Anonymous I am once again in the mental health treatment sausage machine. Plucking up courage to approach a GP to admit defeat, being shoved on drugs to stop me topping myself, told that there’s a huge, long waiting list for treatment, the false hope of a “gateway worker” assessment followed by another interminable wait of undefined length. Then I know I will have my allocated batch of treatment before being deemed “fixed” and dispatched back to the world again. I am sick and tired of the roundabout. I suggested that instead of this system, once a mental health patient has had their allocation of therapy, they should remain on the books, so when they feel themselves slipping back down, they can call up for a booster session instead of having to go through the whole rigmarole again.
I’ve just quit my job of six years because, following a disclosure to my new boss that I have bipolar tendencies she proceeded to bully me into submission. She had absolutely no understanding of how to get the best out of (a very talented) employee who has mental health issues. I was stopped from working at home, an important aspect to being able to manage my condition. I had unreasonable targets imposed, with no support offered to go about achieving them. My job was chopped and changed, hours cut and autonomy removed. I have been pushed back to the brink of suicide and had to go on antidepressants to simply survive.
Anonymous From September 2015 until December 2016, while I waited for an NHS referral, I was so ill I didn’t know how to cope and resorted to self harming. These aren’t all of my scars, but they’re the ones no one ever sees; so it’s easy to think they’re not there. One year of my life, and I will have to be reminded of it forever.
Cat, 24, South Yorkshire People often mistake bipolar disorder as your mood rapidly changing from up to down. It’s not like that. That would be my other illness, borderline personality disorder (BPD) or as my psychiatrist put it, emotionally unstable personality disorder. It’s complicated telling people you have both bipolar disorder and BPD, as they both involve intense mood swings. Well, that’s when I do tell people – social anxiety sort of puts a brick wall between me and people. BPD makes your mood change within seconds and it is a strong mood swing. Like fire, it can destroy you and those around you. With bipolar, the mood swing sort of creeps up on you. It’s when the mood gets high (mania) or low (depression) that it becomes destructive.
Every day it feels like I must wear a mask, however, hiding never did me any good with these illnesses. It just becomes more of a shock to those around you when the symptoms start to leak through. Even as I write this, it’s hard to concentrate, thoughts and emotions are saying one thing, while that one bit of mind that tells you “everything will be ok”, is telling me to push on.
The rendition of a darker moment. A painting of a depression experience by Cat, South Yorkshire
I’ll admit when I’ve been at my lowest I’ve done things I’ve regretted. The overdose, which sent me into hospital, was one of the things. I know there’s a stigma around psychiatric hospitals, but I did meet people who it’s worked for. When I was admitted into hospital the first time, I had psychosis – a female voice was constantly screaming in pain in my head. I don’t even bother to count how many times a year I have to go through this. Medication helps keep me in some control, especially with the manic side. I prefer the manic side to the depression side. Mania brings with it the thought that you’re this amazing person, who can do anything, someone who deserves to be with people. The bad side of mania is that loss of control. Nights become sleepless and the thoughts running through your head won’t stop. Every time you try to grab one, it just slips through your fingers. Health and safety also goes out the window.
I managed to get through my art degree. I have to remind myself that I’m more than my diagnosis, but with the right help and support it does become a lot easier.
In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.
Naomi, Cambridge Depression comes from the mind and invades the mind. It’s like an unstoppable force. Were it not so evil, it would be impressive. It zaps the joy of sleep and relaxation. It causes aches and pains and exhaustion. And then it weighs this tired body and brain down with apathy and robs me of enthusiasm. And just when you get used to the apathy and accept that you will amount to nothing more than a TV-watching, Netflix-browsing, Candy Crush-playing robot, it hits you with panic.
The panic makes you crave company and someone to stabilise you and tell you that it’s fine. But only then do you realise the full extent of the invasion. It has conquered you and you didn’t even notice. There is no one. You’ve asked for help one time too many, you cried and broke down and scared them or bored them (or both) once too often. And they were kind so they let you do it again and again, but eventually they had to look after themselves and their own sanity and they backed away while you weren’t looking. And you’re left holding on by a thread to those that are left, but you can’t risk breaking that thread so you pull your lips into a smile and you weaken yourself further by pulling yourself into the shape of a sane person.
The second wave hits with self-loathing. It hits you with all your foibles and all your huge gaping faults. It opens your eyes and makes you understand in graphic detail why everyone hates you, why you’ve been alone for days, why you’ll always be alone, why friendship and companionship is something for other people. Not for you. The second wave leads to the third: regret. Regret after regret after regret. All the things you said and did wrong. All the misjudgments and missteps, all the failures.
And then the final blow: happiness is gone. Not just missing, but gone. There is only sadness and regret and panic. I can’t remember the last time I was happy and I can’t remember what happiness feels like. I know there were times, lots of times, when I was happy. I try to recall them, but I can never get a clear picture. Was it a night out? A country walk? A hand held? A roller coaster cresting a summit? I try to summon up these moments and the people I spent them with. It’s like looking at a stranger’s photos. No emotion comes to the surface. Depression is sadness for times gone and chances never taken. It is missed opportunities and a missed future. It’s missed friends. It invades and leaves you right on the edge of the cliff of sanity. And then the ridge gives way.
