Open Letter to Minister Michelle O’Neill on NI’s poor treatment of mental health…

Megan Haste suffers from anxiety and depression. She shares her own experience of issues a sincere challenge to the new Health Minister to take mental health out of the third division status it currently enjoys in Northern Ireland

I am a daughter, a sister, an auntie, and a friend. I am 19 years old, and for 6 years I have been living with mental illness. This year, just before my birthday, I started seeing a cognitive behavioural therapist.

She is the first therapist that I’ve clicked with, and my mental health has finally started to improve significantly.

For 6 years, I have been unable to take advantage of support offered by charities due to the fact that travelling to Belfast from Moira in a crisis is impractical at best, impossible at worst.

Trains trigger a feeling of dread in the pit of my stomach, strangers make my head spin, and if you stand me in front of a room full of people to speak, my voice will shake just as much as my hands.

There are days when I can’t find the energy or motivation to leave my bedroom, and sometimes I deactivate my social media accounts because the idea of interaction with anyone makes me feel nauseous.

This is the life I live. I am living with anxiety and depression.

I am a survivor of suicide attempts, and my left arm and thighs are home to permanent reminders of my time as a self-harmer. I was a patient in Northern Ireland’s only child and adolescent psychiatric inpatient unit for a grand total of 27 days at the age of 16. I have been a victim of relentless bullying in school due to my self harm.

Yet my most impressive feat is probably surviving CAMHS (Child and Adolescent Mental Health Services).

A week before my 17th birthday I was told by a “professional” that I really ought to be “growing out” of self-harm; and despite the fact that Christmas is evidently the worst time of year for my personal mental health, it was around that time that my therapist decided to see me only once every three months despite my illness showing little to no improvement.

After three of my then quarterly appointments, I discharged myself from CAMHS due to the fact that it was a waste of my time and NHS funding.

Today I am standing up and speaking out. I am sick of seeing people burying their heads in the sand over youth mental health. There are hundreds of young people out there with stories just like mine, and hundreds more with stories worse than mine. The services available to us are simply under-resourced and therapists are all too often ill-suited to their jobs.

Every time a young person’s suicide is publicised, politicians stand up and remark on how sad it is. They then promptly return to arguing amongst themselves about comparatively petty issues.

In fact, last year I watched politicians’ reactions to a suicide, and those on the same side of the political divide of the young person spoke out in sympathy for the family. Those on the opposite side of the divide stayed silent.

Mental health is not a green and orange issue. It is a serious topic and should not be put on the back burner in favour of sectarian mud slinging. Mental health is everybody’s business. We all know someone who has experienced depression, anxiety, etc., and a lot of us have experienced it personally, so it’s about time we all started to give it the attention it deserves.

Following the recent election and appointment of ministerial roles, I have a challenge for our new Minister of Health. Work with young adults to shape a service that is better than barely adequate.

You may be surprised by some of our suggestions, but they come from experience. We know what does and doesn’t work, whereas for the time being, decisions seem to be being made on speculation alone, not to mention an apparently wilfull ignorance of evidence.

Hear us out. Work with us. I, and many like me, simply want to ensure that no child has to endure the same hell that we have. What do you say, Michelle O’Neill?

There are plenty of us running around trying to move mountains, and you’ve probably never heard of us. Isn’t it time we started working together?

You can follow Megan’s other writing at her own website at meganhaste.co.uk.

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  • Lee

    Very good article Megan and I hope you start to get the service you need. I think you are spot in aiming your communications at politicians in the first instance, I always try to take in a societal view of mental health issues as well as individual, a joined up view is needed.
    For me mental health is intrinsically linked to whats going on in the rest of society. When high levels of deprivation are evident, mental health issues excarbated by drugs and alcohol issues, are high. NI has a particular problem with troubles ‘legacy’, the amount of traumatised individuals now in their 40s, 50s, 60’s is through the roof. It is not a legacy the troubles are still going on, especially in West and North Belfast, Foyle, Craigavon. Youngsters under threat or having been beaten are presenting to MH services who can do little about these wider societal problems. On Nolan it was said the presentation rate with self-harm to A&E in Derry was 80% higher than Manchester. MH services can’t sort out society ills-this needs a concerted joined up effort from politicians and different agencies but it is easy for politicians especially those who were involved in the troubles to label it it just mental health issues and nothing else.

