Thanks for the thought

Last year, I was attending a meeting with some clients. Halfway through the meeting, an assistant walked in and asked one of the team to step out. When she came back, she was pale and quiet. She said: “There’s been a suicide.”

I started crying immediately. Not because I knew the victim, but because suicide is an instant trigger for me, and because at that time, I was supporting a friend who was trying to recover from a series of attempts to take his own life.

I’ve had people ask me – “How does someone get to that point? Why do they do it? What were they thinking?” I guess my answer is, by that time, you’re not thinking. By that time, you are so distraught, you’re convinced that there is nothing left for you, and that nothing will ever change. By that time, there is nothing else.

And as for “How do they get to that point?” Well, that’s a different story.

My answer? One John Kirwan does not a revolution make.

Due to childhood trauma, anxiety and depression disorder, I’ve been having psychotherapy since I was nine years old. Without this Depressiontherapy, I very much doubt I would be alive today. It taught me how to cope, how to challenge and reset my own brain. It taught me how to understand what was going on in my head.

Many of you have told me that you believe therapy is utterly vital to your health, recovery, and survival. You’ve described it as “seeing a hand reach down into a tunnel to lift me out.” (Via Stage3Gen).

Under the current government, we can no longer rely on that hand being there.

This year’s budget revealed that 20 million has been cut from mental health funding in New Zealand over the last four years.

This includes: $4 million from mental health training, $4.2 million from the Like Minds Like Mine mental health campaign, $5 million from mental health research and $6 million from mental health promotion programmes.

New Zealand right now not only does not have any fences at the top of the cliff – the ambulance at the bottom is a clapped-out Holden ute with a Lilo in the back and a first aid kit with a couple of panadol in it.

When I was younger, my therapy was paid for by ACC. Since then, their sexual abuse policies have been “tightened” and almost 90% of claims for this support have been either turned down or put on hold.

Later on, I was lucky enough to be able to pay for therapy myself, with sessions costing between $80 and $120 for 50 minutes. For many – for me right now – that cost is far beyond their means.

For me, and for others judging by my research, there are around three different degrees of managing mental illness.  One is when you are coping fine. You consider yourself stable, and you have the support you need. Two is when things become harder and you need more help – perhaps increased therapy and/or medication. You might have thoughts of self harm. You might feel like you’re not really stable or coping. Three is when things become unsafe. When your illness has overwhelmed you. When you seriously consider, and or attempt, self harm,

It is easiest to get the help you need during stage One. You’re capable of being on waiting lists for therapy. You’re capable of changing medications if need be.

During Two, things get more difficult. You need support more urgently. But because you’re not quite suicidal, you may not get it. And because of the stigma involved in asking, you may not ask.

Then you hit Three. At this point, urgent care can be accessed. But my own experiences and my research show that too often, it’s too little, too late.

Pic courtesy Beatrice the Biologist

Pic courtesy Beatrice the Biologist

As I mentioned earlier, last year I was trying to support a friend who was suicidal. This was difficult because we live in different cities. It was an incredibly frightening and stressful time. Both I and other friends called the police on more than one occasion, when he told us he was making plans to commit suicide. The police are trained to deal with any immediate situation, not provide substantial help. They would turn up, have a look around – and leave my friend alone in his flat with knives and prescription pills. One of them informed him that, in order to “cheer up” he should “get himself a woman.”

Over a period of three months, my friend visited ED at least four times, having inflicted self harm. Each time, he was sent back to his flat, alone, with the knives and another prescription. When I called CATT (Crisis Assessment Team), they informed me they “knew of the situation,” and were “keeping an eye on it.” Then I would  wake up to another message from my friend, back in the hospital. Needless to say, I was not reassured at all.

I totally believe that the only reason he got through that time in his life is his own personal strength, and nothing to do with any mediocre help he received.

