Tuesday, 10 September 2013

We need to talk about Helen

As I type this blogpost there is an entire conference taking place in London with the sole purpose of saving my life ... yes, it's the How Can We Save Helen Harrop? conference and approximately 100 delegates there will be discussing how they can to apply the findings of a five year research project in order to prevent me from killing myself.

Of course I'm exaggerating for comedic effect, the conference hasn't been held purely to discuss how to save my life, there's a *slightly* wider remit than that ;-) But given that I currently find myself once again in the icy clutches of a suicidal crisis it does mean I have a very larger than average personal interest in what's going on there.

Over the past week I've watched as hundreds of tweets in my twitter stream shouted loudly about the fast approaching World Suicide Prevention Day - All full of very worthy sentiments and proclamations about 'tackling stigma' and 'getting people talking' and 'saving lives'. I don't have any problem with any of that sentiment but I do find myself doubtful about whether any of that admirable sentiment will lead to a reduction in the number of suicides.

I don't doubt that the stigma around suicide meant that I put off seeing my GP for months but the brutal truth is that for all the stigma-busting I've been doing by seeing my GP, seeing a therapist, and with the people I know in real life, through Bettakultcha presentations (not once, but twice), via a published book chapter, on twitter and here on my blog, I still find myself standing to all practical intents and purposes alone in my fight to save my own life. Yes I have wonderful friends, family and colleagues who all know what I'm going through but I don't think it's being unfair of me to suggest that for the most part they have no idea what to say or do in order to help me through my dark night.

Yesterday I went for a check-up with my GP and to update him on my rapidly declining mental health. We talked about the 18 month waiting list I'm facing before I can find out if CBT sessions will help me. I fought back tears as I explained with a violently shaking voice that asking for help and then being told I have to wait for more than a year was making me feel like my life wasn't that important. My GP was as patient and sympathetic as ever but in the face of my suffering he effectively shrugged his shoulders and admitted that there just wasn't any funding to help me. In retrospect the question I should have asked is 'What if money was no object? What would you be advising me to do then?' At least then my husband and I can make a pragmatic decision about what we do with our combined income this year ... pay off the mortgage or gamble it on expensive private therapy.

Actually I already have an idea of what that advice would be because my therapist gave me that advice earlier in the year - An intensive course of individual and group therapy involving Dialectical Behaviour techniques which would be centred around helping me recover the self which was forced into hiding during a childhood that appears to have left me suffering from complex post-traumatic stress/personality disorder symptoms. Price tag: £14,000 per year. [which coincidentally is approximately the same as my entire annual salary after tax]

Or maybe I could save up and take a chance on the Hoffman Process which looks like it would be helpful and claims to have helped 95,000 people worldwide to turn their lives around, including none other than Thandie Newton and Goldie. Price tag: approx £3,000

Or maybe I could start seeing my therapist again or start again with a new therapist. Price tag: approx £2,500 per year

And not forgetting the approx £100 a year for my current anti-melancholy prescription that I'll need to keep paying on top of whatever path I choose.

And maybe I'd gradually find that I'm well enough to work full time again and every single pound and every single hour I'd spent on therapy would have been totally worth it. Or maybe I'll just be another £10,000 poorer but at least I would still be alive, albeit still in utter anguish. Who knows? Spin the wheel and place your bets. Whatever way I play it the house will certainly win.

I'm sure the funding situation is worse, or better, or just different in other parts of the world and in other areas of the UK but I get the impression that services here in York are currently stretched to breaking. I made contact with the local Mind office last Friday to see what support and advice they might be able to offer and I'm yet to hear back from them [update, they phoned me yesterday afternoon]. I stumbled across the York Women's Counselling Service yesterday but it looks like they can't even add me (or anyone else) to a waiting list at the moment (and it looks like they haven't been able to since March). It takes an awful lot for me to ask for help but at the moment it feels like whenever I do it leads to a door with a solid brick wall behind it. It's making me wonder whether I'm looking in the wrong places or simply not using exactly the right words I need to use when I finally ask for help. Or maybe that's just my depression talking.

So today, on World Suicide Prevention Day, I feel like running through the streets of York shouting at the top of my lungs: "My name is Helen. I am Suicidal and I am Standing. Right. In. Front. Of. You!" 

But no, I won't do that, because I was raised to be as invisible and as silent as I possibly could be in order to try and stay out of harms way. So I will sit here and I will wait and I will try to my hardest to keep up hope while I continue to work as hard as I can at trying to save the only life I can. And all the while I will try to stave off the nagging fear that I am doomed to become a news headline on the front of our local paper: 'NHS Fails Tragic York Suicide Woman'


Hannah Goraya said...

Hi Helen,

Saw the post and was sorry to hear you're still struggling to get the support you need, I hadn't realised, sorry.

I asked my friend who is a Clinical Psychologist in the South West and she said this:

"Unfortunately your friend's situation is typical of people all over the UK and things seem to be getting worse despite the governments well meaning 'increased access to psychological therapies' scheme. I would be asking a few questions, is your friend waiting for CBT at the G.Ps (primary care), in which case could her and her partner have a conversation with the G.P about referral through to secondary care (the community mental health team). Even though therapy might not be more forthcoming your friend would at least have a care coordinator (a person who gets to know you really well and helps you plan your care- usually a nurse or social worker).

Your friend could also look up their local CMHT on the Internet and see if they take self referrals. I would expect that if your friend stressed her suicidal feelings (I hate to give this advice but make this bit really really clear) and her chronic low mood that she would meet the criteria for a CMHT. I think MIND is a great idea, and would also look around to see if there are other sources of support in the voluntary sector. In terms of treatment for personality disorder/low mood your friend is right that DBT is a very good option, this is available on the NHS but through secondary care (the CMHT).

There are self-help guides etc out there, the MIND website have the most comprehensive collection of information and self- help material I've seen. Your friend could get hold of the Dialectical Behaviour Therapy Skills Workbook (Matthew McKay) which is on amazon and introduces some of the principles she could try, but the relationship with a grounding, helpful care team is really important so I think pursuing this too might be a good idea.

The most important thing is to know that the lack of services is not a reflection of how important your friends life is, though that is exactly how it feels when you're banging your head off a wall. The key is to make very clear the risk she is in, and be familiar with what options should be available- the NICE guidelines (google NICE borderline personality disorder) are a good place to start with this,

Hope this is helpful, feel free to forward this if you want to."

I'm posting this publicly in case it's of use to anyone else but if you want to remove the comment, please do.

Good luck and keep an eye out for that cheese under the fridge*! x


* That's a hyperbole and a half joke in case that just confuses the crap out of this well meaning message.

Helen Harrop said...

Hi Hannah,

Thanks for asking for your friend's advice and for passing on what she says - it's all really helpful.

I have been referred to our CMHT (our area doesn't accept self-referrals) and tried ringing them once ... it went to an answerphone message telling me to contact another service if it was urgent (Samaritans, emergency GP or 111) and finished by asking me to please not leave a message! I should try again really but it takes a lot of energy to make the call and it was pretty crushing when I couldn't even leave a message but I need to get into the system so I'll try again when I feel up to it. :)

The difficult part is that on days when I have the energy to deal with getting help it feels like there's nothing wrong with me and I'd be making a fuss over nothing. And on the days when I need help I have almost no inclination to ask for it. I need to write a big reminder note for myself: "Even though you feel better today you are still unwell, get help you ninnymuggin!"

The DBT workbook sounds good - although I know that my executive functioning skills make it unlikely that I'd work through it well on my own.

I will keep on reaching for that sliver of dust-covered cheese with every fibre of my being though :)

Helen x