  • Granni Trixie

    Your article shows you are very insightful about the bigger picture and also how professionals in the system can makes things worse…..or better. Your own story in itself is very educational about the debilitating impact of lack of mental well being – here’s hoping your improvement with help of CBT continues.

  • chrisjones2

    My own experience with a family member mirrors yours in a way but was about 12 years ago.

    He was referred into the system and offered an appointment that he didnt attend . He didn’t attend because he was ill and reluctant to engage. He was simply then taken off the list. It as simple demand management

    Good luck but I hold out little hope. The system is so mismanaged that the money will go to propping up votes somewhere

  • Hi Chris! I’m sorry to hear you had a similar experience. It is appalling how the mental health system is currently managed. You’d think they hadn’t studied mental health sometimes, because surely if they had they’d know that self isolation is one of the things that can occur.

    I don’t blame you for not holding out much hope, however I would really appreciate it if you could back the cause anyway. The only way we’ll stand a chance is with a huge amount of voices calling for change.

  • Thank you Trixie! I’m hopeful that things will continue to improve, I really am lucky to have such a fantastic therapist. Everyone such have access to a therapist that’s right for them!

  • I think you’re absolutely right regarding societal links Lee. It’s a tough one, because you need to make a decision about what you want to tackle first. For me I’ve decided to tackle mental health first because in my personal experience my mental illness wasn’t caused by environmental factors, and I’d also like for there to be adequate support for people currently suffering from mental illness regardless of the cause.
    In the meantime I’m engaging in discussions with Jeffrey Donaldson MP in an attempt to get mental health on the curriculum, as well as to get a localised support service established in Lagan Valley.
    Various other projects are in motion to bring about change, but they’re currently being kept under wraps. I am hopeful that we’ll see an improvement sooner rather than later!

  • chrisjones2

    They are just totally underfunded because few politicians want to engage especially when its young people as they simply dont vote

  • Agreed! However as a young person (who does vote!) I think the best way to get young people to vote is by giving them a reason that isn’t “to keep themmuns out!” 🙂

  • Lee

    That sounds excellent very impressive

  • Cosmo

    Dear Megan
    I agree with your observation that NI mental health treatment is currently in the 3rd division. can you pls expand on what you meant by “therapists are too often ill- suited to their jobs”. I have my own theories, but would very much like to hear your experience. Thank you, in advance.

  • Granni Trixie

    WAS/is there not a cross party committee examining mental health issues?

  • Irwin Armstrong

    There are many things wrong in Northern Ireland and in the main they are have been down to the DUP and SF being unable to lead their supporters away from the past. They continually pandered to the extremes in Northern Ireland and ignored those most in need, preferring to blame others for their failures.

    Maybe now they are in a two party executive they will tackle the big issues and get away from the narrow green orange debate.

    The first thing they should set out a policy leading to integrated education. It will mean the closure of some schools and the loss of teachers, but it will not only help to integrate our society but also to free up funding for a better education and other sectors.

    A second is rationalising healthcare not by looking at the current provision but by what is needed. We are wasting money and providing a service that is not what we need by having too many hospitals and not enough specialisation. Again this could free up funding for services that are under provided.

    What I am really saying is that mental healthcare cannot be looked at in isolation as many parts of the health service are also underfunded. We need to look at the whole NI budget and decide what our priorities really are and what we need to eliminate to provide funding for all of them.

    So get the program for government, look at it and tell the executive what you really want.

  • Certainly Cosmo! In my experience, I’ve come across therapists who seem to think they know all of the answers because they’ve got a qualification – which of course isn’t the case, because each person is different, and I believe that nobody is ever a perfect textbook case. In those cases the therapist has done an awful lot of the talking. Part of my illness is that I zone out very quickly if I’m not fully engaged in discussion – so the therapist doing all of the talking just wasn’t helpful.
    Then there’s the situation I mentioned in the letter, when I was told I ought to be “growing out” of self harm the week before my 17th birthday. It goes without saying that self harm is not an age-related habit / addiction / coping mechanism.
    I’ve also been mocked for my body language by a therapist in the past. I often sit with my arms crossed, which is widely viewed to be a sign of being “closed off” or unwilling to engage – the truth is, I generally sit like that because it’s comfortable for me. What can I say – I have poor posture! 🙂

    Hope that helps!

