The most important things are the hardest to say

“The most important things are the hardest to say. They are the things you get ashamed of, because words diminish them…

“And you may make revelations that cost you dearly only to have people look at you in a funny way, not understanding what you’ve said at all, or why you thought it was so important that you almost cried while you were saying it.

That’s the worst, I think. When the secret stays locked within not for want of a teller but for want of an understanding ear.”

― Stephen King, Different Seasons

Although Stephen King was talking about something else entirely, for me he could be describing perfectly the stigma that exists from having a mental illness.

The statistics tell us that one in four people will suffer from mental health problems at some stage of their life. However, despite the fact that mental health problems are relatively common, people experiencing them can often find themselves facing stigma and discrimination.

A recent study among service users conducted by St Patrick’s University Hospital showed that many people live with the distressing symptoms of mental ill-health for long periods without accessing mental health advice or treatment. This is due mainly to the stigma that surrounds mental health as well as lack of knowledge about mental health problems and sources of help.

Forty-one per cent of those surveyed had lived with their symptoms for at least one year before seeking help, while Forty-one per cent of people surveyed would not discuss their mental health problems with their employer.

It makes me sad that people feel the need to keep such a significant part of their lives a secret.

As Stephen King says, the most important things are the hardest to say, not because there is no one to tell but because there is a lack of an understanding ear.

-STIGMA-

So how do we address this stigma which is preventing so many people from seeking help from the mental health services? In my opinion, not only do we need to address the attitudes of society in general, but we need to overhaul the mental health service itself.

Although services are improving in many parts of the country, there is still a long way to go. A recent programme on RTE ‘Behind these walls,’ showed the harsh realities of being treated in a mental hospital in the past. For many people, little has changed.

Many people are still being treated in out-dated facilities, and this adds to society’s negative attitude towards those being treated for mental health problems.

Although various campaigns have attempted to address the stigma of mental health problems to me there is one fundamental flaw. Mental health is more than just mental illness or mental health problems so, we need to spend as much time emphasising how to stay well, as we focus on being sick.

-FUNDING-

This is exacerbated by the government’s failure to ring fence money for mental health services which is leading to an inadequate and underfunded service for the majority of people.

Ireland has the fifth highest youth suicide rate in Europe, with more people dying by suicide each year than on the road. Despite this only a fraction of the government’s budget is spent on suicide prevention.  In 2008, €45 million was spent on road safety and accident prevention measures. In the same period only one-tenth (€4.5 million) was spent on suicide prevention. It seems to me that the stigma of mental illness rises right to the top of society, to governmental level.

One reality of the lack of funding is that the mental health services are so busy dealing with people with crises, that they cannot always provide the essential services to help those people in recovery stay well.

-THE REALITY OF ACCESSING SERVICES-

In recent years there has been an effort to reduce the stigma of mental illness, and to encourage people to seek help. But what the powers-that-be neglect to mention is the actual reality of asking for help, which includes months of a waiting list to see a psychiatrist or counsellor.

Time is precious and every second that ticks away is another that the person has not received help. To be given a prescription and told to come back in a few months, is hardly ideal, but is the reality.

Instead of intervening early, things are left to build up, growing worse and worse until one day the person snaps. Everything at that moment in time is unbearable. It is then that they make the decision. It’s not that they want to die, they just need to escape from the horrible place that they’re in, it’s just too much.

Why is more not being done to prevent people from reaching this breaking point?

Take for example a friend of mine- He has suffered from depression for a while now, and recently made an appointment with his psychiatrist as he was going through a difficult time. He requested to be referred to his old counsellor to help support him through the rough patch and to prevent him from getting any worse. He thought he was being sensible and pro-active, taking care of things.

However, to his surprise he was told that he couldn’t be referred to the counsellor until things got worse, and was offered medication in the meantime.

I’m no health professional, but surely we should be helping people avoid relapsing and prolonging their wellness, instead of only offering them support when they reach rock bottom.

As a result my friend has been left disenchanted and confused by a mental health system that relies heavily on medication, with those who don’t want to take medication being left with very little options.

The HSE has been criticised for not implementing the ‘Vision for Change’ plan, which was introduced in 2006. It is now 2011, and it is definitely more vision than reality. Both the HSE and government have failed to act on its recommendations and Irish people are suffering as a result.

Every day that those recommendations are ignored another person dies. Enough is enough. The question is how many people have to experience difficulties or die from suicide before something is done to help them? This issue has to be addressed sooner rather than later before any more lives are lost.

-WHAT CAN YOU DO?-

I ask you now to take a few seconds and re-read the opening quotation from Stephen King. Imagine what its like to have such a burden on your shoulders.

We all need to take collective responsibility to tackling mental health stigma and can start by taking time to talk about mental health with the people around us.  Often the fact that it’s difficult to talk about mental health problems can be one of the hardest parts of having mental problems.

But it doesn’t have to be this way. Take some time to open up and start your conversation today.