Youth Mental Health Workshop

This morning I attended the Youth Mental Health Workshop initiated and organised by the state government Mental Health Commission. I was there as a Youth Reference Group representative from the local branch of the Youth Mental Health Foundation of Australia. Others in attendance included those from other government departments and NGOs; the Drug & Alcohol office, Arafmi, Department for Child Protection, The Freedom Centre, the Inspire Foundation, a rep from a public hospital psych unit, headspace, housing, police, amongst many others I didn’t get a chance to meet. There were about seventy of us in the room. What was disappointing though was the lack of young people they did consult in trying to grasp what needs to be done to improve the mental health of young people. Of the seventy, only three of us came from the consumer/young person point of view, the rest were there as an employee of the organisation they were representing.

That being said, a lot of insightful discussion was held. We were put into tables of about eight and posed with questions of what an ideal youth mental health system would look like, what’s working that could be built upon and what are the key policy directions for youth mental health. Being an issue that I’m passionate about, have experience of as well as having heard other people’s experiences, it was great to be able to put forward my ideas and opinions. Integration between the public, private and NGO sectors would be one that needs to be done better. The cut-off between child and adult services were another- it is not good service delivery when an 18 year old is shoved off to adult services from CAMHS as soon as they hit that age and be placed in an adult mental health ward along with middle aged patients who may be quite acutely unwell. The internet is something that works well- many young people will turn to the internet as their first point of contact.

At the end of it I got to speak with and have a photo with Professor Pat McGorry! For those not in Australia, he is the psychiatrist who won Australia of the Year in 2010 and is right up there when it comes to mental health experts.

Prof Pat McGorry...and me.

Why yes, I do have a black oval in place of a head…

Later in the day when I looked at the calendar, I realised this marks exactly a month since I was discharged from The H Clinic. Seems kinda fitting that today I’m doing what I love, contributing to improve youth mental health and services available. It serves as a reminder of why I don’t want to be hospital- I have things to do, I have a life to live on the outside.

The last of my pills

My mother claims that she came into my room to ‘tidy up my desk’ while I was out. Right. Because the first thing one does in tidying a desk is to pull open and rifle through the drawers. That’s how she came to find the box of escitalopram and sertraline I still had in my possession. And my desk is still as messy neat as it was before I left for the day. 

I was confronted by my mother as soon as I arrived home, when she came into my room, pulled open my drawer and enquired about the two boxes of medication I had. I tried to claim they were ‘left over’ from when I still took the aforementioned medications. Except she pointed out the date written on the dispensing label of my box of sertraline. 24 June 2011. Caught out. She confiscated the two boxes and asked for the script. I gave her the one for escitalopram, leaving the one for sertraline. She came back two minutes later realising, and asked for the sertraline script too. Caught out again.  

I feel as though nobody understands how much more desperate and determined to OD that makes me. I’m left with no more antidepressants and no more scripts in my possession. Similar to some people needing their blade there as a safety blanket in case they have the urge to cut, I need those pills in case I have an urge to self harm by ODing. Yeah, I could OD on something like paracetamol, but then I’d have to go to hospital afterwards for treatment to prevent liver damage. With the SSRIs, I know I can OD without needing hospital treatment. I’ve done it a fair amount of times and recovered at home. I don’t want to self harm and end up in the Emergency Department, I want to self harm without; ending up on a hospital bed, my parents finding out, having a cannula stuck up my arm, adding another OD to my hospital records, being labelled as a ‘psych patient’ and undergoing an assessment by ED psychiatrists.

I’m lucky that my mother didn’t find the good stuff. The stuff that has a much more likely chance of killing me. The stuff I had the sense to hide a little better. The stuff that required some effort to obtain. The stuff I wouldn’t take unless I was really sure I wanted to go. But that’s my ‘suicide stuff.’ I’m still angry, embarrassed and upset that I had my ‘self harm stuff’ taken away from me.

Cuts to Psychology Sessions

In this year’s federal budget, the government announced that $2.2 billion would be put towards mental health. Which you’d think would be good news right? After all, mental health has been neglected and under-funded for years. That’s what I thought too…until I found out that to fund this supposed big increase to mental health funding, the government are cutting back on the number of subsidised psychologist sessions per year.

At current before the cuts come in, a person would be eligible for twelve psychology sessions in a year, or eighteen in severe/exceptional cases. This means that instead of paying about $170 to see a private clinical psychologist, Medicare will help fund a maximum of eighteen sessions so that we end up paying about $50 per session. Twelve, maximum eighteen sessions are not that many in the first place. The government however are now reducing that even further to six sessions a year to a maximum of ten. Only ten sessions a year?! Are you kidding me?! So if someone sees their psychologist once a week, they use up their allowance in two and a half months. If they visit once a fortnight, then five months. So what happens in the seven months of the rest of the year? I myself have already had eight sessions with R, my psychologist, from March through to June. Keeping in mind too, I didn’t see her at all during the month of May, as I was in hospital and she was away. So ten sessions would last me, hmm, three to four months? Unless I was rolling in money which I am not.