  • Quite possibly Trixie, though I can’t say for sure! If such a committee exists, I’d be keen to engage with them!

  • Granni Trixie

    Megan – you call on experiences which perfectly illustrate what I referred to (above) as individuals within a system of provision who do their job inadequately. Most particularly looks like the root cause is lack of personal skills such as sensitivity,empathy and learning on the job skills . Or could be they started off with what was needed but adapted to a professional culture not conducive to nourishing them. Or again the system has ground them down.
    I remember being puzzled myself when I queried from a friend,who was such a professional, about how a doctor had not recognised that another friend was gong to kill himself. He had seen this specialist the day before his suicide and my doctor friend said it was impossible – if someone’s going to do it they do it. Sounded to me like the received professional wisdom is that doctors can do nothing to prevent suicide of their patients. Yes, people are individualistic In their behaviour but in a commonsense way I wanted to know if nothing is learnt from patterns of behaviour which would alert a doctor to imminent suicide?

  • Cosmo

    GT, you cover a lot of ground here. including depicting a professional culture, which maybe does not recruit people with developed Ei ( emotional intelligence), or a pernicious culture which grinds this out of the staff – or perhaps both. I have to say that many psychologists I have met seem somehow lacking in personal empathy, imagination and feeling, and seem trained towards providing chemical ‘solutions’. But perhaps a form of professional detachment is one way to cope with a succession of problem ‘cases’.

  • When it comes to doctors not recognising signs that a patient may be about to commit suicide…well, that’s a difficult one. Some people just don’t show signs. For example, having taken my first overdose at the age of 13, by the time doctors were aware of what was going on, I was very good at hiding it.

    Sometimes people make it clear by saying things that could be seen as a cry for help, other times they maybe seem a little lower than usual. It’s hard to differentiate between “lower than usual” and “dangerously low” sometimes. We all have bad days, and with mental illness those bad days can be more extreme than people without mental illness, but it doesn’t mean we’re about to attempt suicide. Does that make sense?

    I’m very sorry for your loss.

  • Lynn Bodkin

    You need to get in touch with Paul Greer (if you haven’t already) He is one of us and is doing lots of brilliant campaigning and getting results (albeit slowly). Put your name forward to be the NI mental health champion.
    Sorry for the rushed note, I’m just off out but I wanted to applaud you, hug you and say GOOD FOR YOU! You are such an inspiration at so young an age. You are a survivor.
    I’ll write you my experiences of being in ‘the system’ both here and in England.

  • I think you’ve hit the nail on the head there Cosmo. As a blogger who talks about mental illness day in, day out, I myself have to detach from what I’m writing about. The emotion is still there, but even when dealing with a particularly emotionally charged guest piece, the only way I can do it is by putting an emotional barrier in place and being very matter-of-fact about the whole thing.

    Thankfully everyone I communicate with on the blog understands the need for this, but it does lead me to have sympathy for professionals who don’t always receive the same level of understanding when they have to put emotional barriers in place.

  • Thank you Lynn! I really appreciate that and will look into making contact with Paul and make enquiries with regards the NI Mental Health Champion!
    Please do get in touch with your experiences! I’ve never encountered the English mental health system despite the fact that I’m originally from Birmingham, and I’d be very interested to know how it shapes up in comparison to NI.

