Money money money

A paper collage of an open mouth screaming

I know I’ve talked about cost before and I do understand the pressures placed on the NHS however this isn’t just about the actual finances but the attitudes towards money being spent on mental health care. Last year when the mental health trust that covers my area was considering putting in a crisis café I went to a consultation which was for service users, mental health professionals, third sector workers and generally anyone that might be interested or might consider bidding on to run the service.

Someone else attending the event worked out how much it would cost per person per night to attend a crisis café based on the figures from the model that the trust were basing it on and asked whether this was good value for money. This frustrated me for so many reasons one of them being why are we looking whether someone’s life is a cost effective use of funds and another was that the alternative to me is self harm and a&e.

It costs the NHS money to treat me – stitches and anaesthetic, dressings, bandages, Doctors and nurses time and psych liaison, if I get an ambulance to take me there because of blood loss or not feeling physically able to get there alone it costs the health service money and although I don’t know the exact figures (and I’m not sure I’d want to as it increases the guilt) but I’m sure it’s a lot more than the cost of attending a crisis café. I’ve seen people say that if you do it to yourself you shouldn’t expect the NHS to pay to fix it and while I can think of a few things I’d like to these people I also think once you start going down the route of denying people treatment if they’re responsible for the cause I think it’s a slippery slope towards finding blame for almost anything (didn’t notice your laces were undone sorry your fault, broke your leg skiing should have stayed at home).

Prevention is almost always better then cure and while I’m under no illusion that crisis cafés or any other crisis support would mean that no one went to a&e; I know it wouldn’t mean I never self harm but it would be an alternative. There’s a lot of talk at the moment especially with an election coming up about mental health and in particular the mental health of young people. I volunteer on a youth mental health project and highly encourage mental health education and advice in schools but it doesn’t help the adults or children already experiencing mental health difficulties, it looks good on paper and even a liberal cynic like me can almost believe that’s not the only motive but it’s almost as if they want to write off those already in need of help and start again.

If we want people to thrive rather than just survive there needs to be more support, more money and more collaboration between the NHS and the third sector (actually collaboration not just expecting the third sector to pick up the pieces), the crisis concordat I’m part of has been cancelled twice in a row, it only meets every three months and the last one was in October there now won’t be another one until August. People with mental health problems deserve better and deserve more, too many people are left with nothing or sent home from a&e at 3 am with no way to get home, at this rate we cannot survive let alone thrive.

Surviving or thriving? (Another awareness week)

A mental health awareness week promotional image by the mental health foundation

Is there anyone who isn’t aware of mental health problems? Survive or thrive? Sink or swim?
Much like my life and my mental health the way I approach these awareness days/ weeks/ months are how I feel about can vary. This is partly down to whether I’m representing the organisation I volunteer for or another mental health group or whether I’m just representing myself. Having started this blog at the beginning of the year having awareness events can be a prompt to write and I always try to be genuine, I want to present the reality – my reality of having a mind that is often not mentally healthy but the reality is it’s often not very interesting.

I often feel like contradiction and the idea of survive or thrive fits that nicely because I can be one or the other or both, although I want to be seen for the things I do at mind or with mental health awareness rather than the things I do to myself I also want to fight the illusion that I create. The term high functioning is thrown around a lot in various communities whether it be neurodiversity, learning disability or mental health it’s meant to be a compliment yet I’d happily drop the term into the nearest active volcano; I’m a (mostly) high functioning borderline I volunteer, I live alone, I’m in a relationship and while none of these are bad things they tend to be used to overlook the other side of things and the part the wants to sabotage all this because the more you do the less help you get.

Black and white thinking is something frequently mentioned with BPD but it’s not as simple as they make out my thinking can be very black and white in specific areas but in others I can see in technicolour. There’s a lot of mental push and pull especially when it comes to “recovery” I’m not a fan of the recovery model some days I want to move on from all this and thrive others I miss and crave the self destruction some days I go round in circles between the two and it’s times like this that being high functioning and self aware is actually painful because I can see what I’m doing to myself and others but there is no pull in the world strong enough to stop me from self destruction that can override the self hate and self sabotage.

I found myself arguing with someone the other day trying to break this myth that I’m high functioning and can manage without support that I’m ok that they only see one side of and it’s not the side that gets kicked out of a&e at 3am or that feels like the internal rage could burn up the entire world if it was fully released. So many things are subjective and thriving is one of them, as much as I welcome the idea of mental health awareness I’d like an awareness of the lack of services of the people who turn up to an appointment to find their care coordinator has left, of the people who feel that they’ve been chucked onto the mental health scrapheap because they’re not recovered and the high functioning people who are really just treading water and desperate to keep their head above water.

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