder

– After the 5 years, she was then recommend some treatment that would work, but she had to wait for this

– Hailey was led to feel that she would not be treated unless she was in a crisis; she felt that she had to be seriously ill to be put on any waiting list, otherwise the treatment just wasn’t going to be accessible to her

Gillian

– Had thought she would be fine, had lived all of her life, had a career, thought that she had been reasonably successful, and then she took early retirement in her early 50s

– After initially feeling like it was a holiday, autumn then came and the nights drew in, and she suddenly thought “Why am I here?”, “What am I doing?”; without knowing why, she started to get depressed

– At a fairly early stage she went to see her doctor, which she rarely did as she was never ill

– Her doctor gave her anti-depressants, and told her that she had to wait at least 2 weeks to see the effects

– Gillian took these anti-depressants, but she didn’t get any better; she for more and more depressed

– She didn’t want to go out, she didn’t want to get out of bed in the morning; she didn’t want to interact with people, she wanted to withdraw

– She had lots of thoughts along the lines of “Why am I here on this planet?”, “What is the point of my life?”, “What good can I possibly be doing anybody?”; she felt that she was using up resources — that tablets waste money, and questioning why the NHS should be spending money on her, and she felt that she just wasn’t worth it

– At that point, she said that the last thing that she wanted to do was to talk to someone; you need somebody to intervene on your behalf, somebody who understands

– Her only way through all of this, ultimately through a very supportive partner, was to find a charitable organisation (which she is now Chair of), who gave her replied in a crisis; this was not funded by the NHS. The organisation helped her to rebuild by finding people with other similar experiences to her own, demonstrating the value of peer support, and “what we can do for others, if only we are given the support we need to do this”

Sarah

– After having her second child, Sarah developed post-natal psychosis

– This was horrific; she thought that she was going to kill her kids at one point, as she felt that she couldn’t look after them. The fear of having them taken away from her was also awful

– She had no clue as to what was going on

– It started from her pregnancy; throughout it she was quite erratic.

– She recalls that she had her baby, and then the next day she was out of hospital and on a high, going out shopping with people

– However, one day she was just sitting her and this fear came through her; she dropped her plate and she screamed the place down. She then went into the bathroom and didn’t come out for two hours

– Sarah didn’t know what was happening. She went to the doctor and was given pills, which she then took but these just made her worse

– She got progressively worse; she couldn’t even have a bath as she thought that she was going to die; she couldn’t go near her children as she thought she was going to kill them — she was adamant that if she touched them, she would harm them

– She started hearing voices telling her to kill herself; this was the last straw. She then rung up her mum and told her abut the voices

– They rang the doctor and she was sent to A&E, where she waited; this wasn’t nice as there were lots of people there who she didn’t want to be around — she was in her pajamas, she was an “absolute mess”, she hadn’t had a bath for a week

– The duty psychiatrist then came out, but it was actually the nurse who mentioned post-natal psychosis (his wife had had it four times)

– She signed custody of her kids over to her mum, and she also moved in with her so that she could be looked after; she couldn’t even get out of bed, she was like a baby

– Her mum had to look after her and also her newborn baby

– She had to go for daily counselling session for 2–3 hours a day to ensure that the medication that she was on was working; she managed to pull out the other side

Kathryn

– Developed post-natal psychosis within 24 hours after giving birth to her first baby, having had a Caesarian-section

– Luckily she received the help that she needed, and her family also received the support that they needed

– She had acute delusions and hallucinations — she thought she was dying, that it was the end of the world; at one point that she was the last person alive in the world. She had various hallucinations around death and dying

– At one stage she became fixated with panic buttons

– She was very quickly hospitalised and, thankfully, lived in a part of the country where her hospital had a ‘mother and baby unit’; she was there for 3 months along with her baby

– The acute psychosis lasted for around 3–4 weeks, after which she managed to gradually get better

– She now works with different mental health charities and offers peer support

Emma (28)

– First had issues when she was 13, and she also attempted suicide at this age

– Since then, she has been up and down

– Her GP had administered her with 10 different types of anti-depressants

– Finally, 5 years ago, she was diagnosed with borderline personality disorder

– She felt like she wasn’t taken seriously with her problems as a teenager, and this continued into her 20s

– She feels that there is a hierarchy of mental health issues, and that her own borderline personality disorder isn’t considered one of the “big ones” (versus, perhaps, depression, bipolar, etcetera)

What is borderline personality disorder?

– A behavioural and emotional problem

– Reactions to normal things can be extreme in one form or another

– No grasp or self-awareness of what is happening around you

Zoe

– Has used mental health services and worked in the field in the past

– Believes that there is a hierarchy of mental health issues

– Believes that with ‘severe and enduring’ cases, there seems to be a sense that you are not going to recover, almost as if it is a life sentence.