  • Katyusha

    Very much my view on the matter also. I think, within the medical / psychiatric community, there has been a tendency to try and approach mental illness in a manner directly comparable to physical illness.
    This leads therapists to treat everything “according to the textbook”, and maybe believe that there is a textbook solution to every problem. They get caught up in jargon rather than trying to understand what the person in front of them is going through.
    The fact that you were told that you should be “growing out” of self-harm, as well as being quite repulsive from my point of view, kind of illustrates this problem, in that your therapist probably saw you as a seventeen year old girl rather than as Megan Haste. Perhaps his/her textbook had a little box with statistics showing self-harm falling in aduthood, rather than asking themselves “Why does Megan self-harm? What are the underlying issues in her life that need to be resolved?” I imagine those words were extremely hurtful at the time, and the therapist did not understand the effect that his/her words may have on their patient.
    Having someone who is actually prepared to listen to you and able to show genuine empathy and concern is infinitely more valuable. An academic qualification in psychology does not confer on you the ability to listen to and empathise with other people.
    May I also say here that, while mental health provision in NI is pretty terrible, the increased public awareness around mental health in Ireland is encouraging. I’m living in Germany at the moment and it seems to be very much absent, and possibly carry a greater stigma. If in Ireland we can foster a culture where we can discuss these issues openly and foster understanding of mental illness within the public at large, it would be a great victory in my view.
    We are not perfect or flawless human beings, but our society asks us to wear a mask and pretend that everything is okay. There is no need for us to delude ourselves and blind us from the troubles that people are facing day-in-day-out. We need a society that recognises and understands and accepts our vulnerabilities.

  • Cosmo

    As someone who is a lot older than you; it seemed to me that to be a so-called functioning adult one is forced to develop detachment/hopefully more objectivity, and various blinkers and tunnel vision, to just do things, and protect oneself from the overwhelming wongs and the outrages and sadness of this world.
    But, we should never forget one’s early often painful/certainly strong responses in childhood to things – as they are a potent resource for the dulled adult to tap into, for creativity, realism, authenticity, morality and perhaps what makes your life meaningful. As Wordsworth…
    …..”Those shadowy recollections
    Which, be they what they may,
    Are yet the fountain-light of all our day,
    Are yet a master-light of all our seeing:”….

  • I absolutely agree Katyusha! One of the things I’m doing in an attempt to develop a better society is fighting for mental health to be on the curriculum. It’ll take a long time for us to see the dramatic effect, so long that it’ll probably not seem so dramatic to future generations, but once we’ve got a society of people who were educated on mental health in school, I’m sure we’ll see an awful lot less stigma and lots more understanding, and possibly less money being spent on adult mental health services as people will have been given tools with which to cope from an early age.
    Hopefully we’ll also have more truly empathic therapists as a result, too. I’m a firm believer that the best therapists are those who have experienced mental illness for themselves. I know that always makes me trust my therapists more, and I wind up having a lot more respect for them, not to mention being more open with them.

  • Certainly, I’m all for looking back at my past experiences and acknowledging that they were painful, and that there’s still some residual pain remaining from those experiences. I can only speak from my own experience as a blogger, and if I were to leave all defences down in my work, I would spiral again quickly. It’s a difficult one to describe / explain, and also a difficult technique to learn. I can see how it would become easy to leave those emotional barriers up, but I’m certain that if I did, my ability to empathise with my readers / contributors would diminish. So it’s a case of slipping in and out of my working frame of mind, which is exhausting and does take me dangerously close to burnout at times, but it also allows me to do the work in the first place.

  • SeaanUiNeill

    Megan, my own training as an analyst was in Jungian therapy, but with a man who had worked (and even lived) with R.D. Laing and had gone on to train with that insightful critic of many of the reductive modern approaches, James Hillman, with whom I had the good fortune to take workshops also:

    https://en.wikipedia.org/wiki/James_Hillman

    With such a raft of anti-establishment psychological thinking in my background I’m entirely there with you in criticising the absence of empathy and “everything by the textbook” (usually ticking off check lists, mentally, but even physically at times!) mindset of those who simply see what they are doing as a job. I entirely agree that no-one who has failed to experience something of the stresses and suffering of these problems in themselves can seemingly ever even begin to cross over to an entirely empathetic approach. I can only wish you all the good fortune that can occur in your efforts to work through our local system!

  • I too have the same experiences Megan. I have suffered with depression anxiety for 10+ years although antidepressants never worked for me. They made me worse. I then discovered it was more than depression and anxiety and found I meet every symptom required for Borderline Personality Disorder. I have medication for that now though my mental health team doesn’t even understand my illness and they aren’t qualified in the slightest to treat this personality disorder. They give you tabs and tell you to come back in a month.