Sophie Adams, Cardiff, 42
Work from Sophie Adams’s Spring Back, Fall Forward. Photograph: Sophie Adams
I’ve experienced mental health difficulties – primarily depression – since my late teens. The piece I’ve submitted is part of Spring Back, Fall Forward, a multimedia art book. It represents one year in my life, a year lost to illness and isolation, when I rarely ventured beyond my bed; a bed whose bounds transcribed the bounds of my life, for a while at least.
A painting by Michelle Baharier.
Michelle Baharier, 52 I have complex depression and post-traumatic stress disorder with somatic symptoms. I make these images to try to stay well.
Anonymous I’ve experienced what I would now loosely term as “depression” since I was about 14. That’s the first time I remember having an extended period of feeling overwhelmed by my own mind, by a profound sadness I couldn’t explain to anyone. After a while, it just went away, as suddenly and inexplicably as I’d felt awful. And so it’s gone ever since.
That’s not to say I breeze through these bad spells. I’m only just out of one of the worst spells I’ve had in a long time; 12 days with little to no sleep, the same, very specific suicidal thoughts (specific because I’ve planned meticulously over the years what I feel is the optimal way to do it – the least harmful and hurtful to others) playing on a loop. It’s like being attacked by yourself. No one has access to your private repository of past disappointments and humiliations, and no one can twist them and filter them through skewed levels of self hatred like you can to yourself. My mind is so thick with the fog of “everything, but mostly me, is awful” that I can do stupendous acts of doublethink on myself. I called a friend one night totally deranged with all of this. It’s just horrible. All of it is horrible.
This innate self hatred, this will for death, is compounded by the guilt I feel burdening others with this. Everyone has their own stuff. I’m not unique. This thought, along with the fact that no one wants people they love and admire to think that they’re “crazy”, doesn’t really incline me to be open about it in the moment. Luckily for me I’ve got well informed, loving friends. I’m very fortunate to have them and my own way of dealing with this, it means that (so far) I’ve emerged from these spells relatively unscathed.
In terms of treatment – well, nothing has worked better for me than a process of learning to rationalise it, and exercise. Exercise is key. I’ve been on anti-depressants and found them unbelievably unhelpful – when it took the bad thoughts away it also robbed me of the capacity for joy, or any pleasant feelings. I’ve become very pragmatic about the whole thing; there is no secret trauma eating away at me, my life is good, it’s social, I have good friends, I like my job. I see it purely as a chemical deficiency, or an inability to regulate levels of serotonin.
In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.
Anonymous, 22 The first time I was depressed, I was 12 and I didn’t know I was ill. I didn’t even know what depression was. After a family feud and several years of being a victim of bullying, I didn’t want to live any more. I remember standing on my balcony, hands on the railing, and thinking: “Should I jump?” I thought that I was a coward, because I was afraid of dying more than I hated living. I began to self-harm, and my mental illness had the sting of a pair of scissors cutting into my skin.
I was 16 when I decided to lose weight, so the boys and the girls wouldn’t laugh any more, and perhaps, just perhaps, someone, one day, would even desire to touch me. Three years later, I was sitting on the toilet bleeding because I had taken too many laxatives, and my mental illness was as red as blood.
At 19, I gained all the weight back and along with it came anxiety and depression and the sense of failure. I had moved in London, away from my family, to study and build a new life. So why wasn’t I happy? Why had the balcony turned into a tube platform and I was wondering again: “Should I jump?”
I lost the weight again at 21, and by 22 things were OK (in a precarious, risky balance). I decided that I needed help before things got worse again. Now, once a week, I meet with a therapist, thanks to the NHS, and she asks me how my week was, and I am as honest as I can be.
Jessica Secmezsoy-Urquhart: ‘I will always have multiple conflicting sides to myself but I’ve found ways to bring them together more now.’ Photograph: Jessica Secmezsoy-Urquhart
This photo is called Alone Together, and represents the duality of my identity. I’m a recovered sufferer of an eating disorder, an abuse survivor and I was hospitalised twice before the age of 15 with depression caused by the social effects of Asperger syndrome. I have everything from attention deficit disorder to anxiety and I’m chronically ill with a connective tissue disease. And yet I’m mentally better than I’ve ever been and have found my place at university, but to get there I’ve been to many dark places.
I had two selves, like in this image – the real one that was disgusting, pathetic and deserved to be dead and mistreated, and one that others saw that was normal and good. I will always have multiple conflicting sides to myself, but I’ve found ways to bring them together more now. Recovery is possible. I’m proof.
Anonymous, 29 I have suffered with anorexia nervosa since I was 12 and have been in and out of several inpatient units. As an adult, having been a service user for the past seven years, I have seen a rapid decline in the quality of services available, not just for eating disorders, but across the whole of mental health.
NHS cuts have led to decreased beds being available for desperately ill patients, resulting in more strain on community services. Working hours and staff shortages have also put a huge strain on nurses in this field, resulting in reduced quality of patient care.
Treatment in all areas of the NHS, but particularly mental health, is being severely compromised. I am currently a patient at a hospital in south London, on the eating disorders unit. Staff shortages, lack of trained nurses and increasing demands on the few nurses on the ward, are seriously jeopardising patient care. In some cases patients are being left to deteriorate to such extremes that they have required nasogastric feeding to save their lives.