– She believes that you, in fact, can recover from a severe and enduring mental health issue.

– It is important that the right message is being given — being wary of pathologizing/medicalizing these conditions, which are sometimes quite natural reactions. e.g. Mental health issues which arise from bereavement

– Rather than just handing over some drugs, therapy, etcetera we need to be a bit more “human” about it

– The current language that is being used is affecting mental health patients and how they perceive themselves and their limitations

Oli

– Diagnosed with bipolar disorder

– As an electrician, often works on a building-site in a male-dominated environment

– Was often told by the other men/lads on the building site — “Man up”, “Sort it out mate”

– He has written a film where all of the actors have mental illnesses; they have a group chat on Facebook where they all offer help to one another

– He was recently put on the SANE charity website

Jessica (35)

– Has had depression for 20 years

– Works as a management consultant, and with her former employer was working in a pressurised environment, enduring long hours and carrying out difficult pieces of work

– When she told her boss about her mental illness, her boss seemed more concerned with the work not getting done rather than her having the mental illness. She subsequently lost the project, with her boss saying it was best that she left, and not giving a reason

– As a result of the way her boss had reacted, she felt ashamed of her illness

– Now at KPMG in the City doing the same job; having initially been frightened about speaking to her employer when she came out of hospital last year, Jessica decided to put this aside and speak out. She is now now longer frightened about talking about her mental health.

– She has since volunteered with Mind and started blogging about her mental illness

– Her view is that we have to be honest and stand up and talk about how we are feeling (in reference to those within the community living with mental health issues). Otherwise, we will never dispel what people think and say about what mental health means.

– She can work full-time, with sensible hours (which she asked for and was given by her current employer), and can volunteer, and also speak up to raise awareness; this has helped her to recover. She thinks it can help others to do the same.

Andy & Kerry

– Husband Andy had a good career and was financially stable. Unfortunately things took a turn and he ended up going bankrupt. His wife Kerry found him crying at his bedside, hitting his head against a wall.

His wife and inlaws were very supportive — he described his wife as a ‘godsend’.

With help and support he received, he managed to turn things around and now helps to run an independent recovery project.

– He believes that training courses and peer support are the key.

Phoebe

– Diagnosed with borderline personality disorder 5 years ago

– In her experience, the policy appears to be putting bpd down on the patient’s medical record and not telling the patient that they’ve been diagnosed with it (!). Lots of people she has met have had this same experience.

– There are several therapies but they are seen as expensive, and fairly intensive programmes are being developed in the US

– For personality disorders, you need a lot of involvement with people to feel like you have a supportive network

– Whilst 2-year therapies are being developed, 12-week therapies are the ones that are being delivered — and they don’t give any help

– Perhaps existing funding is not being used in the most effective way; she feels that the people with the mental health problems themselves need to be involved in the development of the services

Gordon

– Diagnosed with Post-Traumatic Stress Disorder (PTSD)

– Waited 102 weeks for treatment on the NHS

– He was in an abusive relationship 10 years ago, and repeatedly turned up to the GP

– He also abused substances, and is a recovering addict

– He has tried to take his life twice in the last 4 years, received no treatment

– “Please don’t give me a mind-altering substance to keep me “safe” in inverted commas. I’ve tried anti-depressants before. They don’t work. You’ve heard that consistently throughout…. They do work for some people. But we’ve heard it consistently here [in the studio today] that they make the symptoms worse. It took me nearly 10 years to get a diagnosis. When I did get a diagnosis, 102 weeks I waited for the treatment to start”

Laura

– Counsellor in private practice, previously worked for many years in mental health

– She is increasingly seeing people having to wait longer and are having to come and seek a private counsellor

Unnamed gentleman (in wheelchair)

– With the stress that everyone goes through, how that’s dealt with will determine their mental health in the future

– He has a history of mental problems, arising from an accident he had which put him in a wheelchair; of course, the wheelchair is visible to all, it can be seen — as such, there are things which employers, etc. can put in place for a wheelchair. This is not the same case / there are not the same provisions in the case of mental health issues

Joss

– Had anorexia for 6 years

– As a patient, saw no cohesion between inpatient and outpatient service

– Due to the lack of cohesion, she managed to relapse whilst waiting

– Weighing just 4 stone, she desperately rang her GP and the hospital; she was told to drop her weight even lower(!)

– Has a “beautiful brother” who visited her and helped her pull through

– She is now working for MIND and another charity to raise awareness

Kenya

– Diagnosed with seasonal affective disorder; she feels particularly low in the winter

– She comes from an abusive household

– She was told that he case wasn’t sever enough, as she had not self-harmed; this was despite the fact that she had had suicidal thoughts

Sarah and Lauren

– Sarah has worked for several years in mental health, Lauren has a history of mental health illnesses

– They have had a major battle with mental health services

– Lauren had severe bulimia which transitioned to anorexia, also had a record of substances abuse and severe depression

– At one point weighing just 6 stone and living off “air and wine” for a time, Lauren was advised that she needed a lower BMI (Body Mass Index) — !

