Tag: youth activism

Posted in Managing Mental Health, Mental Health

Nature and Mental Health

Posted on by Millie :)

I think the connection between nature and mental health is under-utilised. 

There are hundreds of studies out there looking at the proven positive effect time in and connection with nature has on our mental health, but I’ll be talking from a more holistic/ theorised place today. 

I think we have learnt to see ourselves as separate from nature, but the truth is we are part of nature. We breathe the same air as all animals, given to us by trees and plants. We are connected to the same ground as all flowers and vegetables, all fruits and roots. We are nature. We’re nature with opposable thumbs. So of course climate change affects us – not only on an intellectually anxious level, but a deep intrinsically natural level. Of course a sunset or a flight of birds can inspire us on an instinctual level. We don’t need to completely understand it, define it – of course at a scientific level that’s useful. But on an emotional level? I think just leaning into that connection can help set us free. 

The pace of the world we live in is in direct juxtaposition to nature. In the western world at least we run at what I think is an unattainable pace. The capitalistic society is intent on promoting not only individualism but also productivity. And we’ve learnt that productivity is a good word. The model citizen is a productive citizen – this really means blindly following the rules put upon us and always striving for more, at a faster rate. Not only does this harm us individually, but it is a driving cause behind the industries that are contributing most to climate change and destroying the nature we are so deeply connected with. So we are severed from the nature we are a part of, and told to keep busy enough that we never question the system we have become a part of; perhaps more importantly, in order to have the resources to survive we cannot question. We are placed in a deep survival mode, and often forced to be unaware of it. 

The next logical step would be to assume that a person with a mental health issue is individually at fault. A weakness in the mind, a personal problem. It isolates the sufferer further and gives the rest of the world and excuse to keep going as is. The common narrative surrounding mental health awareness continues to ignore, on the whole, how much societal and economic factors are contributors and causes of mental illness – and by extension how a lack of connection with our roots in nature is a contributing factor. It should be made clear I am not advocating for full blown communism or anarchism or anything like that – it’s not like we haven’t seen ample issues when those structures have tried to be deployed in the past! In fact I have very little idea how to face these issues on a wider scale. But I know how to face them on a smaller scale; I know where to start (I think) and maybe that’s enough for now. To start, perhaps we look to the pace of nature; to the connection we inherently have (but so often ignore) with nature and our fellow beings. 

Nature does not rush. It works at exactly the pace it needs to. In fact time itself is a structure we have projected onto the world to help us make sense of it – with very obvious reasons for helping us level our experience with each other. But what the construction of time can tell us is that though we may share hours between us, we can redesign what the contents of an hour should be. To explain: resting for an hour in the grass can be redefined to be just as important as furiously analysing stocks to meet a deadline. We can redefine what productivity means and looks like. Nature rests in winter – its pace changes to match the weather and the temperature, the presence of bees and hibernation of bears. And nature still survives. So by extension, perhaps we can learn to respect our rhythms. To work with the sun, to respect the rain, to rest when we are tired and flow when we are not. We are not machines – we do not have endless energy or an ability to always be running. We are not all designed to sleep and wake at exactly the same times each day. We are nature. Maybe we can learn from it. 

Then of course there is the simple benefit of being among other nature. As mentioned countless studies – and poems and songs and personal experiences in each of our lives – record the boost to our mental health when among nature. Simply taking time to sit under a tree and imagine our own roots connecting, or take a walk in the woods (if that’s possible – everyone should have access to green spaces), or swim in a lake, run through a field, watch the flowers in the breeze or the sea crash to shore. Simply taking the time, even if it is only a minute, to start learning how to just be again – alongside our nature – can have a huge positive impact. It can calm us, make us feel more connected, happier, lighter. 

Oh and by the way, this isn’t new or revolutionary. It’s been strategically forgotten and hidden. Native communities around the world have known this for such a long time; the colonial view of society and mental health has detached us from this. I’m not at all the person to be listening to on this perspective and this history  – but here’s just one article written by Indigenous writer Edson Krenak Naknanuk from Brazil about connection with nature: https://www.culturalsurvival.org/publications/cultural-survival-quarterly/indigenous-peoples-are-essential-rights-nature

As the article explores, a view to see nature as a part of us – something in a reciprocal relationship – is important when looking to solving climate change too. 

Remember – we all breathe the same air; we share a consciousness of being through nature. So why do we seek to intellectualise that connection always? How does that separate us from our connection with freedom of mental health? How can nature support us mentally, as a community and individuals?