    So you suffer month in month out without any sort of understanding of what your going through and your left on your own to fester with your problems. I am currently waiting for MBT treatment to help with this although I have been told DBT is what I should be offered. But the northern health and social care trust doesn’t offer DBT as a treatment when other trusts in NI do. I was told by a practitioner after he assessed me I ticked all the boxes for this illness and still no one has diagnosed me and I just have to live with the suffering without any justification or answers to my problems.

    I completely agree with your letter and I believe this country is way beyond miles behind in terms of treatments and basic understanding of mental health conditions. I am with you. Check out my new website currently a bit light on content but in the middle of building – http://thebpdpatient.com

    Thanks.
    Aaron.

  • Lynn Bodkin

    Hi again Megan,
    I’ve been in the system for about 30 years now, mainly in England and I can honestly say that hardly anything has changed. I suppose people are talking about their own mental health issues more openly now but treatment and social acceptance has still a long way to come.
    I suppose my turning point was when I was ‘sectioned’ at a hospital in Oxford. During my admittance, the nurse asked me if I took any recreational drugs. When I said ‘no’ and jokingly added ‘I wouldn’t even know where to get them!’ the nurse looked at me and said, in total seriousness ‘You’ll soon find out here!’….I knew then that I was in the wrong place. I was on suicide watch and not allowed to lock my door. I heard various screaming and sounds of distress all night and every night, so I hid myself away in my room as much as possible. We had to queue up for meds morning and night and could only go out with supervision. I hated it. I hated every single 28 days I spent in that horrid, horrid place and have vowed never to let myself get to the state of being admitted again. It’s a constant fight and since coming here 3 years ago I’ve had to fight professionals and battle my anxiety and depression even more. My GP here didn’t even bother reading my notes when I went to him pleading for help….told me I was wound up! (I later put in a formal complaint about him) I’m on my 3rd CPN, have been told I’m not well enough for CBT and because I’m not a teen, perinatal, abused past and present etc etc I’m not in any category that is ‘trendy’ to focus on. If I hide myself away, nobody comes looking. I’m tired of speaking out and defending mental health issues. The last straw for me was at the recent Mental Health summit where Simon Hamilton came to talk. I learned that he’d been booked for months and tried to cancel at the last minute. When the FM and DFM ‘persuaded’ him to attend, he came along, said his piece, and left pdq!
    I am not ashamed of my illness. Why should I be? It’s not something I can control any more than people with diabetes, cancer etc etc. I am not ashamed that I am on antidepressants and other medication because it saves my life. It really does. Depression is a chemical imbalance in the brain, not a ‘state of mind’ or ‘feeling sorry for yourself’ or any other belittling expression. It is a medical condition that can be life threatening.
    As for the English/NI comparison, I think the NHS in general is on its knees over here compared to England and I really don’t see it improving, despite what the politicians are saying.

  • Granni Trixie

    Thanks to you too “BDP Patient” who like Megan is bringing home how ongoing bad mental health impacts. It is so unfortunate too that you each seem to feel that professional help and knowledge is letting you down. I hope that taking action as in starting up a blog proved to be empowering.

  • Oh gosh Lynn that sounds exhausting! We absolutely need to create change, and your story just emphasises that.

    Also, with regards to Paul Greer, I’m having trouble finding contact details, could you drop me an email please? meganhaste@hotmail.com

    The more of us that work together, the more chance there is that we can effect change.

    I’ve also realised NI doesn’t currently have a mental health champion when I went to look into it, and will be raising that with MLAs via email tomorrow. Here’s hoping for a response!

  • Yes I have created a YouTube channel also and I will be uploading videos to create awareness and educate on mental health. I can tell you there is hundreds and hundreds of us that think the same way in regards to our mental health services (or lack of) but many will not speak out or speak up about these problems because of stigma and because most have no hope in these services so as to say they would be wasting their time and energy. It’s certainly empowering alright! But It is important for the future generations that mental health is understood and most importantly talked about openly. I hope to change that with my videos and website just like Megan.

  • I think textbooks have their place, and it’s not in treatment of individual patients. Once again, it’s going to be a tough one to change, but it’s a change I’ll fight for!