Suz Hemming, Aylesbury
Suz Hemming: ‘It took six years of my life just to get past the shape and size of the thing I have that keeps me alive – my body.’ Photograph: Suz Hemming
This photo is representative of my battle with mental illness, which I have lived with from a young age. I have borderline personality disorder, that frequently leaves me with this overwhelming sense of identity diffusion and a profound confusion and disparity between my image and my body; my thoughts and who I am. This photo creates a way of capturing who I might be in the one moment, because my rapid mood fluctuations and unstable sense of self often leave me with this idea of my life as a string of photos, disconnected from one another, with no narrative or person a its core. Its black-and-white presentation symbolises the black-and-white, all-or-nothing thinking style that is the cornerstone of my illness. It’s what keeps me stuck, what keeps me searching in the mirror for an answer to the question: “Can I be just one person, a whole, not fractured with flashbacks from my past?”
Also, being in stable recovery from anorexia, the photo asks what is it in a piece of glass that has so much power? Not just over me but over you too. It took six years of my life just to get past the shape and size of the thing I have that keeps me alive – my body. This photo asks me who and what is real. Is it me? Is it her? Is it her image? Or mine? And whether any of those things can be the same as each other – each a part of a bigger part, of a much bigger picture of my journey towards living a life in a “working recovery” from acute mental illness.
In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.
Anonymous Last night I had a dream about my eldest son who’s just turned 11. Because of my mental illness, I have not been able to speak to or see my three boys for eight months now. In the dream I’m hangin’ with my eldest, shooting the breeze as we’ve done many a time, but this time I notice a difference; his voice has broken, and with this realisation my heart broke, too.
This dream is analogous of all those golden moments of childhood I have missed in their lives, that can never be relived, moments that seem even more precious when it comes to my eldest, as he rapidly approaches adolescence. The dream also feels analogous of everything I’ve lost as a result of mental illness; my marriage, career, liberty (sectioned twice), self-respect and societal approval.
What really frightens me about my mental illness is the way it suddenly grabs me and leads me to do things that I, when feeling stable, just would never want to do. Like right now I love my boys and mum so much I cannot believe I’d want to never see them again and devastate them through taking my own life. Yet out of the corner of my eye, I can see the omnipresent scar on my left wrist that is a constant reminder of how my mental health can construct a vast distance between me and my values.
Anonymous, 21 I have bipolar disorder, a highly stigmatised diagnosis. One of the hardest things to deal with is knowing you’re hurting people around you. After taking an overdose, lying in A&E with someone who loves you and feeling the guilt and horror of what you’ve done. They’re scared that this time you might die, but the urge was so strong you couldn’t stop yourself from doing it. Even when you know you are loved, you still wish to die. I have an illness. I wrote this poem in art therapy.
Today you are possible of great things,
Things of beauty, of purpose and of wonder.
Your voice is of importance, your body is of splendour.
Today you are tasked with only being fair to yourself and your soul, and to be fair to yourself and your soul is to be kind.
Kindness is all that you deserve.
Today you are you, and that is a magical thing, no one else will ever be you.
You are strong, you are mesmerising, you are intelligent, you are divine.
Today you are loved, as you should be, and as you always will be.
Anonymous Go me: a poem about mental health, from a mother’s perspective
I am the world’s greatest mum
My teenage daughter is perfect
Good grades, no shouting, no drinking, no boys, no worries
I’m expert at giving lifts, coordinating activities, supporting vegetarianism, saying no to piercings, organising cultural excursions and understanding UCAS points
I’ve got this covered. Go me!
I am the world’s most understanding mum
I can support this exam stress
Distant, withdrawn, eating less, sleeping more, staying in
I am an expert at finding French tutors, arranging extra physics, breathing exercises, pep talks and staying positive
One of life’s challenges. Go me!
I am the world’s most bewildered mum
I don’t know why this is happening
School dropout, counselling, anger, a handful of pills, some minor cuts
I am expert at managing panic attacks, investigating colleges, negotiating the NHS and weird piercings
But I’m up for this. Go me!
I am the world’s most exhausted mum
I love her to death
Major overdose, psychiatrist, cardiac ward, cutting, minor overdose, more cutting
I am expert at bandaging cuts, hiding razor blades, 999 calls, police statements, social services, riding in ambulances, fighting for support, staying up all night, dispensing pills
But we’re still here and stronger. So go us
Helen, Manchester, 35 Fourteen years ago, I found my flatmate (and close friend) almost unconscious, with an empty bottle of pills next to her bed. I got her to the hospital. I stayed all night, until she was released in the morning. It was horrible. What came next was worse. At the hospital I asked the doctor what I should do the next day. He drew a blank. My other flatmate and I had no idea how to react. We were angry, we blamed her, we thought she was selfish. We treated her like a stranger. I went to my GP, who suggested we focus on ourselves because finals were coming up. Within a week, we just left her – went to our respective homes to study, claiming that we needed peace and quiet away from university.
I’ve never forgiven myself for that response, or forgotten how awful it was when she quietly confronted me about lying to her. In the end we both apologised, cried a lot, and made peace. It took me a few years, though, to fully accept that she wasn’t selfish or to blame. I hope that today’s 21-year-olds already know that, and that their doctors are giving better advice. By removing the stigma around mental health, and by educating people in how to support their friends and family, perhaps we can prevent other people being judged and abandoned.
Anonymous, early 40s
A poem dedicated to old friends, hopefully to return.
In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.
Saturday 1 April marks the fourth anniversary of NHS’s medical director Bruce Keogh’s scathing report on the regulation of cosmetic procedures. It concluded that dermal fillers are a crisis waiting to happen – and said they should be classified as a prescription-only medical device.