Sending so much love and support to you all today xx

P.S. For a related science look at some of these topics I would recommend the book ‘Beyond Biocentrism’ by Robert Lanza and Bob Berman

Posted in Advocacy, autism, Mental Health, neurodiversity, Personal Growth, sobriety, therapy

Hurt by Psychiatry

Posted on by Millie :)

Content warning: ED, psychiatric abuse, suicidal ideation, any mental health topic really

I want to write a really strong and defiant letter. I want to write some crazy, proud, creative theatre piece. I want to write something truly hopeful. And while I do have hope, and I do have gratitude – because it is essential to my survival – I also have a lot of pain. And anger. I can talk openly about so many traumas and just general shitty things that have happened in my life. But the one I’ve never been able to write about, never even been able to get through a conversation about without screaming and crying, is the pain endured under the psychiatric complex. Because they were meant to help me. Time and time and time again I have gone looking for help and time and time and time again I have been turned away with only more hurt. I know help is a brave word. I’m not afraid to say it. But I am afraid that when I say it no one will listen. This is my story of a journey through the mental health system. 

Just a disclaimer, because as a writer on mental health I feel it is my responsibility – if you are in a bad place and looking for professional help, please do not use this as your excuse not to. I do know some people have been greatly helped by the mental health system, and you could be too. This is not intended to invalidate anyone’s good experiences, but rather to say that all of us deserve to have those good experiences. This is simply my story as someone who feels they have slipped through the cracks. If you feel this may affect you negatively I implore you to take the decision not to read any further. 

I first asked for help from the mental health system when I was 12 years old. I was experiencing mood swings and distress that were really bothering me – maybe just normal teenage things, maybe not, but the point is it doesn’t matter. They were bothering me. Anyone who wants help, even just to navigate daily life, should be given it. I was assigned a counsellor from the early intervention team. I didn’t like them, so I asked to change. I was discharged from the service – I took that as a message that if I had an opinion on my care, my care would be withdrawn from me. 

My first contact with CAHMS (child and adolescent mental health services) was due to an eating disorder at 14. My life was being ruled by it – I had complete meltdowns when I couldn’t exercise, was hyper fixated on food all the time, was weak and angry and alone; I was really hurting. They weighed me. They told me I wasn’t a low enough weight. I took that to mean I wasn’t sick enough. Without any regard for how I felt, or how food was ruling my life; without anyone trying to find out anything about my experience they denied me the help I so desperately needed. Suggested possibly a meal plan – with no support to implement it or formulate it. If a teacher hadn’t sat with me at lunch every single day for a year and coached me through it because she’d been there too, I don’t know how I would’ve gotten through it. 

I severely relapsed with my eating behaviours twice more, and I still struggle with some thought patterns and triggers to this day (though I am in a much better place, largely due to recovery in other areas giving me the tools to transfer). But I never felt like I really recovered from it, or had the support I needed. Even 9 months ago that teacher would still notice when my old behaviours around food crept in – even before I did – and help me to recognise and head them off. I am immensely grateful for that… but it wasn’t her job. It was never her job to be the main guidance and support in eating disorder recovery. 

CAHMS did offer me six sessions of group therapy. This was to deal with my overwhelming anxiety – much of it around socialising – and deep depression. They didn’t see it as deep depression. It was. It was really, really dark. I stopped going to any lessons and lost all sense of self and hope. But yeah, six sessions would be enough apparently (obviously not). I freaked out at the thought of group therapy, it was entirely unsuitable for me. Once again I received the message in response that if I had an opinion on my care, I wouldn’t get any care. They wanted to discharge me right then, but my wonderful mum stuck up for me so they offered me three – I repeat THREE – CBT sessions. They were not useful. I was put on a years long waiting list for an autism assessment. I was offered no more support. I continued to struggle. 

My mum’s determination to get me the help I deserved was incredible, and probably the only reason I got any support at all. (My mum is probably reading this, so thanks mum). She found a charity that was amazing in supporting us through my teen years, and funded me to see a private psychiatrist – this would not have been possible without them. However I wouldn’t say that was particularly helpful either. That psychiatrist did diagnose me with autism (side note – the assessment for autism really needs to be changed), anxiety and depression. I am eternally grateful for my autism diagnosis – it truly did change my life knowing I was autistic. But it changed my life because I went away and learnt about it, as did my family. The psychiatrist did not formulate a treatment plan for any of this, or provide any further support. Some medication that didn’t work was all she offered. 

