On Mental Health Crisis #1

On Mental Health Crisis #1

Mental health crisis #1 openly discusses the topic of distress and crisis that some readers may find triggering. If you are in the UK and your need is urgent, please call 999. If you need support, please call 111, option 2, or Samaritans freephone number, 116123.

Introduction

‘A mental health crisis is when a person’s emotional or mental state puts them in danger or prevents them from being able to care from themselves or function effectively in the community.’[1] ‘Crisis occurs when something happens or a series of events happen that take you over the edge and reduce your ability to cope or function normally. Stress and sudden changes in your personal life such as the death of a loved one, divorce, the loss of a job, incarceration or illness can all result in emotional overload and overwhelming feelings of helplessness.’[2]

Very Well Mind describes a mental health crisis as ‘when you are so overwhelmed with emotions like fear that your go-go coping mechanisms aren’t helping. Being in a state of crisis means that you’re so afraid and confused that you can’t make decisions.’ Mental health crisis #1 discusses how living with unresolved facial pain for so long has precipitated a serious mental health crisis, which began in October, 2019. I have been in crisis for five years.

My Mental Health Crisis

Image of a woman holding onto her head and crying. Purpose of image is to illustrate a woman who is in a mental health crisis.

What caused my mental health crisis? Simply put, I could not endure the physical pain that I was in anymore. It was too much. The medical profession’s outright refusal to take any responsibility became unbearable. They would not listen. They would not act. This burden was too heavy to carry alone. I crashed.

I had been resilient up until October 2019. My late mother graced me with a stoic spirit that carried me through until that point. I had been going to medical appointments and articulating my symptoms to clinicians with a clear head. I did this for six years. However, in 2019, NHS trusts started to reject my GP’s referrals. They gave no reason for this. I felt invisible.

My periocular pain became particularly acute at this time. I developed throbbing pain in my temporal artery region. The pain in my remaining parotid gland was becoming more severe, and I developed ear pain on my affected side. Clinicians were refusing to see me or answer my questions. It was an impossible situation. As my facial pain intensified, so did my despair at having no medical help. After so many knockbacks, I broke. I had not experienced this level of distress before. I had known trauma from my childhood and adolescence, but I had never known this overwhelming and perpetual level of distress. A protracted crisis was new to me. My mental health crisis has lasted five years. Enduring distress for this long is exhausting.

A Vicious Circle

Mental health crisis is terrifying. The ground literally falls from beneath your feet. The word “fragility” takes on a new form. My mental health crisis has manifested in acute distress, severe insomnia, and suicidal thoughts. I have felt uncontrollable rage about how these NHS trusts have behaved, but my most predominant feelings are despair and helplessness. I explain in On Medical Trauma that I am in a constant state of shock and hypervigilance. These emotional states are also major components of my mental health crisis.

When my mental health crisis began, it did feel like everything caved in. The absence of any medical care left me feeling unsafe and frightened. This was made worse by the fact that I have had no one in the system to turn to for help or support. There has been no one to advocate for me. Doors close one after the other. As one NHS trust after another has closed my case, my mental health crisis has worsened. As clinicians have gaslighted me and continued to overlook abnormal pathology, my crisis levels have intensified and deepened. It’s a vicious circle.

Setting the Record Straight

This is an image playing a record. She looks like she could be a DJ. The purpose of the image is to show a metaphoric image for the title of the paragraph, which is setting the record straight.

I was not in any mental health crisis when my facial pain began in 2013. It’s important that this is understood. It is no secret that I had a challenging upbringing. My first novel, Lucia’s Poltergeist, is about the difficulties I experienced growing up. It’s not a secret that I suffered abuse at the hands of two damaged parents. However, I had dealt with my childhood issues long before my facial pain began. I had had years of psychotherapy, and I was doing well. There is no mention of suicidal ideation on my medical records before 2019.  The first entries of suicidal ideation on my medical records start in October 2019.

Discrimination

This is an image of a woman, who looks like she has been crying. Purpose of image is to show how the mental health discrimination that I have experienced has worsened my mental health crisis.

I have spoken openly in this blog about the systemic mental health discrimination that I have experienced. Mental health discrimination has worsened my mental health crisis.

The lack of resolution to my facial pain and the medical gaslighting by clinicians have caused my mental health crisis. Not the other way around. I am not imagining my facial pain. However, clinicians don’t understand this. Clinicians attribute my “distress” to unwarranted “anxiety” or to “mental health” problems. They don’t join the dots. They fail to understand that my distress is being caused by not being believed by clinicians about my facial pain. The lack of self-reflection that clinicians demonstrate deepens my distress levels as I feel more unheard.

On top of the lack of empathy that I have received, clinicians have directly discriminated against me by either refusing to see me, stonewalling me for months on end, or writing inappropriate comments about me having “psychiatric problems” on radiology forms. This has exacerbated my feelings of despair.

Torture

This is a distressing image of a man, who is being hung. The purpose of the image is to illustrate the theme of torture. I am discussing in this paragraph how being in this much physical pain and not being able to get answers or treatment is like torture.

To not be able to get answers about one’s health is a form of torture. The pain around the left side of my head now feels sinister. It feels like someone is drilling a screw into my head. Meanwhile, NHS trusts have information on their files that shows there is abnormal pathology. They have chosen to ignore this evidence, take no action, and give me no treatment. This feels inhumane.

