Addressing barriers to effective mental health care

What I felt compelled to write about is, what I personally perceive to be barriers to effective delivery of mental health care in more general environments.

My first ever profound encounter with someone experiencing mental health problems was when I worked in accident and emergency as a general nurse . It wasn’t uncommon to witness the admission of those who had self harmed or taken an overdose and I felt that the attitudes of those I worked with were very accepting, kind and empathetic towards these individuals. I was very happy to work alongside such a strong team that radiated kindness and compassion in such a dedicated manner.

The encounters with the individuals I cared for in this environment are very vivid.

The most vivid encounter was with a young lady whose arms were visibly scarred and badly maimed due to repeated attempts at cutting herself , a desperate outward expression of inner angst and perhaps self loathing.

We engaged in very deep conversation as I recall, she divulged personal details of a troubled past, highlighting periods of being bullied very badly at school. I am sure there are many people who identify with being bullied through life, whether at work or in school or other situations, and the resulting feelings of rejection, isolation and worthlessness that ensue.

From the outset, in many circumstances she could have been perceived as a prolific self harmer or someone ‘seeking attention’ as I feel some people enduring this condition are so easily mislabelled or stigmatised. I have read many articles on those who have felt misunderstood in relation to their self harm attempts, which has led to deep frustration and further psychological distress.

However the root of such behaviours is often very much misunderstood and dismissed so easily, as opposed to addressed effectively.

I don’t believe there is an easy solution to such a phenomena as ‘self harm’ but I do believe reduced stigma, clearer knowledge and broader understanding would elaborate a more stable connection between the person who has personal experience of self harm and those who are able to deliver elements of a therapeutic nature which could produce a positive therapeutic relationship and therefore a stepping stone towards recovery.

I often believe that in life, it is so easy to view people with prejudice or based on our own misconceptions, I believe that people are people, bubbles of human spirit, an entity of unique thoughts, feelings, beliefs, life experience that so often can determine the path that ensues.

I think people are a product of their past, roots associated with genetics, family upbringing, relationships with others, parents, siblings, childhood friendships, the turbulent teenage years where emotional development is constantly in transition towards adulthood and therefore what we experience enables thought processes that can become fixed and inflexible as we grow older.

Unfortunately, the negative experiences of life can so easily effect our relationship with others and most significantly with ourselves. If those around us mistreat us, it is often difficult to accept that we are worthy of love and respect. If we are judged it compounds our inner frustrations and diminishes the feelings of being understood enhancing inner helplessness.

Often this feeling of inner helplessness is projected in very overt outward behaviour, symptomatic of inner roots of distress.

Such symptoms are reflected in self harm, not just physical forms of self harm, but other forms of self destructive behaviours, such as addiction; drugs and alcohol, gambling, shopping addiction, etc.

All forms of self harm, whether perceived or not, are a form of inner escapism, from roots that lie within.

This is my analogy of self harm in the form of addiction…..

It’s like planning a journey, let’s say from Edinburgh to London.

My destination is London, I am not that excited about driving through London because it is arduous and painful sitting in miles of traffic Jams. The M25 can be a very scary place, and tedious at the same time. And even though I really like being there and enjoy the pace, it can sometimes evoke opportunities and feelings I’d rather not face due to the swift pace of life, so it’s easier to prolong the journey and delay the journey as long as possible.

So in order to drive to London from Edinburgh and avoid all the hassle when I get there, I’ve decided I need some transient avoidance and excitement from the reality of a situation that is uncertain and complicated to face within.

I’ve decided to hire a car with a 3 litre engine for my journey and a bit of rapid acceleration. Adrenalin is also very addictive. I’ve decided to hire a nice Subaru Impreza Turbo for my journey., but I am not thinking too far ahead, I just enjoy living in the moment, it’s more fun. So I am not going to bother enhancing my car insurance, I’ll not worry about that.

So, I’ve started this journey and it is going really well, it is a real thrill tearing down the A1, possibly breaking the speed limit and knowing I am pushing myself to the limits, averting all types of responsibility., knowing I won’t get caught and currently there are no consequences.

Or so I think…..

The gyst of the story can continue as I want it too, but the excitement soons dries up, particularly after a few speeding tickets, points on the driving license, the quadrupled cost of fuel due to the poor judgement in choosing a car and an accident resulting in excess costs because the insurance wasn’t fully covered.

For such a thrill as the hypothetical set out above, there are many detrimental consequences.

Unfortunately every type of act of self harm or addiction is the same, it ends with detrimental consequences, a cost to ourselves, not just financial, but at a much deeper level, our own emotional and spiritual health, because we are always avoiding the very things we need to face without realising those things are not going to disappear, nomatter how much we try and escape and what methods we use to avoid them.

The destination of London still remains, but instead of a more simplistic chapter on arrival, it is filled with deeper complications and excess baggage I have bought with me as a consequence of a previous journey that I now have to carry with me on what could have been a chapter that was faced, dealt with, unpacked and resolved.

Is life really that simplistic?

Possibly not, but if we want to improve as people and not get sucked into behaviours that will deplete us emotionally, mentally and spiritually and allow us to grow as human beings in order to embrace the life we have ahead of us, facing up to life, is often the only option we have.

One of the wisest pieces of advice I ever heard was not to live a defeated life, not to become a victim of life’s circumstances, by living in self pity, doubt, fear or hurt. But by using pain to enable change and growth on a much deeper level. Developing new coping strategies to manage inner distress, without forming unhealthy ones, using pain a platform which would propel ourselves to a higher plain!

Staying in patterns of addiction, does not elicit change. It promotes a stale mate. It hinders emotional development., because it diverts emotional pain, which is actually an inner symptom of unaddressed/unmet need.

Numbing that pain with either self harm strategies, alcohol/drugs does not remove that pain, it merely anaesthetises that pain. There’s a big difference between the surgical procedure and the anaesthetic involved in that procedure. The surgery involves the extrapolation of the dysfunctional tissue/organ hindering growth, the actual anaesthetic is used to depress the nervous system and to block the pain. But if we never had the surgery and only the anaesthetic the dysfunctional tissue would still remain problematic only now we are unaware of it, which is even more of a critical position to be in than when we began.

Emotionally, spiritually, mentally we have an accountability to ourselves, to be responsible for our own emotional health and wellbeing, to allow our circumstances to propel us to ‘victory’ from a stance where previously we could not recognise our own need for help.

And victory in our lives comes from, addressing our inner angsts, raising our own self awareness, choosing to recognise our own inadequacies and imperfections, embrace change and growth in our lives and connect with those around us, those who are compassionate, warm, understanding , who incense us with peace and happiness and not aggravate our own feelings of self loathing or self defeat.

On a spiritual level, reaching out to a power beyond our own understanding, (a power motivated by the spirit of love and peace) as expressed in previous entries. when we choose to rid our lives of the negativity, addiction, anger, resentment, helplessness, by believing that only a power greater than ourselves could allow us this inner strength , than nothing is impossible and we can engage in a life much more meaningful and peaceful and deeper, than we ever knew was possible as that love and peace flows through our lives, as opposed to the toxic devastation we knew before.