Yet today little has changed. As an NHS reconstructive surgeon, I am frequently called on to fix the mistakes of unqualified beauty consultants.
Understanding the intricacies of facial anatomy and physiology has taken me half a lifetime of rigorous medical training to master. Yet flimsy regulation means an individual can jump on to YouTube, watch a couple of “how-to” clips, order supplies online and set up as a bona fide consultant.
The dangers are clear. I have seen around 50 women in the past few years, some with allergies to filler, others with filler pouring out of their faces – many in need of multiple, complex procedures to restore their features. And it is clear numbers are increasing.
Health minister Philip Dunne recently said that the majority of these products were intended to be used in reconstructive surgery, and regulated medical professionals are bound by professional standards and terms of registration. But what of the budding hairdresser turned beauty consultant? Who is there to regulate these rogue practitioners?
The non-surgical cosmetic procedures market is worth £3.6bn. And non-surgical procedures account for 90% of all cosmetic interventions. Individual filler sessions can cost £300. Such clear financial incentives are unlikely to dissuade the let’s-give-it-a-go brigade. Regulation is key. The General Medical Council has compiled a guide for physicians to establish standards. But binding regulation is needed. Other non-medical organisations such as Save Face have also tried to direct the public to practitioners with appropriate training.
As a plastic surgeon who works in the NHS, I have a team of colleagues who reconstruct the faces of children and adults with facial deformities.
Sadly, a new group of patients are emerging whose features have been changed, sometimes irreversibly, by non-surgical cosmetic procedures. It is essential that anyone receiving these treatments has confidence in their practitioner, and we must encourage patients not to be lured by quick fixes and unbelievable deals. Simon Eccles Member, British Association of Plastic, Reconstructive and Aesthetic Surgeons
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The government must do everything in its power to combat obesity (Supermarkets must stop discounting unhealthy foods to tackle childhood obesity, say MPs, 27 March). Obesity is a public health disaster inextricably enmeshed with cardiovascular disease, obstructive sleep apnoea, gout, type 2 diabetes, hypertension, stroke, gallstones, cancers, osteoarthritis, breathing problems, dental decay and gum disease. The obesity statistics are staggering. The Lancet reported this year that around 700,000 new cancers caused by overweight are predicted by 2035 and that the number of those afflicted with diabetes in the UK alone has topped 4 million. The costs to the NHS are projected to reach £9.7bn by 2050.
Obesity is a vivid example of the link between general and oral health. Sugar is the main culprit in the unabated increase in obesity and dental decay. A holistic, comprehensive and sustainable approach is needed that transcends medicine and dentistry, challenging the avoidable consequences of modern lifestyles. Dr Munjed Farid Al Qutob London
• People in this country are consuming too many calories, many of them from sugar, which is contributing to unacceptably high levels of obesity. The government has published sugar reduction guidelines for certain types of food to bring overall sugar levels down, while still allowing people to enjoy their favourite foods. This is an important step and must form part of a broader range of initiatives to help individuals and families towards better diets and healthier lifestyles. To play their part, responsible food and drink manufacturers, retailers, restaurants, cafes and takeaways will adapt recipes and take action to encourage consumers towards low- and no-sugar options. In some foods, portion-size reductions will be necessary. Producers will keep consumer tastes and preferences at the heart of this work.
Health charities and professional bodies will support this ambitious agenda by providing clear advice, backed by robust science, and helping to combat often confused messaging around nutrition and health. As well as pushing for full and continuing industry engagement, these groups can also help to create an environment where recognition is given to companies’ efforts, challenges and achievements. This will encourage the sustained industry engagement that is needed. Ian Wright Food and Drink Federation Tam Fry National Obesity Forum
• The Commons health select committee has released a report admonishing the government’s plans to fight obesity, claiming that proposed measures do not go far enough to tackle the crisis. The committee argues that ministers had ignored recommendations from health bodies to regulate price promotions of unhealthy food and drinks aimed at children. Research from Oliver Wyman shows that 81% of UK shoppers have noticed that sugary products are more often on promotion in their supermarket than healthy options – and 60% of consumers say it is their supermarket’s responsibility to help them be healthier.
Rather than waiting for the regulatory hammer to fall, supermarkets in the UK should redefine themselves as health and wellbeing brands, by simplifying choices and building customer loyalty through healthy living programmes. By showing customers how their activity and shopping habits feed into their health outcomes and helping them make informed decisions and trade-offs, supermarkets can influence habits in a way that is positive for their business while also delivering health benefits. Duncan Brewer Oliver Wyman Consulting
• New NHS statistics show that one in four adults are inactive and levels of obesity have more than tripled since the 1990s (One in four adults take less than 30 minutes of exercise every week, 31 March). An easy solution to our sedentary lifestyle is getting more people walking their short, everyday journeys and yet the report shows that one in four adults aren’t even walking for half an hour a week. Getting off the bus a stop earlier, going for a lunchtime walk or choosing to park further away and walk the rest of the way are all easy ways to get moving more and can make a big difference to our health and happiness.
