This post is not about bashing GPs. There are some truly wonderful medical professionals in this country, and abroad, who do very important work, especially in the mental health field. I have met several of them through this blogging and advocacy journey. I also have a couple of personal friends who work in the NHS. I don’t wish to generalise and I don’t wish to tarnish all with one brush, I just want to share my own personal experience of mental health treatment in the NHS in an attempt to highlight some heartbreakingly large gaps in training, resources and experience.
First, the good. I was lucky. I’ve said this many times but it never stops being true. I had a fantastic health visitor who recognised my cries for help and referred me to the Perinatal Emotional Wellbeing Service who, in turn, saved my life. That sounds dramatic and it probably is. I also had a loving family and support network who saved my life too but without the professional support of PEWS I don’t know where I would have ended up. I would certainly have visited A&E and possibly been admitted at least once. I feel lucky because the support of PEWS, my health visitor, my family and, eventually, an NHS therapist allowed me to get better at home, whilst being with my son. I was lucky and I’m grateful.
There’s no money. I get that. The country is in debt up to it’s eyeballs and the NHS is forever under strain. But with one in four people experiencing mental health issues I can’t help thinking that of the money that does exist a large chunk needs to be redistributed to this area; we need more crisis teams, more NHS therapists (with shorter waiting lists) and, in particular, more PEWS teams like the one we have in South Essex all throughout the country.
I was lucky and I got help but even with that luck I hit some frustrating roadblocks. For example, my first GP. Frankly, what this woman said to
me was so damaging that I’d love to name and shame her here, but sadly I don’t even know her name. She wasn’t my usual doctor (thank heavens!). Let’s call her Dr Fool, because that’s exactly what she is.
I first met Dr Fool at my standard six week postnatal check-up. She checked my c-section scar, asked me how I felt and rushed through the obligatory Edinburgh scale questionnaire. I scored a 10 which is considered borderline. I knew things weren’t at all right with me but thought the baby blues were just hanging around longer than usual and all would be better once Caterpillar began sleeping longer.
Since my score was uncertain I asked what I should do. She shrugged and said “do you want antidepressants?” whilst looking bored and already shuffling me out the door. There was no discussion regarding medication or types of drugs available, side effects or length of use. No chance for me to even discuss whether I needed them at this stage. Just a casual, half-hearted offer. Antidepressants was still a dirty word to me back then so I said no and off I went.
Only three weeks later, after the world had caved in, I was back in the office of the same locum. I hadn’t slept or eaten for over a week. I couldn’t think straight and couldn’t stand being alone so Hubs was in the chair beside me. I (mainly he, to be honest) explained how things were and Dr Fool looked at me almost blankly. I may as well have come into her office with a rare tropical illness that only three men in the whole world had ever seen rather than something that affects up to 15% of all new mothers. Then she said words so hurtful it was like a physical blow to my chest:
“But what have you possibly got to be sad about? The sun is shining and you have a beautiful little baby!”
She may as well have shot me. Did she not think I knew that? Did she not realise that I asked myself the same question over and over and every minute of every day? Did she not know how ungrateful and selfish I felt for not wanting to spend time with my baby when some poor women weren’t able to? Could she not see how confused and angry and devastated I was that my gorgeous son was not enough to leave me filled with joy? Could she not see I was terrified and wanted advice and not judgement concealed in platitudes?
She topped it off by turning to my husband and telling him to take me on holiday to “cheer her up.” We had a newborn baby, no money and I struggled to get dressed in the morning so not the most practical solution! He looked like he wanted to put a hole in the wall. Or perhaps in her face.
Lastly, she threw some prescriptions at me – antidepressants, highly addictive anti-anxiety drugs and sleeping tablets – again with no advice, no discussion and no interest. This time I snatched them up before running outside to burst into tears and descend into a panic attack.
I had put my faith in that doctor. I was a woman desperate for answers and treatment. I trusted that medical professional with my fragile mental health and it was left shattered further. I know there is no quick fix for anxiety and depression, I know there is no magic pill, but there is the opportunity for a GP to treat you with compassion and understanding, and perhaps even have a little bloody knowledge of what they are dealing with! I understand that GPs are just that – General Practitioners – I know they aren’t psychiatrists or trained therapists or even psychiatric nurses but I don’t think it’s too much to ask that they have enough training to have a basic knowledge of what to say and not say, and what treatments to offer to a new mum suffering from constant anxiety attacks. More and more people are affected by mental health issues so is it really too expensive or too much effort for all GPs to become a little more well-versed in the topic and the latest treatments?
Maybe she was a bad egg. Maybe she isn’t the norm. I really hope not. But the more I speak to fellow sufferers the more I hear these stories. And if it’s not GPs it’s midwives, or health visitors, or A&E staff or even staff in psych wards! These people are the frontline when it comes to perinatal illness and several appear to be decidedly lacking in both expertise and basic human empathy. It takes everything you have to ask for help and if you take that step and it isn’t forthcoming, or worse, actually damaging, it can really stall recovery.
Outside of the medical professionals themselves there is the system as a whole. After my extraordinary appointment with Dr Fool I completed a form to gain access to NHS therapy. I handed this to the surgery receptionist and when I hadn’t heard anything several weeks later I called to check, they told me to call the third party who provide the therapy, who in turn informed me they had never received my information and referred me back to the surgery. On closer inspection my paperwork had never been submitted as I apparently didn’t complete an extra questionnaire (which I was never given and was never followed up). Forms were resubmitted and I waited again. Thankfully, I was seeing a PEWS-allocated therapist during this period to tie me over which, again, I don’t know how I would have coped without. Eventually I had to beg the provider for an individual therapist’s name and number and call directly to chase my application along and eventually I was given an appointment. That’s a lot of research and phone calls for someone still struggling with basic life function and I felt like giving up many times.
My therapist was fantastic, she helped me hugely. But after eight sessions I had to say goodbye. If I wanted more I’d have to reapply and go through the process and list again, and I’d be unlikely to be given any more time for six months to a year.
During my recent anxiety struggles I applied for NHS therapy again. I received a letter fairly swiftly to say I would be offered an appointment. That was almost five months ago and I’ve heard nothing. I see a private therapist who is brilliant but almost unaffordable.
The truth is there is some fantastic help and brilliant individuals out there but accessing that help can be terribly difficult – whether that be because of unhelpful gatekeepers, long waiting lists or simply living in the wrong postcode. This isn’t right, isn’t fair and can be downright dangerous. I don’t know the solution, I’m not a politician or an NHS budget-holder – I’m only a survivor. But I’m passionate and angry, and I have a inquisitive mind and a big mouth, so I plan to find out.