I liken being in crisis to treading water in the Atlantic Ocean. I have nearly drowned. Waves have washed over me, and I have struggled to come up for air, but I am still straddling the waves. I am out of breath. I am exhausted. There are days when I cannot feel my own legs, but I keep going in the naïve hope that a lifeboat will see me and get me out of these perilous unforgiving waters.

This is an image of the ocean with a hand reaching up from under water. Purpose of image is to to show how being in a mental health crisis is like straddling the waves in the middle of the Atlantic ocean. I speak about how close I have come to drowning. This is metaphorical, of course, but it is trying to show the acute nature of the crisis that I am in.

The Doctor-Patient Relationship

This is an image of a doctor and nurse attending to a woman, who has just come out of surgery. She is in the recovery room and the medics are smiling at her. Purpose of image is to show how important relational working is in healthcare.

I cannot emphasise enough how is dangerous when a clinician does not take a patient’s physical symptoms seriously. It is a form of gaslighting. It can worsen a patient’s despair. Each time that a clinician has told me that I am imagining things or that the pain I am experiencing is not real, my mental health has spiralled downward.

Image is of a doctor in a white coat, looking down his spectacle sat the camera. Purpose of image is to show the impact it has on patient when a doctor doesn't take your symptoms seriously. In my case, this is what has caused my mental health crisis.

Relationships are a mirror. They are a two-way street. Both parties need to be honest and open with one another in order for a relationship to work. The doctor-patient relationship is no exception. However, the doctor-patient relationship toolkit, which the British Medical Association published, states that ‘the onus is principally on the health professional to make contact with patients work well.’[3] It states that ‘while doctors and patients should both be honest in their communication with each other, doctors have specific, patient-focused duties.’ [4] Doctors must:

  • Treat every patient considerately.
  • Listen to patients.
  • Make the care of the patient their first concern.
  • Give patients information in a way they can understand.
  • Respect the right of patients to be fully involved in decisions about their care. [5]

None of the forty plus consultants who I have seen have listened to me, treated me considerately, given me any information, or involved me in any decisions at all about my care. The last NHS trust who refused to see me didn’t even let me or my GP know that they had rejected my GP’s referral.

Good doctor-patient relationships are characterised by mutual respect, open and honest communication, and respect for the dignity and choices of patients.

The British Medical Association.

Reflection

Image of a middle aged woman, sitting, looking into the distance. She looks reflective, like she is thinking. Purpose of image is to show someone reflecting, as the paragraph is about reflecting on how my mental health crisis has bene caused by a lack of respect and kindness from the medical profession.

I have fallen into a mental health crisis because of a lack of listening and respect from the medical profession. As I say in Good Medical Practice #3, there needs to be stricter regulation to ensure that doctors follow this guidance. Medical skills and knowledge on their own are not enough. The relational workings of the dynamics between doctor and patient are just as important. It is part of patient safety that healthcare professionals adhere to the guidance about the doctor-patient relationship. A strong working relationship between doctor and patient is key to successful health outcomes.

Modern medicine is complex and dynamic. Although highly specialised, technologically sophisticated and often delivered by multi-disciplinary teams, strong doctor-patient relationships are at the heart of good care.

The British Medical Association.

Conclusion

This is an image of a white board with the following words written on it: 'stop bullying. Show empathy.' Purpose of the image is to accompany the final paragraph, which says that in order for my mental health crisis to subdue, the medical profession have to show some kindness and empathy and take some responsibility for what has happened.

My facial pain is a physical condition. It has a medical/biological cause that medics have not yet identified. My facial pain is not a mental health-related condition. I am in a mental health crisis because medics have not resolved my pain. This must be understood. The mental health crisis that I am in is a human response to extreme adversity. Anyone who had taken this many knocks would eventually crash. There is nothing “extreme” or “unreasonable” about feeling despair and distress at not being heard by the medical profession when I am in this much pain.

The healthcare system needs to acknowledge the impact that their decisions have had on me. Just an acknowledgement would suffice. I am a human being. I am not bionic. The human condition is fragile, and I have buckled. For my mental health crisis to subdue, a medical professional within the UK healthcare system must take responsibility for this. Until they do, I will remain in a perpetual state of crisis and, quite possibly, won’t make it. I cannot carry this burden indefinitely. I am not Superman.

Good therapeutic relationships, whether face-to-face or remote, are characterised by partnerships between doctors and patients.

The British Medical Association.

Foot Notes

[1] Psyche Hub: What is a Mental Health Crisis?

[2]  Crisis Symptoms, Causes and Effects  www.PsychGuides.com

[3] British Medical Association, The Doctor-Patient relationship toolkit, Chapter 2, www.bma.org.uk

[4] This quotation is from the same source as footnote 3.

[5] This information is from the same source as footnote 3.

Photo Credits: Austrian National Library and National Cancer Institute on Unsplash. Wikilmages, Granderboy and Abdou Moussaoui on Pixabay. Reneterp, David Garrison, Ayyub Jauro RDNE Project, ShotbySylvesterabigail and Cottonbro on Pexels.

Blog Authored By Felicia Kate Solomon

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