Professor Pat McGorry, psychiatrist and former Australian of the Year, is quoted in a news article saying, “What we’ve seen is a slight reduction in the maximum number of sessions that are available under that scheme but the vast majority of people using that scheme only need about five sessions.” Erm, who is this ‘vast majority’ you speak about? Most people are cured within five hours of therapy? Really?

I’m someone who finds it hard to talk and open up in therapy.  The eight sessions I’ve had with R and the however many sessions I had with my previous two psychologists have hardly made a dent. By the time I even begin to reveal a little bit more, my ten sessions would be up already. Which makes me think, is there even much point in starting then?

What’s funny is that by reducing the number of psychologist sessions available to me in a year, I’ll probably end up costing the government even more in hospital resources. Meh.

Life scares me

How do people do it? How do people progress through life with such competence and confidence? Or are they just talented actors, able to hide their fears and their doubts? Sometimes it feels as though everyone is equipped with the tools to deal with the challenges life throws at them, except me.

I was talking to a friend last night who’s been here in Australia for five months on exchange from the US. Another wants to move to Canada for further studies after she completes high school despite knowing no one there. How do they find the courage to do that? And it doesn’t even take such major changes to terrify me. Even the little things can start to invoke waves of anxiety and fear. Contacting someone through email or phone. Asking for assistance. Entering unfamiliar situations. Having to learn new things and complete tests and assignments. Asking questions and speaking my opinion. Starting and maintaining conversations with people.  All in the comfort of the place I grew up in.

Semester one of uni has come to a close and the new semester starts in July. Already I’m feeling the nerves. Having to walk into new classes, learn new material, complete all the work and study requires, starting fieldwork…

So how do I survive life when every little thing scares me and prompts me to want to run back into the hidey-hole that is my room? I wish I had the ability and confidence I perceive everyone else to posses instead of being a shy, timid and awkward coward.

SBS Insight: Talking About Suicide

There are many road campaigns encouraging us to slow down and refrain from driving when tired or affected by alcohol. ‘Drop 5, save lives,’ ‘Don’t drink and drive,’ ‘Distracted drivers are dangerous drivers’ are a few of the slogans that come to mind. Why do they pop into my head so easily? Because of the frequency it’s broadcasted on television and radio. Which is great, a reduction of the road toll would be a wonderful outcome. What about suicide though? It claims more lives than road accidents. Yet when I try to think of just one ad campaign targeting the suicide rate, none come to mind.

At current there are certain rules and regulations governing any discussion of suicide in the media. There is a reason for this; the risk of ‘copycat suicides,’ the fear that portrayal of suicide methods may generate ideas and some viewers may find it upsetting. What’s the risk of not talking about it though?

This was the topic of discussion on SBS Insight last week, Talking Suicide. Those interested who live in Australia can view it online here or alternatively read the transcript here.

I think most within the discussion agreed that we do need make suicide a less of a taboo subject and there needs to be awareness surrounding the issue. Doing so in a sensitive manner which fits the guidelines and doesn’t ‘promote’ suicide is the tough part. Professor Pat McGorry raises a good point though- those who are suicidal can seek out material discussing suicide online quite easily and there are no guidelines governing what is posted in the virtual world.

There were two sample suicide prevention ads shown, one from the UK, one from Israel, and the audience were invited to discuss. One woman in the audience commented, “Very strongly I feel that if you want to create an ad regarding prevention of suicide, it should be completely highlighting the victims of suicide, that is people who are left behind because their agony is something which will prevent a person from committing suicide.” John Brogden, the National Patron for Lifeline and a suicide attempt survivor himself, disagreed with this idea. Drawing on his own experiences, he said that one of the reasons he wanted to take his life was the shame he felt he had put his family through, and that thought that they would be better off without him. I’m also one who disagrees with the woman’s views, that an advertisement portraying the devastation of the people left behind will prevent me from attempting suicide. When I’m in the depths of depression, family and friends don’t really come into the equation. I believe that no one cares, no one would notice if I died. I’m so absorbed within my own pain and wanting to end the agony that I don’t even think I may end up passing on the pain to those around me. Or maybe I’m just selfish?

