I’m still here. Still. – A personal journey in the Irish mental health services

So I’ve just informed my psychiatrist that over the Christmas period I was getting suicidal thoughts. She doesn’t even acknowledge it, just keeps writing on her chart as if I told her I was having pains in my arm or something. There’s no compassion or basic empathy, even forced empathy. She just looks down her chart and keeps asking the same questions I’ve been asked since I was 16: What was your appetite like?; Were you socializing much?; How are things at home? She then gives the question asking will I do anything to myself in the short-term, not because she cares, but because it’s required in case the health service later gets sued for malpractice. She then says she’s upping my medication, despite me telling her I wasn’t satisfied with it so far. The idea is more drugs help. More having to swallow a big fat capsule every night which is so horrible it makes me gag doing it. She tells me we’re done for now and she’ll see me in two weeks, and then goes off to photocopy my prescription. I was in there for 15 minutes. I spent more time in the waiting room than in the room talking about how I was feeling.

I leave and go outside to read a bit while my dad comes to collect me to bring me to college. The place is a small little HSE building in one of Cork’s suburbs. Hard to get to and not on a bus route. All the staff are cold and clearly have no interest in their job. Except for the odd young person clearly fresh out of college who’re visibly losing faith quickly in their hope of helping anyone seriously. In the waiting room, there’s a gold plaque celebrating the opening of the place by a Fianna Fáíl politician during the Celtic Tiger years. It’s my second time going there. Over a year ago, I attended a few psychiatry sessions which were the same type of box-ticking interview before I eventually decided not to waste my time going there. I only went back this time as my GP said it was necessary if I wanted to improve. Can’t say I was surprised, I’ve been in enough of these sessions to know what the protocol is.

I first went to counselling when I was 15. I went to a place ran by CAMHS – Child and Adolescent Mental Health Service – on the Western Road across from UCC. It was in a rented out old building where the budget was clearly being stretched. The staff were all friendly and very hard-working, but even still, they were forced to follow a script taught to them by the HSE. It was more about keeping the HSE safe rather than helping people with mental illness. After 2 years in and out of counselling and therapy I was in a tough spot because of my age. I was getting too old for counselling with CAMHS, and they were already stretched with demand, but I hadn’t turned 18 yet so I couldn’t use adult services. I was stuck between a rock and a hard place [It must be mentioned, minors that are “sectioned” are often placed into care in the adult services due to lack of beds in the appropriate facilities – Ed.]. Eventually, I got referred onto the psychology department in a city hospital, where I went through the same checklist interviews. I received my first diagnosis of clinical depression and anxiety. Apparently, I ticked enough of the boxes. I was started on medication for the first time, and had weekly counselling for 10 weeks. I was 17 at the time and just going into my Leaving Cert Year. After the 10 weeks of counselling ended, that was it. No follow-up, nothing. It wasn’t until my first year of college that I was referred onto somewhere again. Again, on the first day, the same predictable interview. No emotion is shown, no compassion, just the same automatic questioning and jotting down the answers.

Most of the counselling I’ve attended has only been for a fixed amount of time. Just when I start to get comfortable with someone, enough to really begin going in-depth into my mental well-being, they’re sent on a course with their college, or moved to a different health department. Then someone else comes in and it starts over again, with no conclusion. I never get the chance to talk about the actual issues I’m facing. Such as the guilt I feel that every time my parents leave for work I can see the dread in their faces that they’re going to come home and I’m after doing something. That’s not something that can go on any clipboard, that’s the human side of a deeply widespread issue. I only got home that day after my appointment to see that 8 people in Cork had taken their lives that week alone. There’s an obvious crisis, but the response to it is just cold. I’m in favour of treating mental illness as a medical issue, and I couldn’t care if I got a horrible person as a counsellor, if they helped my mental well-being. But the services just aren’t there. Throughout my entire time in the mental health industry (yes, industry), I’ve never met someone else who’s gone through the same thing. It’s a purely individualized treatment.

This is the personal side of mental health services in Ireland, but it’s reflective of a broken system. It reflects a state and a system that doesn’t cherish all the children of the nation equally. It’s the result of austerity and cutbacks to healthcare so bankers could be paid off. It’s the result of a system that puts profits and money ahead of social wellbeing. A system that puts the individual on the spotlight, taking away the strength that lies in our co-operating together, as we have done for thousands of years.

Graham