Before I go any further, I want to acknowledge that I am not blaming the professionals who work in the mental health industry. I understand that most of the time, they do what they can. But they are constrained by smaller and smaller budgets, which mean that help can often only be offered to those who are considered the most ‘at risk,’ and proper prevention and follow-up rarely occurs.

I was partially inspired to write about about this topic by Nicole Skews’ post on the Daily Blog about the importance of talk therapy. She points out that the “1 in 5” statistic seems highly unlikely, as she doesn’t know anyone who hasn’t dealt with a mental health issue. I don’t, either. She addresses not only the massive importance of mental health services, but also the barriers that stop people accessing help.

“Our top insurance provider refers people to counsellors out of “the goodness of [their] hearts”. The Government thinks truancy officers will help young people feel less suicidal. I am still questioning whether I should be so open about my mental health in case it’s used against me later in life.

Our ideas about mental health in Aotearoa in 2013 are completely fucked. The stigma and the lack of support are hurting people. Actively,tangibly, hurting people. We need to grow our resources and break the barriers that stop people getting help. We need to foster understanding and openness. We need to talk about this.”

I was also interested to see many people, in the comments on the piece, agreeing that services are only available to those who need them urgently.

“The fact you have to get to a point where you want to kill yourself to GET access to that healthcare is already a major issue.”

This was the point I decided to do some of my own research. I spoke to my friends and family, and I put a call out online for people to share their experiences of mental health and mental health services with me, for anonymous use.

I was utterly humbled by the openness of those who have told me their stories. I had no idea when I asked, what I would receive.  I’m honoured by your trust, and I credit your courage, intelligence, and empathy. Thank you to all of you.

I thought for a long time about how to do these stories justice. I didn’t think it was appropriate to share them verbatim. And I didn’t want to reduce their significance by summarising them as saying they all supported my hypotheses.

Of course, they didn’t. Some of you told me that you had been able to access the support you needed, which is fantastic – although all too often, this happened after you had already had to go through some very rough times.

But most of you spoke about how difficult it is to live with a mental illness. How you suffer from misunderstanding, mislabeling, (or labeling at all), and not being able to get the help you needed when you needed it.

You spoke about waiting lists, and lack of proper care. You spoke about being prescribed the wrong medications and not being listened to. You spoke about the difficulty of speaking out for fear of judgement.

And all of you – every person who I spoke with on this issue – had either seriously considering, or attempted, suicide. Every. Single. One. 

This fact is what stuck with me. This is the one that had me asking –  surely, if we were able to get the help we needed, there shouldn’t be so many occurrences of stage Three?

New Zealand’s suicide rates are one of the highest internationally, and youth suicide in particular. Ministry of Statistics provisional figures show 541 suicides in 2012/13. (That’s a link to a very interesting NZ Herald article, which talks about the increase in female suicide).

541 unnecessary, preventable deaths. And we’re cutting services?

The New Zealand Association of Counselors (NZAC) condemned the funding cuts, and say that the government needs to recognise the value of mental health services to society.

“We appreciate there are budget constraints, but my concern is that this reduction of services will ultimately have a detrimental effect on New Zealanders who need help and are now left with nowhere to go to get it.

“It’s counter-productive and will have its own flow-on social and economic costs.” (Source – NZAC newsletter).

Yes, of course it will. If people are pushed to the brink and have their options removed, what happens? Suicide, crime, homicide? If we don’t pay for it now, we’re certainly going to pay for it later.

The suicide I spoke about at the start of this piece was a 17 year old boy. His parents had no idea he was depressed. We lost him, because he couldn’t speak out. We lost him, because the support he needed wasn’t given.

Those of us who struggle, will continue to do so. We’ll continue to sit on waiting lists. We’ll continue taking drugs with undisclosed side effects. We’ll continue to try every day, with courage, hope, and sheer determination, to stay out of stage Three.

And the government will continue to provide us with a couple ads featuring an ex All Black and a website. Cheers, guys. Thanks for the thought.

2 Replies to “Thanks for the thought”

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