The report also shows that more than a third of children are overweight by the time they leave primary school. Creating safe walking routes and encouraging more children to walk to school will help the whole family get more active and ensure children develop healthy habits for life. This is vital if we’re going to protect the future of our health service. It’s Living Streets’ National Walking Month in May and we’re encouraging people to fit 20 minutes of walking into their day. We know from people who took part last year that it’s an achievable way to get active and stay healthy. Jenni Wiggle Living Streets
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Cod liver oil has been taken as a dietary supplement for centuries. It is extracted from the liver of the Atlantic Cod (Gadus morhua), and is extremely high in Omega 3 fatty acids. This supplies us with the good fats that our bodies need, to function efficiently, and makes it a natural anti-inflammatory product. In addition, cod liver oil contains vitamins A & D and has other health benefits. These include:
1. Maintains Bone Health
Our bodies can convert sunlight into vitamin D, which is very important to develop and maintain healthy cell functions and bone metabolism. For those living in more temperament climates a vitamin D supplement is recommended. Cod liver oil can be used by people of all ages, and has been used to prevent rickets in children since 1824, as well as for older people to treat osteoporosis.
2. Decreases Cancer Symptoms
There are many different types of cancer and each comes with its own symptoms. The vitamin D and fatty acids contained in cod liver oil help to reduce these in some types of cancer, including breast cancer. It also lowers the risk of tumours developing, and helps to keep cancer that has been treated in remission.
3. Increases Fertility
Omega 3 fatty acids help to boost the production of sex hormones in both the male and female reproductive systems. The anti-inflammatory properties contained in cod liver oil also promote healthy pituitary and adrenal glands, as well as the hypothalamic system. These glands are responsible for regulating pregnancy and reproductivity.
4. Helps Control Diabetes
Irregular blood glucose levels, controlled by insulin production in the body, are the main reason that people develop diabetes. There are also many related illnesses that can be caused by having this disease, and the fatty acids contained in cod liver oil help to control these as well as regulate insulin production. Omega 3 supplements are also recommended during pregnancy to decrease the chances of the new-born developing the disease. Research is also being conducted into whether cod liver oil can be used as a diabetes treatment, in addition to preventative measure.
5. Treats Arthritis
The anti-inflammatory properties in cod liver oil help to reduce pain, joint stiffness and swelling in arthritic patients. The supplement works in the same way that many prescribed medications do, and is used alongside them to treat rheumatoid arthritis.
6. Regulates Cholesterol
Many of our diets have a high content of Omega 6 fatty acids, which can lead to increased cholesterol levels. Cod liver oil provides our bodies with Omega 3 fatty acids, which balance good fat with the bad in the body helping to lower cholesterol.
7. Improves Cardiovascular Health
Normal blood pressure and cholesterol levels within our bodies are essential for a healthy heart. Cod liver oil helps lower the number of triglycerides in our bloodstream, reducing the risk of heart disease. The Omega 3 fatty acids also help to prevent hardening of the arteries, which control the blood flow through our body and maintain proper cardiovascular health.
Sophie growing up was told by multiple doctors her chronic sinusitis would never subside. Healthy eating, daily exercise and yoga completely cured her and transformed her life. Sophie is now extremely passionate about all things related to health and fitness. She is a fulltime blogger and content contributor at HealthyHubb.com
One trouble with dropping targets is that such a decision tends to create a target. The head of NHS England, Simon Stevens, has outlined many sensible goals in his proposals for the future of the health service. But attention has focused on one thing. In order to take the strain off A&E departments and improve cancer treatment, Stevens has decided to drop the target whereby 92% of routine surgery is carried out within 18 weeks of a GP referral. The moment that some ghastly failure can be personalised in the form of an iconic victim of this change, Stevens will be held personally responsible. He is the target now.
Why is Stevens taking this risk? Largely because the government has made it clear that the extra funding Stevens needs will not be forthcoming. But it’s also another attempt at a nudge, to GPs and to patients. People can be aggressively passive about their health. They want doctors to fix it for them. GPs are wary of berating patients into losing weight and exercising more, especially now, when patients have read on the internet all about the operation they can get. The promise of elective surgery within 18 weeks, I’m afraid, only encourages both GP and patient to kick the can down the road. The hope is that the removal of the target will encourage GPs and patients to opt first for physiotherapy, which is what all sensible people should be doing anyway.
Some of the problem is with us, and our demands. We trail off to the GP with our colds and beg for antibiotics
Around 150 urgent treatment centres are being planned, to take the strain off A&E, which NHS chiefs say still attracts about 3 million people each year with minor ailments. Stevens is hoping to persuade all GP practices to offer evening and weekend appointments, so that A&E departments don’t become one-stop-shops over the weekend. Astoundingly, Stevens is also demanding that all A&E departments should introduce “comprehensive front-door clinical streaming”. Here in my metropolitan elite bubble, I’d imagined that all A&E departments had been assessing all walk-ins by medical need for decades. It’s easy to forget just how much sheer inertia is inevitable when dealing with a beast as large and complex as the NHS.
Stevens also addresses the system’s two most glaring failures – the lack of integration with social care and the relatively slender access to mental health services. On the first, Stevens aims, through closer coordination between hospitals and councils, to free up potentially 3,000 hospital beds. On the second, the aim is to provide talking therapies to 200,000 more people. These are ambitious goals. Considering the lack of investment, they are valiantly optimistic. Sometimes, people doing tough work need a bit of encouragement and applause. Stevens is one of them.
