It’s okay not to be okay? Sure. With a huge caveat

I’m 30(ish), married, and have two kids and two dogs. I work, I have good friends who understand me, and a really supportive family. On paper all good, right? But, I also have borderline personality disorder (bpd) that occasionally morphs into depression, so life can be a touch unpredictable here.

We are making huge progress as a society when it comes to talking about mental health, huge. Slowly but surely, the stigma that surrounds it is being chipped away. There are several well established national campaigns encouraging people to talk, and these are getting a bigger response year on year. It’s fantastic to see.

So where’s the caveat? I write from my own experience. I’m not a mental health professional, but I’ve spent years in the public mental healthcare system in Ireland, and that is where the caveat comes in.

No more than any other illness, there are varying degrees of severity when it comes to mental illness, and I think that’s where the problems arise. Yes, it’s okay to ask for help. Seeking support is the first step towards addressing any mental health difficulty. But what about when that help is not forthcoming? What about when a call to a helpline, or a trip to the GP, is not enough? What about when professional support is needed? The barriers are immense.

First, there’s the cost. Let’s suppose I don’t need psychiatric support, but I very much need to speak to a therapist. However, I’m on a low income. Barrier number 1. I need therapy, but unless I can access a low cost service (which may still be too expensive depending on the scale they use) it’s not an option that’s open to me, so I’ve to find a way to manage on my own. The impact that this can potentially have is far reaching. I may find myself unable to work, further compounding the financial situation and increasing the stress, which in itself has a knock on effect on whatever the original issue was… you can see how quickly this can spiral out of control.

Let’s take it a step further. I’ve been to my GP, I’ve been fortunate enough to access therapy, but the situation still isn’t improving. I need psychiatric assessment. Barrier number 2. I have two choices – take my chances with the public system, or pay to see someone privately. Going privately was never an option for me, so I can tell you about the public system. In the first instance, unless there’s an emergency trip to A&E, it will most likely involve a lengthy wait, and once I get in, I will be seen by a consultant. Thereafter, I will be seen by a member of the team working under said consultant. The lack of continuity that goes hand in hand with this approach – new doctors at almost every appointment, trying to explain the same issues over and over again, varying opinions – is heartbreakingly frustrating. I’m lucky that in recent months I’ve seen my consultant at every appointment for which I’m ridiculously grateful, but prior to this there were years of rotating doctors asking me to rate my mood over the previous number of months on a scale of 1 to 10. Given that my mood can shift dramatically a number of times in any single day, that’s a question that’s both impossible to answer and profoundly unhelpful.

Again, I must emphasise that I’m writing from my own experience, and I’m at the more severe end of the scale in terms of mental illness. But, I’m far from being the only one.

Barrier number 3. Private therapy isn’t an option. I’ve made it through psychiatric assessment and a very specific form of therapy is recommended. But, there’s a waiting list. A lengthy one, with no guarantee of when a place will be available. So what do I do in the meantime? I dig in. I hang on. I have no one left to tell that I’m not okay, because I’ve followed every avenue that I can. My bad days are horrendous. My bad days I quite literally fight for my life. Yet I’m aware that I’m still one of the lucky ones. I have good friends, and a loving, supportive family who do the very best they can for me, but it’s not enough. More than that, it’s not fair to expect that to be enough.

I don’t want to detract from the incredible work that is being done to get people talking about mental health. It’s absolutely vital, and I’m confident countless lives will change for the better because of it. It’s okay not to be okay? Of course! It’s okay to ask for help? Undoubtedly, and it is 110% the right thing to do. It does somewhat work on the assumption that help is both available and accessible though. That’s the caveat right there. From my perspective at least, it’s quite a big one.