I stopped

In June last year, after trying my hardest for several years to get access to NHS mental health services, I stopped. I stopped trying to access NHS mental health services.

I live with severe & enduring mental illness for which I’ve been sectioned and have no care plan or treatment, yet I stopped trying to get NHS mental health care.

I stopped, because I eventually realised that the two most likely outcomes of me continuing to try to access NHS mental health services are worse than receiving no care.

That this is my life now, that this is as good as it gets, and that it is better for me to just accept that and get on with it.

I stopped because I realised that, even if I do get access to mental health care, treatment and support, it is likely to go badly. And that, if I keep trying to access care, it is likely to go badly. So I should just stop – and get on what life I have left. Focus on maximising enjoyment and minimising discomfort. Just live for the present as if there is no future.

I thought about the likely outcomes of me continuing to try to access NHS mental health care, and these were the two likely outcomes:

Outcome 1: I do not gain access to mental health care, treatment & support

I continue to use my time trying to get access but don’t succeed and, as well as spending my time doing unpleasant things like trying to trawl through records or write letters or sit in meetings, I risk further iatrogenic harm – by for instance further defensiveness by mental health services such as further pathologisation of me seeking & failing to gain access, risking adversely affecting how other non-mental health services respond to me (diagnostic overshadowing).

Outcome 2: I do gain access to mental health care, treatment & support

Even if the care at that time is excellent, there is no continuing of care so, each time I see a new psychiatrist, they will want to start from scratch as if their colleagues were all untrustworthy twits then go off at a tangent, changing or adding diagnoses (whether telling me or not), changing treatment.

And being put on meds would lock me in to a continuing relationship with psychiatry (because you can’t just stop the meds) – dependent on their largesse to continue to prescribe, potentially destabilised at any time by either an unwanted change of meds, or by a refusal to change meds if the current ones stop working or better treatments are developed.

This decision took a long time to reach, but I think the final straw was a letter written about me by NHS mental health services in 2021 where they stated, amongst other things, that I had always had access to community mental health services.

Okay then, show me the care plan. Tell me the dates of the appointments I had with community mental health staff. Tell me what medication I’m prescribed for severe and enduring mental illness. They can’t, because there is no plan, no care, no access. It’s a lie.

The system protects itself.

It took me a long time to proces this lie and what it meant for me, in the context of everything that had gone before and how long I’d been trying to access mental health care.

But eventually it became clear to me that, to local mental health services, I am not a poorly and vulnerable patient with severe and enduring mental illness who needs care, treatment and support to help manage my condition and live an ordinary life but … a threat.

They view me as a threat to be neutralised by for instance building up a record of distortions and, to be frank, lies. The system protects itself. Covers its own arse.

Even if I were in good health, perhaps I would be able to fight the system. But I am not. I am struggling with untreated severe and enduring mental illness without any care, treatment or support.

And it’s no longer I system I seek to be part of.

Forgetting

Another year, and I am still here. I did not imagine I would be, but I seem to just limp on, unable to do anything decisive either way.

A London friend just rang. I didn’t pick up. She leaves messages, but I don’t play them. I can’t speak to her because I am rubbish at spin and untruths, & I don’t have a socially acceptable answer to give when she asks me how I’m doing.

Messages drop off voicemail after a week or so I guess. My friend will stop calling, & I’ll fade from memory. The lockdowns loosened ties with friends that had already been stretched by my move to a new area. I don’t have any basis to rekindle those relationships now, with so little left of me.

My world, my life, my health, are so diminished now. Left to struggle alone for years without needed care, treatment or support, there’s so little of me left. What I could have been has gone. I’m ashamed to show them what’s left. It feels selfish to draw them in to my suffering.

I’m no good at putting on a show. Or putting people at their ease with fake assurances of how things are for me. It’s hard maintaining relationships when your life stays the same or slips back while theirs continues on. So much has changed for them. I’m happy for them. Sad for me.

I used to be able to rest lightly on many different things. As we all do. That’s as it should be. But, left with very little – with so much of society dismantled by austerity cuts, without care for SMI, knowing nobody in a new area, treated as a problem – I’ve inevitably withered.

There’s too big a gulf now, too great a distance between us, to restart those friendships almost from scratch. Our lives are so different now – our shared hobbies & locations no longer providing the bridge it once did. I’m not seeking witnesses to my decline & demise.

I’ve sunk so low. I’ve been left to sink so low. I need more than individuals can give – & there is no effective way to galvanise State support. I’ve tried all routes. So I’m not going to join my old friends in to my suffering so they feel the sadness & powerlessness too.

They’ll forget in time. And that’s fine.