One point made by the Magistrate State Coroner which I found a bit dubious was the comment that some teenage boys will complete suicide in a moment of teenage angst. The exact quote was, “The one that I really get most upset about, and I’m sure, nothing’s worse than anything else if you’re involved I suppose, but teenage people, especially boys who I actually think don’t understand that they’re mortal. And I think often they will say ‘Well I’ll teach you mum,’ because mum just said you can’t go down and play soccer before dinner or whatever, and so within a few minutes, without having thought about it much, they go up to their bedrooms and hang themselves. My feeling is, and I’ve talked with mental health nurses about that, that they actually don’t realise it is forever. There’s this moment of teenage angst […]” I find it hard to get my head around the idea that these teenagers don’t realise that they can die if they try to kill themselves and that they do so just because their parents restricted them from going to play soccer. Surely if it drives someone to go kill themselves they already had deeper issues before they did the deed?

Breaking down the barriers and creating change is hard. But it can be done, and it has been done in the past. As said by John Brogden, “Forty years ago I’m sure that people would have been aghast if you suggested that we should suggest to women to get their breasts tested. How could you use that word in public? Now cricketers play cricket in pink once a year or whatever it is to promote that you know – how could you talk to men about testicular cancer or prostate cancer – oh my god – we are big enough and smart enough to deal with this now rather than find excuses and I don’t want us to find excuses to telling people who feel this way – there is a way to deal with it. That’s the message.”

The closing message I’d like to quote was also made by John Brogden. “One thing I want to make sure that people watching this show understand and I don’t think there is a person here who would disagree with one message from tonight… it’s that you’re better off talking about suicide than not.. I’ve met parents who say I wouldn’t know how to talk to my kid…. You’re better to talk about it than not talk about it as that will open them up… you’re not going to put the idea in their head and that’s a great worry that too many people have and I’d like to think that people will turn off the TV after this and think about talking to friends and family and this very important issue.” I couldn’t agree more. The time is now to talk about suicide.

Temazepam- to sleep, not to OD

Besides the reasons I’ve already mentioned regarding why I do not want my mother keeping and dispensing my medication, I’ve discovered yet another reason why this idea is not to my liking.

I’ve been prescribed temazepam PRN to help me sleep. My mother however, does not quite approve of taking sleeping pills, claiming they are addictive. She does have reason, her father took benzos to aid his sleep and was ‘addicted’ in the sense that he could not get to sleep without them. It doesn’t mean she won’t give them to me, but she has said that I “shouldn’t/can’t have them everyday,” depending on how you translate the Mandarin. And I’m not even able take a few to store myself so that I can have it when required as prescribed either. She’s moved my medication from where it was being stored in the kitchen cupboard to her room and gone so far to label ALL the medication boxes in the house with how many pills each contain.

Sighs. It’s not as though I even want to overdose right now. My moods have not been as low as they had been, perhaps the Pristiq is working? I just want to get decent nights of sleep gosh dammit!

Pleasurable Activities

My psychologist provided me with a handout when I saw her on Saturday for my appointment. It’s entitled ‘Pleasurable Activities Catalog.’ The title itself already sounds a bit dubious, and that’s ignoring that they’ve spelt ‘catalogue’ incorrectly. To be fair, R did warn me that some of them are a bit odd and will be irrelevant to me. Still, that doesn’t stop me from doing my second most favourite thing to do when I receive therapy handouts: tear them apart as I did Marsha Linehan’s Distress Tolerance handout back in February. Not in the literal sense- that would be my first most favourite thing to do.

There’s a list of 185 ‘pleasurable activitives’ suggested on this sheet. Included are;

24. Remembering beautiful scenery. And find myself all the more disappointed I’m stuck in this dull and drab place.

29. Thinking how it will be when I finish school. Well I’ve finished school, which was awful, and now that I’ve finished, it’s still awful. How disheartening.

32. Thinking about retirement. A bit early for that….

58. Losing weight. Yeah, that’s really helpful for someone who has a history of eating issues and is currently struggling with bingeing and purging.

60. Thinking I’m an OK person. Hmm, alright then. “I’m an okay person. I’m an okay person. I’m an okay person.” Nope…still don’t believe it.

62. Having class reunions. What, so I can come face to face with people who didn’t treat me very nice at all and come to the realisation that everyone else has turned out more successful than me?

98. Thinking I have a lot more going for me than most people. That’s a bit of an arrogant attitude to take on isn’t it? Not to mention it’s not all that true.

102. Thinking about sex. ?????….I’ve never even been on a date.

122. Flying a plane. That’s an accessible activity for the general public. Hands up how many of you are pilots?

127. Cleaning. That does not fit ANY definition I have of a ‘pleasurable activity.’

129. Taking children places. Seeing as I don’t have or know any, I’m picturing taking a random kid off the street and leading him/her somewhere. That would be rather creepy and I’d probably be charged with kidnapping.