  • Hi Aaron!

    I’ve bookmarked your website and will be watching it grow. It’s fantastic to watch “normal people” grow and work to change attitudes. Thank you for joining the fight for change. Hats off to you with the YouTube channel – video and I don’t mix, hence me sticking to writing! 🙂

    Please stay in touch – I’ve said it a thousand times and I’ll say it again, the more of us banding together fighting for the same thing, the more chance we have of effecting change!

  • Lee

    I think that in the main it is not the frontline staff’s fault, though bad professionalism and practice should be called out. They are chronically under resourced for a profession where demand in a very troubled society is just growing and growing. For years now of austerity cuts they are spinning plates and firefighting most of the time, from what I can see, and the chance for real quality work is a luxuary they would love to have but are drowning in a sea of paperwork, a fearful blame culture, little guidance or support, targets and statistics, sometimes physically and verbally abusive patients, and waiting lists that are out the door and round the block. A bit like our police service as well, same as our A+E nurses, and even housing executive staff. The public seem to be sympathetic towards overworked A&E staff trying their best in gruelling fashion, but not mental health staff. I think the majority of staff try their best but are just reduced down by the system to just keeping a lid on the volume and complexity of work as best they can.
    I remember Will Self on Question Time saying that he had many friends working in the mental health system who are on the verge of mental breakdowns themselves.
    From ones I know whove had different sorts of mental health issues over the years, results have been patchy but overall seem to have largely helped, one or 2 bad experiences aside (though with only hearing one side of the story). We hear about the tragic suicides but what of the people whose lives have been saved? It’s hard to quantify. I’m always a bit wary of labelling staff as wholly incompetent or whatever, I think it may be a negative thing to do at times, as it then ignores the massive societal problems in NI and allows politicians and chief executives – those who should be planning services properly and allocating sufficient funding to do so, off the hook. It is the oldest power divide and rule trick in the book. And that is not to say bad practice should not be called out. But as Megan says, it is Michelle O’Neill and our executive who need to be forced to allocate resources and come up with sustainable strategy, and held to proper scrutiny imo in the first instance. Once the quality and health of the NI government improves, then so does the overall mental health of the population.

  • Oh absolutely, when I was in hospital the staff were doing their absolute best. Unfortunately the money apparently isn’t there for specialist units in NI, because whilst I was in hospital there was a young girl who had to be flown to England for treatment for a severe eating disorder. Her parents live and work in NI – personally I think it’s appalling that any child should be separated from their parents in such a drastic fashion just so they have hope of recovery.

    It’s also when you get into stuff like that, that it becomes apparent just how broad a subject mental health is. It’s mildly overwhelming!

  • Lynn Bodkin

    Have just dropped you an email.
    My story is just one of hundreds of thousands and not horrific at all. I feel a fraud sometimes when I have this illness and not real trauma behind it but depression will hit anyone at any time, there’s no prejudice and it’s not something you can avoid by, say, eating healthy. I’m proud to be a survivor, it’s made me stronger, I actually like who I am now. I still struggle, I always will (as will anybody with mental health conditions) and nobody but a sufferer knows how hard it is to wake up every day and survive. Everyone has their own story to tell, some with some horrendous triggers, other’s, like me, with no trigger but EVERY story is a tale of struggle and survival and nobody has the right to belittle mental health illness…..walk a day in our shoes….

  • Cosmo

    Everyone, with feelings, can suffer from ‘compassion fatigue’.
    I find it quite shocking and certainly perplexing with our topsy-turvy values, that frontline ‘Caring’ in general as an activity – is so under-rated, low status and poorly paid.
    But even kindly and sensitive elderly relatives and friends I know, still remunerate their Carers with relative parsimony, in comparison to other services.
    Unfortunately, from what I’ve seen, I don’t think the leadership in the caring professions in NI, are much good at putting their cases effectively, factually and in context – having watched some of the Assembly Committee Meetings.

  • Thank you for your email, I enjoyed chatting with you! 🙂

    There doesn’t need to be trauma for mental illness to occur – if that was the case I’d be as much a fraud as you may feel! Like you say, it’s not something we control. We need to change attitudes so that people understand all of the points you’ve just made!

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