‘Some of the problem is with us, the users, and our demands. We trail off to the GP with our colds and beg for antibiotics; we call ambulances because our friend is very drunk.’ Photograph: Yui Mok/PA
There is a great deal of cognitive dissonance to Britain’s relationship with the NHS. Yes, we love it. No surprises there. It’s worth loving and not only for sentimental or socialist reasons. All but the most cock-eyed of diehard free-marketeers are obliged to bow to the evidence and admit that the NHS is the most cost-efficient health service in the world. Many politicians have struggled to come up with alternative funding models and had to admit that nothing is really worth the hassle it would cause. Insurance-based schemes around the world have been scrutinised and the conclusion is pretty much always that these simply drive up the cost of healthcare generally, with the US a particularly abject example.
Yet at the same time, our love for the NHS is sometimes skin-deep. When things go wrong or are disappointing, this is seen as proof that the service is falling apart, hardly ever that medical problems can be complex and baffling, or that people are not always the most reliable witnesses to their own problems. There’s still a great deal of suspicion about change.
Stevens has come up with a solid plan, and everyone’s up in arms because operations that might not work are being sidelined in favour of restorative exercises that probably will, if only people commit to carrying them out. Why is this supposedly awful thing being done? Just so that people who have been knocked down by cars or people with cancer can have their actual lives saved. Just so that hospitals don’t have to farm operations out to private providers simply to hit their targets on not always terribly necessary operations.
Some of the problem is us, the users; our own expectations and demands. We have this precious, amazing resource. We stand with it and see the government as its enemy. Yet we trail off to the GP with our colds and beg for antibiotics; we call ambulances when our friend is drunk; we’re astounded when our neighbour reveals himself as proficient in first aid.
Right now, there’s a hullabaloo because elderly people with some money behind them are expected to pay for people to help them with things they can no longer do for themselves. This, apparently, punishes “the thrifty”. How can having the wherewithal to pay for things you need be “a punishment”? Sometimes, the basic problem is that we want the best but we don’t want to pay for it. Full stop.
Anonymous, 40 I am a spider. I reach out and all I find is the cobweb I have woven. Woven out of experiences and childhood trauma. I reach out and find I can’t get out of this sticky mess. I can’t get out of bed. Something keeps me there and every time I try there is a wall. A wall of doubt, stigma and pain.
My name is Cobweb and I have schizoaffective disorder, which is a type of schizophrenia. As soon as you read “schizo”, parallels are made with “split personality” and perhaps craziness. Only the other day I heard someone say “schizo” in a casual way. They did not mean this in a kind way – it was referring to a kind of madness or craziness that is associated, perhaps, with crime or being possessed.
I recently explained to a friend that having schizophrenia did not mean a split personality. I believe I have suffered from this condition from the age of 17 or earlier. I was diagnosed only three years ago and got the help and support I needed. When I was 17, I was admitted to a psychiatric ward and suffered a psychotic episode and other complications. As a result, I suffer from chronic pain. I have this to cope with for the rest of my life, and I do not really know what the future holds for me.
Since this episode, I have been ill off and on, however, this did not stop me from studying for a degree, an MSc and a postgraduate course. It has not stopped me from raising awareness of mental health issues in Scotland and helping others with similar conditions. Whenever I have been out of work I have always done voluntary work and been an active member of my community. I may have schizoaffective disorder, but I’m a human. I’m slightly quirky and different, but no one is the same and the world is made up of many beings who deserve their right to be here.
I was born into a broken world, and experienced some things that others may never have. However, it has made me who I am. I have experienced trauma at an early age and am now living proof that with support and resilience it is possible to live with schizoaffective disorder. There is still much to be done. I want to tell Theresa May that more needs to be done to raise awareness of mental health generally, but most specifically among young people.
Ed, 45, from Liverpool I have a diagnosis of schizophrenia, which means I am pretty much excluded from society. Doors that are open to most people are firmly closed to me. The reality of my life is isolation, poverty, fear and hopelessness. I sometimes like to express my thoughts and experiences in little cartoon strips.
Ed’s depiction of living with schizophrenia.
Lisa Heinlen, Arizona, US My son was diagnosed with schizophrenia last March, and it was pretty sad the way it all went down. My mom has paranoid schizophrenia, so I knew the signs. I was trying to get help in a hurry and the crisis unit sent out an officer to assess the situation. The officer had no idea how to deal with someone having a breakdown, and put him in handcuffs. My son was hearing voices and this made him worse. He flipped out and kicked the officer in the groin area and tried to resist, so they took him to jail, and blamed me for his behaviour.
The only thing I can hope and pray for is that officers get more training and understanding. As long as people with mental health problems have a good support system, they’re less likely to end up back in the hospital. I spent months trying to get my son on the correct medicine. It has been a hard road for us. I encourage and love my son. It’s one day at a time for us.
In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.
Holly, 22, Sydney, Australia I have suffered from depression and suicidal ideation since I was about 12. If my parents did not have private healthcare, I would probably be dead.
Vulnerable young people shouldn’t have to wait for months to see a psychiatrist, or to compensate for the lack of communication between specialists. Help-seeking behaviour should be supported and encouraged.
Young people in distress presenting to emergency rooms and hospitals should not be viewed as a problem. You don’t want us to kill ourselves, well, here we are. Mentally ill kids are often really intelligent. We can sense when you feel we are being a burden. Saying there are not enough beds, putting us in wards with elderly dementia patients or adults with drug-induced psychosis will ensure we do not ask for help again.
Malcolm Turnbull and Theresa May have the chance to make a real difference in the lives of vulnerable young people, who have a lot to offer the world in return. Don’t let us down.
