You come to expect a certain number of unpleasant reactions – well-intentioned or malicious – to symptoms like self-harm from other people. Worry, fear, anger, disgust, dismissal: I can see where these might come from. But when unhelpful or undermining comments come from the people you’re supposed to be able to turn to for help, they have a particular way of sticking under your skin.
1) “Did you have a fight with your boyfriend/mum/dad?”
Mental illness doesn’t work like that – at least, not for me. If it were that simple and I could talk about it that easily, I would have phoned the Samaritans and talked it through before things ever got this far. Stressful events can trigger some people into acting on negative thoughts, but often it’s simply a case of having held on for as long as you can and then not being able to any more, so throwing out reasons why a healthy person would be upset isn’t all that useful.
Also, my dad died three years ago and please don’t assume I’m straight.
2) “At least you can recognise that something’s wrong!”
(Crisis Team/ A&E mental health staff/ basically every mental health professional ever)
I’m so tired of people using self-awareness as a way of dismissing your need for help. Sometimes it’s genuinely meant to make you feel better, but it always ends with the same result: even though the first piece of advice every health professional gives you is to tell someone when you have thoughts of hurting yourself, it’s assumed that, if you’re articulate enough to follow that advice, you need less help and can keep yourself safe on your own. But you can know what is happening to you and still be unable to stop it; and it’s no less painful to watch yourself go mad than to be unaware of your own insanity.
3) “I’ve been where you are…”
(Crisis house support worker)
No, you haven’t. You’ve been where you were, which may be better or worse or just plain different to where I am, but our experiences aren’t going to be the same because we’re not the same person. Your history of mental illness is not an instant-access pass to understanding everybody else’s; it only makes you better at your job if it means you listen with more patience and kindness.
4) “I have anxiety too, and I’ve never taken medication for it!”
(Mental health nurse on a psychiatric ward)
Please don’t pill-shame me. I take what I’m told to take, and it’s frustrating having one nurse push you to ask for medication when you think you might need it, and then have their colleague make you feel weak for needing it ten minutes later.
5) “Now promise us you won’t do this again.”
Never mind promising anyone else, I promise myself every time I end up in A&E with self-harm that I’ll never do it again. It isn’t that simple – I am trying as hard as I can.
6) “You really don’t want to be taking problems like this with you into adulthood.”
I am 22 years old. I’ve moved to a foreign country, found a job and a flat, and made a life all by myself; it was when I moved back to the halfway-to-adulthood world of university that I had a breakdown. I’m sad, not five.
7) “What do you want me to do? If it’s really that bad, go to A&E.”
(Crisis Team out of hours helpline worker)
This one was technically not said to me; the night I went into hospital, I realised I wouldn’t be able to get through the night safely at home, and, because I find speaking on the phone difficult, asked my mum to phone the crisis team. The crisis team (sometimes called the home treatment team) are there to try and avoid hospital admissions and keep crisis care community based, which in theory makes sense – psychiatric wards are not pleasant places to be, and readjusting to life outside hospital can be a bit bumpy. She put the worker on speakerphone so that I could at least hear what he was saying, even if I couldn’t talk to him. He told us that the crisis team only offers telephone support at night, and when I still couldn’t bring myself to take the phone, he got frustrated and rude, and completely undermined my need for help. If my mum and my brother hadn’t been there to get me to A&E and to push me to push for treatment, then I might not have survived.
8) “Maybe it’s time to start looking for the positives?”
(Crisis house support worker)
Fuck me, that’s where I’ve been going wrong! Thanks for that, I’ll just pop back to my room and cheer right up now. I mean, what do they think I’m trying to do?
9) Anything in a confrontational tone of voice.
(Usually middle-aged male doctors in A&E)
I refuse to believe that my self-harm injuries are the most stupid things people come into A&E with. My coping mechanisms may be unhelpful, but (most of the time) I don’t actually believe I’m more idiotic than the people who arrive claiming they “sat on” an array of – I’m told – quite surprising objects. So why is that it’s people like me who automatically get talked down to or spoken to angrily from the start, like we can’t be trusted when we ask for help, like we’re just there to waste the doctors’ time?
I don’t mean by all this that I haven’t had some really positive experiences of psychiatric care; I love the NHS to bits, it’s saved my life several times over, and if I were as patient and kind as some of the staff are after a career anything like as stressful as theirs, I’d be doing pretty well. But when your life and wellbeing are basically in other people’s hands, it doesn’t take many bad experiences to knock you back a long way; and if part of you is already convinced you don’t deserve help, or that improvement is impossible anyway, then being pushed back confirms all your worst thoughts. So I’m not ungrateful for the help I’ve received, and I don’t mean to sound angry or bitter about the times I’ve been misunderstood or judged, but to be honest, I am.