Opinion

OCD almost took my life. I need help. Not awareness.

A mental health crisis left James McMahon needing professional help. If only it was so straightforward, he writes.

A woman stands in a field of grass, silhouetted by the sun

Treatment for mental health conditions is becoming more and more difficult to come by. Image: Beatriz Jiménez/Flickr

Last month I had a relapse in my ongoing attempt to manage my OCD. That would be obsessive compulsive disorder, a much-misunderstood condition in which the sufferer feels compelled to undertake rituals in a futile attempt to relieve mental distress. I’d had enough. In the absence of peace I was content with oblivion. I ended up on train tracks. The police were called. It was a whole thing. 

The following day me and my partner drove to a hospital in east London, approached a door boarded up with plywood, and via intercom asked to see the Crisis Team, the NHS unit who offer 24-hour help to those in distress.

We waited. And we waited. And then we waited some more. Twenty-minutes later, somehow, despite the fog engulfing my brain, I managed to turn to my partner and say, “they have a fairly languid definition of crisis in these parts, huh?”

She laughed. You’ve got to laugh.

Most mentally ill people I know struggle to laugh whenever Mental Health Awareness Week rolls around, as it has again this week, even if “I’m fine for awareness, thanks, can I have some effective treatment instead?” is a pretty funny joke. Timeless too. Truth is, unless you’ve found yourself in the mental health system you wouldn’t know how broken it is. I hope you never have to find out. Take it from me, being besieged by platitudes about ‘taking a hot bath’ and ‘calling friends’ feels especially galling when the serious help you need feels so far away. I’m sure the 1.6 million people, including 374,000 under-18s, on the official waiting list for NHS mental health care, feel the same way.

The number of people who need mental health support, says The Guardian, is actually estimated to be nearer to 8 million and growing, with the difference made up of people with bipolar disorder, psychosis and mental health problems related to pregnancy and childbirth, as well as those who have self-harmed or had suicidal thoughts, but aren’t deemed seriously ill enough to be seen as a matter of priority. Make no mistake, as the pandemic arrives at a manageable plateau, we are poised on the brink of a mental health disaster. Government figures show one in six young people aged 6 to 16 had a probable mental health condition in late 2021, up from one in nine in 2017. At the same time, funding is unevenly distributed: last year, says The Financial Times, only half of local NHS authorities met the government target of spending 1 per cent of their budget on children and young people’s mental health.

When I got ill the other month, friends who have no experience of how flawed NHS mental health services are texted me to say, “at least you can get good care now”. Okay, so that’s something I can laugh at. I’ve been in and out of mental health services for years now. 

After colossal waiting times – even after suicidal episodes, I’ve never been seen before an eight month wait – the NHS has given me therapists who’ve been either okay, bad, or very bad. One suggested I take up crochet to combat my OCD, a suggestion that brings up howls of anger (but not surprise) when I recount it at the independently run OCD support group I attend. Upon learning that I had worked as a music journalist, another asked me mid-session if it was possible for me to blag some tickets to see The Killers for him. 

The units that treatment takes place in are tatty, run down, dirty facilities. Bizarrely, in east London – where I reside – they’re nearly all former Victorian workhouses. There are very poorly people there. I once saw someone pick up a dog turd off the floor, rub it on their face and laugh. We send people who are ill to these places to get better. We send people to get better in places that make them ill.

Ultimately, I asked anybody who loved me if they would help me with the finances to see an OCD expert privately, I found the right sort of therapy that way – therapy isn’t a one size fits all – and with the exception of the aforementioned relapse, I’ve been on an upward trajectory ever since. I know I’m lucky, which is a funny thing to say about a person who’s seen a man rub a dog turd on his face, laughing.

OCD is fairly unique in that it’s an illness where you know you’re going mad, even if you don’t necessarily act it. Most other mental conditions don’t offer this. On the plus side, I’ve normally found myself aware enough of my faculties to navigate the Kafkaesque process of getting seen by a psychologist, even if going mad while still being able to essentially function is an especially cruel kind of torment. But I have often found myself thinking, ‘how would you possibly clear the hoops that require jumping through to get help if you were on your own and without any of your faculties?’ I don’t see how you could. 

Being mentally ill is only the starting point in getting treatment and care. It shouldn’t be that way. We shouldn’t treat people this way. And no number of “awareness” hashtags or Twitter threads promoting breathing exercises – a sticky plaster over a gaping wound – is going to do anything meaningful to help it not be.

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