Lindsay, London, 24 I am currently detained under section three of the Mental Health Act, and have been in hospital since 22 July 2016. Before this, I had a full-time job and always managed to keep my mental distress under control. I never imagined I would become a person to whom the psychiatric ward was home.
Amy-Hannah Charman, Cheltenham, studying A-levels This poem was written in 2014 between two stints in psychiatric hospital with psychosis.
I want you to cry, I want you do die,
I don’t want to get hurt, I want to fight’
You need to hurt yourself so you can be free,
You need to ignore him, or in sin you will be,
If you don’t do what I say, I’ll make life hell,
You don’t want to slip; you’re doing so well,
Do this do that, you will be happier then,
Please just draw on yourself in a sharpie pen,
Arggg! Arrg! Cry cry cry,
Please! Please! I want to live life!
You’re a failure; this is not very hard,
Think of your friends, remember Mum’s card,
Cut cut cut, harm harm harm,
Relax relax, calm calm calm,
You need to scratch, you stupid cow,
Just go and find Mum she can save you now,
Cover your evidence, you must be sly,
Don’t do what he says, just look to the sky,
Listen to me, let me take over you now,
No I can’t, I need help, but how?
I hate you and you must hate yourself,
No I don’t want to get help,
You have nothing, nothing at all,
Actually I do like friends and all,
You don’t deserve to be happy like this,
Yes I do, think of that Taylor Swift gig,
You deserve everything I’ve done to you,
I don’t want this, I won’t listen to you,
I want to squish everything out of you,
Little, innocent me please shine through,
I will scar you and hurt you, I will do what I like,
I won’t let you win, I will always fight.
Caitlin Kitchener, 22, PhD student, York It took an attempted suicide to gain access to therapy. I had been taking antidepressants for a few months, but they weren’t particularly working. It happened during the first year of my undergraduate degree and I remember being picked up in an ambulance outside the halls of residence, with people having a peek to see what was occurring.
Things worked out OK for me, but they didn’t for one of my best friends. She was utterly wonderful, witty, sassy, an absolute star of a woman. After my suicide attempt, she didn’t let me sleep alone for a week and made sure I looked after myself. She even helped arrange a surprise birthday party just four days after my attempt. Underneath all this charisma and humour and kindness was someone who was dreadfully sad. In the third year, she killed herself. She had attempted before, gone to hospital, had a review with a therapist, but faced excruciating waiting times. During her four-month wait for therapy, while she was also waiting for access to university services, she killed herself.
No one from the university or the NHS should be blamed. Maybe reduced waiting times wouldn’t have stopped her. But I can’t help it when I sit on her beautiful memorial bench to feel anger towards Tories whose actions are having real-life implications.
Anonymous, 19 I’ve had depression on and off since I was 11. Over the years, I’ve tried various coping mechanisms: self-harm, restrictive eating, bulimia – you name an unhealthy coping mechanism, and I’ve tried it.
The one that’s been the most constant is alcohol. It’s now got to the point where I’m drinking a small bottle of vodka pretty much every day, sometimes as early as 9am. Needless to say, this doesn’t help my depression, but I’m too dependent on it to give it up. I know I’m in desperate need of professional help, but it terrifies me thinking of my friends and family knowing I’m depressed. I worry that people will be awkward around me, feel guilty for not being able to help me or utter the dreaded phrase: “What have you got to be depressed about?”
I hope that one day the stigma surrounding mental health issues will be non-existent and I will have the courage to deal with my problems in a healthy way.
Anonymous, 17 At secondary school I was taught about religious education, maths, science, English and a plethora of other subjects. But there was one thing missing. After countless sleepless nights, and episodes of self harm, depressive thoughts and suicidal ideation, I had no idea what was wrong with me. I went to the top of a car park and watched the people walk past below like nobody in the world cared.
A woman spoke to me and saved me. After that, I got a correct diagnosis. Learning about mental health and that it is OK to ask for help is important.
Anonymous, 23 Over the years my depression and anxiety has come and gone in waves. After a friend who was having similar problems was diagnosed with Asperger syndrome, I visited a doctor and told him my symptoms. He laughed at me and said I simply had social anxiety, and put me on beta blockers.
When I was at university, a different doctor suggested I see a counsellor. After the first session the counsellor said she’d follow up and make a second appointment, which never happened. My confidence was shook, and I tried a second service. The session went well, and she said she’d make a second appointment for me. She never did. I was convinced that they didn’t think I was worth their time.
I called a mental health charity, when my depression got particularly bad. They arranged a time for them to call back and do a full assessment. They never called back.
I have a great family, and got a first in my degree, and a distinction in my postgraduate degree. Still, I constantly feel numb and almost completely emotionless. My few friends have all cut ties with me for unknown reasons.
Dolly Z, New Jersey As a young adult, I wanted to share my life’s journey with mental illness in verse.
Dolly Z reflects on her mental illness.
Laura Vale, 18, student on a gap year “I’m so OCD about that, I have to have everything straight.” Or, “I’m such a clean freak, I’m so OCD.”
People don’t say these things maliciously, however, they do cause upset to actual sufferers of obsessive compulsive disorder. There are four main categories of OCD: checking; contamination/mental contamination; hoarding; ruminations/intrusive thoughts.
My OCD falls into the category of contamination/mental contamination. I cannot eat cold savoury food, and without medication I could not even be in a room with cold savoury food without having a panic attack. This is the main feature of my OCD, but I also can’t deal with foods touching, or sharing food and drink.