In this time I also saw a few therapists – I didn’t like them, one of them didn’t like me and kinda dumped me. All of them were privately paid for. The subpar care I received was paid for privately – can you imagine how much worse it would have been if we hadn’t been able to afford it?

I know this is all a lot of information, but stick with me here. This journey is important to understand because it is something so so many people face. I slipped through the cracks of this system – even with the privilege of being a white, cisgendered woman. I had it reasonably easy. 

In February 2020 I had what I now recognise to be my first (and most intense) mixed episode. I cannot even put this experience into words but essentially it was all the darkness of depression with all the heightened energy and irritability of mania at the same time. I felt reality slipping away from me and I have never been in such intense distress. Two teachers stayed with me at school hours after school ended to try and keep me safe. They eventually helped me calm down, but I later found out they were so concerned they were about to call an ambulance or the police, as the crisis line wasn’t helping. I went to the GP during this episode begging for help. She prescribed me valium to calm me down, but when I begged her for more support I remember her chastising me for being so emotional because she had other patients waiting. I took that as a message that I still wasn’t sick enough; still wasn’t important enough. 

In March 2020 the private psychiatrist diagnosed me with cyclothymia. We had to pay extra for an emergency appointment. She decided I was now too complicated to be under her care and needed more support so referred me back into the NHS. They did not follow up on her recommendation for more support. By the time they saw me I was a bit calmer so apparently that meant I didn’t need help. In her eyes I was too bad, in their eyes I wasn’t bad enough. So I was left with nothing. This was the trend that would continue for the next three years. 

In September 2020 I wound up in A&E. I was broken and desperate. When the CAHMS crisis person finally arrived she acted annoyed about me being there, annoyed she had to be there, uncaring. She essentially asked ‘if things are so bad then why haven’t you killed yourself yet?’ and sent me home with no support. They didn’t follow up on any support because I calmed down a bit after, so I was no longer considered in crisis when they finally did get in contact (even though they hadn’t helped me when I was in crisis) and because I was drinking at the time. Just so we are all clear – if a young person is drinking as heavily as I was, that is exactly the time they need support. I went to my first AA meeting after I left the hospital that day. And excuse my french but thank fuck I did. I have no idea if I would still be alive otherwise. And having connected with others who have been subjected to inpatient treatment, I am incredibly grateful I did not have to bear that extra trauma. This is how bad the surface level service is – it’s even worse inside. 

After I got sober in July 2021 I was still struggling. I finally got to see a psychiatrist on the NHS in October 2021 because of my mum’s insistent fighting for me. When he asked me what I wanted from the meeting, he chastised my response. He was unclear. He shouted at me, and revoked what I thought I had been diagnosed with in a letter. I was meant to see him again in 10 weeks and he cancelled. I got discharged from CAHMS without them ever asking to talk with me about how I was doing. 

The one professional who has been a saving grace is my therapist. She is autistic herself and very flexible. But again – if I wasn’t able to fund that privately I don’t know where I would be. After my charity funding stopped when I turned 18 I had to take the sessions down to every 2 weeks, even with her sliding scale, which is significantly less helpful. Luckily I’ve also found amazing peer support, especially through AA, and spent a lot of time reflecting and doing my own work, so I’ve managed to build myself a much brighter life. But it’s been hard. And sometimes I really do need some more help – no one should have to do this alone.

I Went back to the NHS this October and had my first ever good meeting with anyone, just someone in my GP clinic. Why? He was honest. He genuinely seemed to care, but there was nothing they could offer me. He explained that as far as the system saw it, I had already been helped.

In late 2022 my mental health really started to decline again. I went back to the NHS this October and had my first ever good meeting with anyone, just someone in my GP clinic. Why? He was honest. He genuinely seemed to care, but there was nothing they could offer me. He explained that as far as the system saw it, I had already been helped. So from October I was searching for a psychiatrist who would see me. 

I was turned down by over 10 private psychiatrists for being too complex, having comorbidities, or my favourite way of putting it: ‘them not being able to offer the support I need at that time’. So I was again too bad for private and not bad enough for the NHS. One of the only people who would see me charged just under £1000 a session. Others said they would consider seeing me, but were booked up until 2024.

Finally in March 2023 – 5 months later – I got to meet with a private psychiatrist. And wow, he was amazing. We had three meetings so we could cover everything. He was kind, listened to me – really listened – and didn’t patronise. He treated me like an adult, and made it clear I would have a say in my care plan and the final report that would be sent to my doctor. I would have a say? I almost thought that wasn’t allowed. I’m still sceptical, it still doesn’t feel real. 