149. Reflecting on how I’ve improved. HAHAHAHA.

153. Thinking religious thoughts. You mean think about God, Jesus, church and stuff?

162. Thinking about my good qualities. I have the ability to poke fun at handouts? That’ll get me far in life… Yay?

169. Fantasising about the future. The ‘future’ I imagine is one without me in it. Somehow I don’t think that’s the type of ‘fantasising’ the writers of this handout were suggesting.

174. Erotica (sex books, movies). Um yeah. Can’t say pornography is really my thing…

Okay, so there are ones less ridiculous. But what would be the fun in listing those down?!

I know I must seem like the most uncooperative and cynical client…but there are certain therapies and techniques I do not regard with dismay and derision. CBT and ‘distraction techniques’ just don’t happen to be included. For example. That same session with R, we touched on my difficulties with describing and expressing emotions and feelings. I was shown the ‘feelings chart’ she uses with children. It had happy, sad, mad etc written and the cartoon faces with the respective emotions depicted. I’ve been given the ‘adult’ sheet before, but this was used to go back to those basic feelings to talk about my experiences as a child. I was first asked to give an example of a time when I was happy as a child and then more recently. The feeling of being scared was discussed next, which led to a conversation about the intense terror I had as a child surrounding a situation I couldn’t escape. The very topic had arisen with Dr T whilst I was in hospital too. Though it stirs up some emotions, it’s a therapy type I do believe in- sorting through what caused the mental health issues in the first place.

Another one is art therapy, one of the classes I attended in hospital. Though I don’t believe it can cure anyone of mental illness, I do believe it can be useful for expressing what otherwise cannot be expressed with words. A girl I was inpatient with, she was extremely quiet. She kept her head down constantly, she rarely attended the group therapies, she barely spoke. When asked to contribute, she’d shake her head and stare at her shoes, even at something as simple as stating her name as an introduction. The art therapy though, she did attend. And unlike the more traditional talking groups, she participated. She made artworks. It allowed people like her and people like me, who struggle with verbalising what’s in our head, to start to express ourselves. Of all the groups I attended in hospital, art therapy was the most non-useless.

Where to next?

I’m not quite sure where to go from here. When less than a week since being discharged from hospital I’m back to where I started. Back to thinking that suicide is the only viable solution. Maybe not today, but someday. Life seems meaningless and I just can’t find a reason to hold on.

I spent three weeks as an inpatient and there’s been minimal improvement. Hospital is generally the final option offered when one is in a crisis, and when that doesn’t work, then what’s next? It feels a bit hopeless when there’s nothing left.

It’s been a month since I last saw my psychologist and I have an appointment with her on Saturday. The previous two visits, I spent the session crying with despair in her office. I don’t really want to go in having to confess I’m feeling somewhat the same a month later and hospital has done me no good. Spending the third session in a row in tears would really put me up there on the patheticness scale.

GP Appointment For Referral

This morning I paid a visit to the GP. A completely new medical practice and new GP, seeing as the one I saw last year has toddled off to go practice elsewhere. A discharge summary had been handed to me from The H Clinic to provide to my GP, and besides which, I needed to obtain a new referral to Dr T as twelve months have passed since I first started seeing her. This time a year ago, I would have never envisioned I’d be asking for a second referral…after that shocker of an appointment, I was so ready to bolt from her rooms and never come back. But I did, and here I am now.

A questionnaire was given to me to be filled upon arrival at the medical centre. The standard; name, address, date of birth, Medicare number, etc etc… On the reverse however, were questions based around our medical history. All were left blank except the one regarding current medications and the one asking, Do you have a history of mental illness? Please list. Please list? I almost laughed. Ahh, let’s see…. I debated whether to put down ‘eating issues’ and ‘social anxiety’ or not. In the end I listed down; depression, anxiety, eating issues. I do still binge and purge after all, but decided anxiety can encompass social anxiety too.

The actual appointment went alright. It turns out Dr L, the GP I saw today, was childhood friends with Dr T. I was told a story of them playing together as children, and one of them being bitten by the other. Hard to imagine doctors were once children too. Small world huh?

Dr L asked what makes me happy, besides taking medication. Not that taking medication does make me happy. But anyway. I responded with a shrug and an “I don’t know.” I was then told that besides ‘popping pills’ I should find a hobby, do some exercise such as yoga or Zumba. In which I just nodded and made the right noises at the correct intervals.

“I don’t bite, BtF! I’m just very loud,” she exclaimed at one point. I was a bit puzzled. Did I seem intimidated? It’s only later I realise my pulse also taken while she took my blood pressure. Reading my observations she had included in the referral letter, my resting heart rate was recorded at 96 beats/minute. That’s almost tachycardic! Which I suppose gave away the anxiety I was actually feeling.

This new referral is valid for another twelve months so I’m glad I don’t have to visit a GP for my mentalism for at least another year! Well, unless Dr T decides to discharge me back to the care of a GP.