Every day, I face the obstacle of my own mind. Every day, I face the hurdles of dual-postcode living.
Every day, students up and down the country face the same challenges. They meet barrier after barrier to mental health treatment, with the dawning realisation that their mind is not the only traffic light; they see red on every road they follow.
Katie is nineteen. During her first year of University, she was in a stable recovery for an eating disorder. However, her second year has see a deterioration in her mental health. She need support, so she goes to her GP. The doctor's office is dominated by diversion signs. She is shown a waiting list; she has seen them many times before. It says 18 weeks for treatment - the equivalent of two University terms. Unfortunately for her, it is January; the first week of treatment coincides with the date she returns home for summer. Returns home to another system. Another waiting list. Another diversion sign. Back to square one.
Katie's story is my story. It is the story of hundreds - if not thousands - of other students in the UK. It is the story of the 20% of students affected by mental illness. I have spoken to people who spend summer counting down the days until term begins, simply because they cannot access treatment quickly enough at home. I have heard others say the same of University services. I would always advise someone to ask for help yet - having been in this position myself - I cannot argue with their logic.
Like the majority of students, I registered with the local GP at the start of University. I was in a stable recovery, having worked extremely hard to reach this point. Other people will come to University with no prior experience of mental illness. Nonetheless, it does not discriminate. The responsibilities of time management - juggling classes, socialising, cooking and studying - can overwhelm even the most organised individual. The line that University will be the "best time of your life" also brings unnecessary expectation. Mental health can strike or resurface at any moment.
I began second year on the back of two two bereavements; in addition, I was experiencing complications with my diabetes. By Christmas, I realised I needed to reengage with mental health services. I was assessed four weeks later. Two weeks after this, I received a letter that said eighteen weeks for treatment. That is twenty-four weeks in total. Six months. A waiting time of six months could be the death sentence for a cancer patient. Or a type one diabetic. Or someone with anorexia.
One of these illnesses falls under the "mental health" category. This illness was told to wait six months, which is echoes the average waiting time of eighteen weeks. It is still better than the six months my friend was told to wait, but it displays a fatal lack of understanding. Mental health doesn't wait. It may creep up at first, but once it is there it shows no mercy. This is why the path to recovery is not linear. This is why health services need to offer the stability an unwell mind cannot.
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My GP in Exeter tried to offer this. She was a lifeline and went far beyond the call of duty. I saw her challenge the red tape of the "system", which said I couldn't be seen that week. She saw me during her lunch hour. I have a friend - also at Exeter - whose GP did the same. Yet both of us were let down by the wider mental health service.
The postcode lottery of mental health services only exacerbates the issue. Devon does not offer any specific treatment for eating disorders, unless you "fit the criteria" for inpatient treatment. In short, this criteria involves BMI. After I was put on the 18-week waiting list, earlier this year, I was assigned a caseworker to offer support. What I received were accusations of "avoiding treatment", because I was going home on weekends; I was going home to ensure I had 3 meals a day. I was advised to "reduce anxiety by walking", despite being underweight and acknowledging that I have struggled with exercise compulsion in the past. I do not believe he was ill-intentioned, rather ill-informed.
Nonetheless, it is not a service I wished to return to. In contrast, the AWP (Avon and Wiltshire mental health partnership) provides STEPs - a specialist service for eating disorders. It is this service I returned to last summer. A service that helped me return to University this month, yet it is also the reason I will not be reregistering in Exeter. If it takes a weekly train journey to access support, so be it. I would rather a train journey than a traffic jam.
I am willing to do this, yet it is far from ideal. The commute alone leaves me feeling anxious over money and co-ordinating travel arrangements. It reinforces thoughts of unworthiness. This may seem irrational to some, but it is the story of so many with a mental illness. The challenge of reaching out for support can be monumental, the individual remains silent. Every diversion sign may as well read "You don't deserve support". The illness will always come back with this line, and it is a line that has cost lives and will claim more in the future.
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I am not discounting the merits of the NHS. At its foundation, it is a world-class service, ensuring that illness should never pose a barrier to potential. I am thankful each morning I wake to see my insulin pump. I am thankful every time I talk to my diabetes nurse, University GP or psychologist.
I am indebted to so many individual islands; what I don't have are the bridges to connect them.
Universities may have fantastic wellbeing services, but it is not their job to perform the role of the NHS. There are incredible GPs out there, just like mine, yet they cannot routinely offer hour-long appointments and perform the role of a therapist. They can paper the cracks of a broken system, but they cannot fix it. The outcome? Either you stay on the island that offers the best chance of staying afloat, or try to swim between them and risk sinking. Too many people will sink, and the government needs to respond.
If personal cost isn't enough to sway the questionable Jeremy Hunt - after all, the government has outdone itself in recent weeks - perhaps an economic argument will work. Mental health currently costs £100 billion a year. Mental Health at Universities has increased by 137% in the past three years, while 20% consider themselves to have mental health problems. Students are the workforce of the future. Is that enough to convince them? At this point, I am willing to put forward almost any case that will address this crisis.
For it is a crisis. It may not come in the form of a photo splashed across newspapers, which finally saw our government respond. On the contrary, visual presentation of mental illness often does little more that reinforce stereotypes - this is a topic I discussed in an earlier post. It is a crisis because lives are being cost. When I talk about lives lost, I am not referring solely to deaths. Hundreds of students are merely existing throughout their degree, with minimal support when they need it most. They are in a three-to-six-year standstill, life on hold and a slave to their own mind. The government must act to get them out.
1) Stronger communication between postcodes: the transient nature of University life sees far too many young people fall through the gaps. We need improved communication between home and term-time addresses, so that no student is ever left without a support system close by. There should also be a seamless transition of data - details of prescriptions and past care - so that precious time is not wasted.
2) Stronger communication between Universities and local NHS services: The latter needs to be aware of what support the University can offer, and vice versa. If Universities cannot offer the level of treatment needed, they need to assist students in accessing it locally.
3) An end to the location lottery: Quality of care should not be dependent on where you are in the country.
The charity Student Minds is running the Transitions campaign, which calls for consistent care pathways. In a survey, 92% of professionals felt that the move to University negatively impacted mental health care. I encourage everyone to sign the petition and counter the crisis of student support.
A postcode should never steal a person's right to treatment. University should not place obstacles in the road to recovery. Services need to draw a straight line to care, not place down more stop signs. Mental illnesses already hold enough of those. It is time for change.