When it’s really bad, I cannot eat because I feel as though I am contaminating myself with food. I have to feel mentally clean, too, which kind of means mentally organised. This can be with relentlessly cleaning myself or tidying or harming myself because I was not clean enough.
Once (while taking Prozac, which really messed with me), I had to empty my room and paint it white. I knew this was illogical, I was crying because I felt insane, and yet I felt that this was the only way for me to be safe and comfortable. Intrusive thoughts control my life. From basic anxieties to more obscure ones, such as my absolute terror of ever having a child and then starving the child through my OCD. But it can be manageable and, for those who know me, since diagnosis I have taken massive strides.
The main issue with OCD is the lack of understanding in mainstream society. By making statements such as: “I am so OCD about that,” you are trivialising a mental illness that is so controlling, manipulative and horrible, and making the sufferer feel as though their struggle is not real and their feelings are irrelevant. Education is key.
In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.
Cancer death rates in the United States are continuing to fall and the five-year survival rates of those diagnosed with the disease have risen, research shows.
The Annual Report to the Nation on the Status of Cancer, published on Friday, also shows a decline in incidence of cancer among men in recent years, although it remained stable among women.
Death rates from 2010 to 2014 decreased for 11 of the 16 most common types of cancer in men and for 13 of the 18 most common types of cancer in women, including lung, colorectal, female breast, and prostate cancers.
The authors, from the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute and the North American Association of Central Cancer Registries (NAACCR) suggest a decline in smoking – down more than 50% over the last 50 years – as well as improved early detection and more effective treatment helped bring about the fall.
But they warn that smoking continues to pose a threat along with obesity, rates of which are at 20% or or more in every state.
NAACCR executive director Betsy Kohler said. “The continued drops in overall cancer death rates in the United States are welcome news, reflecting improvements in prevention, early detection, and treatment.
“But this report also shows us that progress has been limited for several cancers, which should compel us to renew our commitment to efforts to discover new strategies for prevention, early detection, and treatment, and to apply proven interventions broadly and equitably.”
The report, published in the Journal of the National Cancer Institute, showed that death rates increased for cancers of the liver, pancreas, and brain in men and for liver and uterine cancer in women.
Overall, cancer death rates decreased by 1.8% per year in men and 1.4% a year in women.
During the period 1999 to 2013, cancer incidence rates in men fell by 2.3%, according to the study.
Compared with cases diagnosed between 1975 and 1977, five-year survival for cancers diagnosed in 2006 to 2012 increased significantly for all manifestations of the disease bar cervical and uterine cancer.
The greatest absolute increases in survival (25% or greater) were seen in prostate and kidney cancers, non-Hodgkin lymphoma, myeloma (bone marrow cancer) and leukaemia.
Further improvements in survival prospects are expected in the wake of recent advances in precision medicine and immunotherapy for late stage cancers. But the authors warn that the high cost of new cancer drugs – up to $ 10,000 (£8,000) per month – may put them out of reach even to Medicare-insured patients, who would still be left with a bill for around 20% of the drug’s cost.
People who work with users have raised concern about a new trend among men in their 40s and 50s who take the drug to fight some of the signs of ageing
Growing numbers of middle-aged men are turning to anabolic steroids to make themselves look and feel more youthful and boost their sexual performance, experts say.
People who work with users have raised concern about a new trend among men in their 40s and 50s, and some even in their 60s and 70s, who are taking the drug to boost energy levels and fight some of the effects of ageing, such as weight gain and a lower libido. Steroids can cause a range of potential health problems, such as heart disease and blood clots.
Cases of depression have ballooned almost 20% in a decade, making the debilitating disorder the leading cause of disability worldwide, the World Health Organization (WHO) has said.
By 2015, the number of people globally living with depression, according to a revised definition, had reached 322m, up 18.4% since 2005, the UN agency said on Thursday.
“These new figures are a wake-up call for all countries to rethink their approaches to mental health and to treat it with the urgency that it deserves,” WHO chief Margaret Chan said.
According to the agency’s definition, depression is a “persistent sadness and a loss of interest in activities that people normally enjoy, accompanied by an inability to carry out daily activities for two weeks or more”.
Lack of energy, shifts in appetite or sleep patterns, substance abuse, anxiety, feelings of worthlessness and thoughts of self-harm or suicide are also common, and can affect entire families.
Jamal Edwards breaks taboos around men’s mental health
The drop in productivity, and other medical conditions often linked to depression, also takes a financial toll, with the global cost estimated at $ 1tn annually, the WHO said.
Shekhar Saxena, head of the agency’s mental health and substance abuse department, said both psychosocial and medical treatments could be highly effective, insisting on the importance of reaching more of those in need.
Even in the most developed countries, about half of people suffering from depression are not diagnosed or treated, and the percentage soars to between 80-90% in less developed nations.
Treatment can be difficult to access, while a fear of stigma also prevents many people from seeking the help required to live healthy and productive lives, the agency said.
According to the WHO, every dollar invested in improving access to treatment leads to a return of $ 4 in better health and productivity.
And “early identification and treatment of depression is a very effective means of decreasing death by suicide,” Saxena said.
There are about 800,000 suicides worldwide every year, amounting to one every four seconds. And the link to depression is clear.
Saxena pointed to studies showing that 70-80% of people who kill themselves in high-income countries, and around half of those in low-income countries, suffer from mental disorders, of which depression is the most common.
In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here
