The cost of not listening

By Christine Gatt

The second week of October was Mental Health Week, a small frenzy of activity I watched with interest. I have been following the debates around NHS funding and waiting lists for mental health treatment. I’m fascinated by the continued discrimination and misunderstanding of the illnesses which fall under this umbrella. It’s not that mental health illnesses are easy to understand, far from it. More that they are so often neglected, or ignored. The term mental health implies something wrong, a disease to go back to the roots of our medical lexicon. The wellbeing of our minds and emotions is neglected and ignored until – until what? Until a very obvious, tangible, physical manifestation of the discomfort, the dis-ease is made evident. This could be anything, from heart problems, to alcoholism, self-harm, bipolar, and even suicide.

Yet, whilst I would never suggest that these illnesses are all in the mind or can be fully resolved by a quick chinwag over a good cuppa, the neglect to treat an illness until it has manifest itself physically is harmful. Not only for the person suffering, but the health service as a whole.

I write this from the inpatient ward of an eating disorders unit. My body is physically compromised, because I haven’t been looking after it. My fault, I know. I wonder if things could have been different. I don’t mean if I should never have started a diet, or never considered running, or never had low self esteem. None of those things. Instead I mean, what if I had got help when I asked for it the first time?

Eight years ago, I went to see my doctor with concerns about my preoccupation with food and desire to lose weight. He referred me to the local Eating Disorder Unit. I was 19, had just started university, and my weight was on the border of anorexia/underweight. I was told by the ‘specialist’ assessing me that she saw girls far skinnier than me all the time, I didn’t have much of a problem and that ‘no one actually wants to be fat anyway.’

Three months later I ran to the doctor and requested hayfever tablets. ‘Yes, whatever, have some antihistamine.’ She said. ‘We have more pressing concerns.’ I raised my eyebrows. ‘You are emaciated.’ She said.

I had lost a lot of weight, and was now around 18 kilos below the recommended minimum for my height. I needed help earlier, but to get help I needed to physically demonstrate it.

The problem is, once you have hit such a low level, it’s hard to recover. I have got better, and worse, and better, and worse. Years later, some ups and downs, I am worse than ever. And despite promises for ‘parity of esteem’ between provision for mental and physical health services, the treatment and service from the NHS hasn’t improved either.

Ending up in this ward was also not something I anticipated (do we ever?), when I visited the service four months ago asking for psychological support.

‘You don’t really eat all this.’ I was told. I panicked. I lost weight. I am now, despite having been holding down a highly paid job, having an active social life, being a fun and dutiful daughter, studying a qualification, organising events, regularly practicing yoga, working as a freelance journalist, and numerous other things that make up a 27 year old female’s life in London, in a mental institution. If I had not agreed to come in to this ward voluntarily, I could have been forced to under the Mental Health Act. ‘Sectioned’ in laymen’s terms. To anyone who knows me outside, that concept is ludicrous.

I’m not blaming anyone for my eating disorder. Whether it is genes, pressures, society, upbringing, social influences, miswiring, or even my choice, it is a fact. But I think about the cost of it. Not only the cost of lost friendships, broken relationships, betrayed loves, parental heartbreak, sibling worry, missed opportunities, but the monetary. How much would six weeks talking to a therapist have cost, compared to this last eight years? Eight years of outpatient, day patient, in patient, CBT, art therapy, body image work, music therapy, group therapy, dieticians, ECGs, dexa scans, psychiatry (looking at this list the main question that comes to mind is why can’t I just eat a f***ing cheese sandwich, but there you go). Health secretary Jeremy Hunt believes that £100 million is lost every year treating physical illnesses or severe mental illnesses that could have been dealt with far earlier on. Perhaps I should be grateful even now – one in three with mental health problems do not get any help at all.

Why wouldn’t they just give me someone to talk to? Is that too much to ask?