– She was then told that she couldn’t be taken on as a patient as she had a substance abuse disorder

– On one occasion, she was sent home from hospital at 2am with no money, and after a suicide attempt

– Sarah commented that this doesn’t happen with a stroke, where you are told to go away and develop more serious symptoms before you can be treated — so why does this happen in the case of mental illnesses?

Panel contributions:

(Please scroll to the top to find individual introductions for each of the Panel members)

Ruby Wax

– The law should protect you, but 56% of employers/bosses don’t hire people with mental health issues

– The Government/someone needs to make it really clear that mental illness is a physical disease, not a fantasy

– She had heard someone comment that if Bill Gates had spent what he did on malaria on mental illness /which gets ‘zilch’), scientists may have found a cure for some of these mental illnesses

– She was performing on stage doing her show (in mental health settings) before she spoke up; she realised that she had “found her tribe”

– Re: spending of the allocated mental health budget, feels that “6 weeks of CBT? You’re burning the cash”

– As opposed to the above, “Maybe we need to get something implanted into kids’ school, so that we don’t burn their little brains out with more exams, because they’ll be fine and they’ll get great grades. But when they’re 50 they’ll be institutionalised.

– Teaching kids emotional intelligence (Ruby showed humility here in admitting that ‘I don’t even know what that means’), rather than academic intelligence — we need to keep up to date with the technology.

– “They say by 2020, it’s going to be stress that burns us out”

– Ruby is wanting to set up walk-in centres for individuals suffering with mental health issues, and is looking for help in setting these up

Dr. Liam Fox

– 70% of adult mental health problems will have been experienced before the age of 18

– To really make a difference, we need education and for the stigma to be removed THEN (i.e. before the age of 18), this is a defining period in youths’ lives; i.e. early intervention

– We should be spending more on child/adolescent services; to pick people up early in the process, as Ruby (Wax) also described

Dr. Adrian James

– Adrian gave information around the ‘mental health’ definition, highlighting the variety of different types of mental health illnesses, and the different ways in which these illnesses

– Crucially, it can effect anyone — no one is immune from mental health illnesses, contrary to what some might believe; stigma can arise from some people thinking that others can get it, but that they can’t

– Mental health problems are really treatable — however, we need treatment, not just a diagnosis for those living with mental health issues

– The key is to get people the right treatment ant the right time, and to intervene earlier; this all leads to much better positive outcomes in the whole of their lives

– Whether employers like it or not, 1 in 4 of their employees are at risk of mental health problems

– As such, good employers who support mental health will find that it is good for their organisation, and also good for it’s finances.

Claire Murdoch

– There is a pattern that treatment seems to be reserved to just acute cases, and that they wait until you deteriorate before they treat you; we have to be careful that the NHS doesn’t just turn into merely just a “crisis centre”

  • The fact that cuts to mental health services are greater than in the case of other health services is unacceptable

Dr. Liz England

– Medical training has not traditionally been focused on mental health

– In the case of personalities disorders, medical students/professionals have been advised “Don’t go there, don’t talk about it”, with the view to thereby avoid opening up a “Pandora’s box”, and not being able to deal with it

– A huge amount of work is currently going on, looking at medical school training, and incorporating training around mental health

Lots of work still needs to be done, and things will take time to improve

So there we have it. All in all, a fantastically well-organised show, with some amazing contributions from panel members and the audience. It must be said, there were some shining star contributors, whose courage we must admire in sharing such heartfelt deeply personal accounts — all in the name of raising awareness towards such an important cause and trying to break down the stigma.

(The only disappointment was the coverage given on the mainstream BBC website, and the title ‘Postnatal psychosis: I thought I would kill my kids’).

Surely someone could have come up with something just well, better, and which gave the show (almost two hours of airtime) and all of those who appeared on it and contributed to it, some more justice? Not to mention the mental health community as a whole. This would have been the perfect chance to put a lovely cherry on the cake, alas — chance missed. BBC, please take note for next time!)

Change won’t happen overnight (it never does), the walls around the stigma won’t be broken down overnight, but it is forums like these — bringing together such tribes and communities together and sharing their experiences — which will push us that bit closer to getting what is much-needed for mental health in the UK and also worldwide.

Bravo to the BBC, BBC2 and the Victoria Derbyshire programme for this. How nice it would be if this wasn’t a one-off which eventually becomes a distant memory, but rather perhaps a more regular show like this focused around mental health? Even a prime-time slot perhaps. Surely the overwhelming reaction to the show has given the BBC producers some food for thought…

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