The NHS and I

During the course of my life, I have used the NHS a lot.

From teenage to my early 20s in London, I received great care from hospitals and GPs alike for both chronic knee and stomach problems. In my mid-20s in London, I had my first child. With the support of a thoroughly magnificent team of NHS midwives, I had a glorious planned home-birth. The physical care of my newborn son and I was simply exemplary.

So far, so good. Up to this point, problems that I had sought help for were physical in nature, but suddenly, I required the assistance of Mental Health services, and that didn’t seem to happen quite so easily.

Following the birth of my first child, my previously untreated and undiagnosed mental health problems spiralled out of control. One health visitor was unable to deal with me and so left me to it, and it was up to me to seek out another and ask for help. She asked me a set of very specific questions and, based on that, identified me as suffering from Post-Natal Depression. She recommended I see my GP. I did, and was prescribed the anti-depressant Escitalopram to begin taking while I waited for a course of Cognitive Behaviour Therapy with a counsellor at the local surgery.

I waited 16 weeks for 8 hours of CBT. Apparently, this was the “fast track”, due to the fact that I had a young child. I have no idea how long the waiting list was for other people. As I’ve mentioned in previous posts, the CBT was effective at improving some symptoms and providing long-term management strategies, but the counsellor was tied to the provision of 8 hours only, with no option of extension. Many issues were brought to the surface, but not fully dealt with.

I was left to manage on my CBT strategies and anti-depressants, with occasional follow-ups with my GP and visits from my health visitor. After 18 months, I decided to come off the medication – the side effects of which withdrawal required medication – and ‘go it alone’. Success!

When we moved to North Yorkshire, another wonderful team of NHS midwives supported us through another glorious home-birth and helped us settle in with our new addition.

A year later, I was sitting in my new GP’s office, unable to speak coherently. Within 2 weeks, I was having weekly visits at home from a Community Psychiatric Nurse who was conducting an assessment of me over time while I was waiting for an appointment with a psychiatrist.  My CPN delivered my diagnosis in conjunction with her team leader, and always made sure I was aware of her communications regarding my condition and care. My psychiatrist appointment came within 5 weeks and was at a local clinic.

This appointment was a complete disaster and I left feeling dangerously worse than I had when I arrived. I was made to feel there was no hope for me at all - that I was always going to feel like this so I may as well just get on with it. I explained this to my CPN and I never saw that psychiatrist again. Nor did that informal complaint delay my treatment. Within 2 weeks I was off to see another psychiatrist – the team leader – who assessed me and stated there and then that she was referring me for psychotherapy with one of her team (who was present at the assessment). Apparently, the waiting list for this treatment was 2 years, but because of my state and the fact that I had 2 young children, I would begin treatment in 3 weeks.

I underwent psychotherapy for 3 months, and now generally manage my condition myself, safe in the knowledge that if things become unmanageable, I can either call my GP or go to A & E and get straight back in to see my Mental Health Team.

So, what points am I trying to make here? Firstly, you may have used many different kinds of services through the NHS, but when you get into Mental Health, it’s a whole new ball-game. When you are at your most fragile and vulnerable, you can find yourself at the mercy of a system that does not always function in the best way, or with the most appropriate professionals. And the success of your experience often depends on where you live.

Secondly, Mental Health stigma exists within the NHS. Fact. This means that sometimes, service users feel they cannot complain, which exacerbates their problems, or discourages them from seeking help at all.

Make no mistake, the NHS is a flawed service, and this is particularly the case with its Mental Health Services. Many Mental Health Service users across the country struggle to access the care they need, and experience problems with the care they receive. The nature of their health problems means poor service is particularly traumatic. This certainly needs to be addressed as a matter of urgency, and many Mental Health organisations and charities are working hard to make this happen.

However, even on its worst day, the NHS provides good quality care to hundreds of thousands more, many of which are Mental Health Service users. And it does much of it for free. When the system is problematic, it can be devastating, but when it works, it is brilliant. Yes, the cost of prescriptions is ridiculous, but if I had experienced my health problems as a citizen of the US, I would have been filing for bankruptcy long ago. Or worse, my condition would have continued undiagnosed and untreated with potentially disastrous consequences for me and my family.

The thing that concerns me most about the current government’s attitude towards the NHS is their desire to introduce “competition”. To me, this means profit, and when you introduce profit, that takes priority over everything else. I despair of the effect that would have on Mental Health services. Will we all just be handed a pack of pills from a giant, profitable pharmaceutical corporation and be sent on our way?

It is the nature of society that we usually only hear or remember the horror stories. A system where horror stories are a thing of the past is certainly what we should be striving for. But let’s also celebrate the success stories of the NHS as it is today, the people that dedicate their lives to providing it, and be thankful for having a national – not private - health service at all.