He diagnosed me with Bipolar type 1. Just think about that for a minute – an 18 year old has been dealing with undiagnosed bipolar 1, unsupported, emerging from 12 years old. I have no idea where I would be without the angels placed in my life along the way; without the undying support of my family and friends; without the flexibility of my school. I knew something more was going on, I knew how much pain I was in, and no one in the mental health industry was listening. I was screaming into a void and not even hearing the echoes of my own screams. (A separate issue is that we shouldn’t need labels to validate that level of human distress, which is what it is at its core, but diagnosis can be so validating. Read more about that here). 

I am not in any way saying this one experience erases all the rest. It does not. It absolutely does not. And it doesn’t not mean that psychiatry isn’t built on an oppressive, harmful foundation whose history has been hidden. It is. But it was a little hope given back to me. A relief at the very least. Before I went into that meeting I said ‘I’ll take them just not being actively mean to me’. How sad is that? What a desperately low bar. 

I’m still scared. He has instructed my GP to refer me back to secondary care teams in the NHS, which I still – like always – hope might offer some help. But the main thing offered seems to be medication, which I have some serious and valid concerns about. But I am terrified of raising these concerns or asking about alternatives for fear that a) I will be labelled as disordered and my new diagnosis weaponised against me or b) I will be labelled as non-compliant/ not wanting help enough, and sent away again. I wish I didn’t want help from them, and maybe one day I’ll be able to find a path that avoids dealing with the mental health system altogether. But I’m not there yet. Nor should I have to avoid it. It should be an inclusive, varied, accessible service. It should have community and individualised care. It should have alternative treatments and input from patients. It should see the human condition as a spectrum. But it doesn’t. And being mentally ill makes me scared that if I voice any of this, I will not be taken seriously. How can anyone ever prove that they are sane?

I deserve better. Everyone deserves better; we deserve to know that no matter what we’re going through there will be appropriate support for us. But it’s not there. And this broken system is quite literally killing people. We can’t just say fund the system either, the system needs to change. I need it to change, we all need it to change. 

I think I’m sharing this because the younger version of me wanted desperately to read it from someone else. So the core message is that you are not alone. You are not alone in the hurt psychiatry has caused you. You are allowed to be angry about it, and distrusting of it. You are allowed to choose your own care and your own path – even if others don’t understand it! (And that applies to all paths – mental illness should not be policed). Your pain is valid, completely valid, and I see you. I see you.

Sending love and support to you all today xx

Posted in Advocacy, Mental Health

The Casey Review and What it Means for Mental Health

Posted on by Millie :)

Content Warning: Police misconduct, abuse, and discrimination

This post is a short overview of how the recent Casey Review relates to the mental health system. There are many more implications for the mentally ill and all intersectional issues so I would really encourage you to do some more research into the review and the topic of police misconduct – it affects all of us, especially the most vulnerable.

What is The Casey Review?

The Casey Review is an independent investigation and review of the standards of behaviour and the internal culture of the Met Police in the UK. Baroness Casey was appointed to head up the review in October 2021 after the kidnap and murder of Sarah Everard by a police officer and several other deeply troubling incidents. The final report has just been released (March 2023) and it is a damning condemnation of the Met Police.

What Did The Review Find?

The police were found to be institutionally racist, misogynistic, and homophobic. Specifically that it has failed to protect the public from officers who abuse women; that organisational changes have put women and children at greater risk; and that female officers and staff routinely experience sexism.

Much of what is found in the report isn’t a surprise to the communities who face discrimination and targeting from the police, and also echos what was said in the MacPherson report back in 1999 after the murder of Black teenager Stephen Lawrence. This isn’t a news – it’s a continually pressing issue that cannot continue to be ignored. This isn’t news – it’s a continually pressing issue that cannot continue to be ignored.

What Does it Have to Do with Mental Health?

Mental Illness has been criminalised in this country for a long time. Police play a key role in enforcing the Mental Health Act (which is used to section people against their will). This means their attitude, organisation and behaviour can have a huge direct impact on those of us with perceived mental health difficulties.

As Mind puts it: ‘This matters to us because we know that people with mental health problems are more likely to be victims of crime, more likely to feel that impact more acutely, and less likely to get the support they need’. And yes – people with mental health problems are more likely to be the VICTIMS of a crime, despite continual stigma that we are more likely to perpetrate crime.

One key way this directly impacts mentally ill people and the mental health system is the institutional racsim. Black people are already 5x more likely to be sectioned, and to reach the mental health system through ‘negative’ routes such as police and court. And this is one of the reasons why – the institutional, systematic racism that pervades our society and police. Once within that system Black people are likely to face more trauma and forced control, a lack of appropriate care and understanding. Their distress likely compounded by the racism they face daily anyway, more trauma is created within the system and only compounded further if they also face homophobia and sexism.

The ways the findings of this report impact the mental health of individuals, and the mental health system are myriad. It is directly in opposition to justice, freedom, and healing.

Ways to Help:

  • Sign up to become a Mind campaigner
  • Look for alternatives to institutionalised care that you can support in your area
  • Contact the Met Police and put pressure on them
  • Contact your local police and MP to ask that they review their own behaviour
  • Donate food and supplies to local charities that support your community
  • Raise your voice however feels best for you – maybe you can use art, or song.
  • See this page for a list of further reading looking at the idea of police abolition and how our systems function for a deeper understanding (and a much better look at ways you can help!)
  • There’s not one way to make change, it happens together!
Posted in autism, neurodiversity

Non-Canonical Autistic Characters

Posted on by Millie :)

Ok so this is actually a list of characters that I have decided are autistic/ neurodiverse – not actual canonically autistic characters. In fact the only media representation of a canonically autistic character I have ever seen is Sam in Atypical – and I really struggled with this series. The only book I’ve read with an autistic character is The Curious Incident of a Dog in the Nighttime. To this day I have never – I repeat, NEVER – read a book or come across a media representation of a canonically autistic character who is female or gender diverse. Ever. I only realised that two days ago while thinking about this post and it made me really sad. In many ways I feel the media is moving forwards, and I do not feel I lack autistic representation in my life because I have had the privilege to be able to actively seek that out online. But to have never come across an autistic girl in the media I consume? I’ve heard there is an autistic character in Heartstopper so I will have to give that a watch soon. I’ve realised how much I want to consume content with autistic characters, so for the first time I think I’m going to actively seek that out. 

But anyway, what’s the point of this? What’s the point of calling characters autistic? Well, in part for fun. This is simply my opinion and not a critical analysis of any of these characters. But also for representation, in a non-direct way. Resonating with fictional characters and relating to the world through them is a huge part of my neurodiverse experience, so if I can see myself in them a little more by calling them autistic, it’s really comforting. And finally also to raise a little awareness of an ongoing trend of creating autistically coded characters (characters with clear neurodiverse traits) without calling them autistic. It lends itself to another ongoing trend where people love the quirky characters on screen or in books – they even seem to worship them – but in real life people with the same traits are bullied and left behind. Recognising that I, as an autistic person, resonate with neurodiverse traits of characters begs two questions: 1 – Why aren’t characters called autistic? Perhaps because people are afraid to relate too closely to neurodiversity, it threatens them; 2 – Why do we celebrate difference in fiction but create intolerance to it in reality? 

With that being said, here are some character I (and other autistics) have decided are autistic:

  1. Sheldon Cooper – The Big Bang Theory and Young Sheldon 

The fact that the creators refused to admit Sheldon is autistic (like literally entirely based on autistic traits and stereotypes) is a source of great frustration – though it may be because they wouldn’t be able to make fun of him in the same way if he was autistic. But nonetheless, I really love seeing some of my traits on a big screen, especially in Young Sheldon, which at times seems to mirror my own childhood experiences exactly. Though it should be noted that autism is so much more complex and varied than the representation of Sheldon (and other similar characters like in Rainman). 

Some of his autistic traits include:

  • Sensory sensitivity (sound, taste, smell)
  • Different speech and intonation patterns 
  • Love of routine 
  • Difficulty dealing with change 
  • Lacking social skills
  • Hyperfixations and special interests
  • The list is literally endless 
  1. Wednesday Addams – Wednesday 

I mean the character of Wednesday is overall very neurodiverse, but the recent representation in Wednesday on Netflix was really relatable for a lot of autistic people. 

Some autistic traits include:

  • Monotone speech 
  • Less facial expressions 
  • Different way of moving (the iconic dance scene)
  • Sensory sensitivities (allergic to colour)
  • Bluntness 
  • Difficulty interpreting others emotions – ‘It’s not my fault I can’t interpret your emotional morse code’
  • Strong sense of justice 
  1. Matilda – Matilda 

I have always been obsessed with Matilda, and that’s probably at the core of why I see her as a neurodiverse character. I think I’ve read the book more than any other book (including in Spanish) and I’ve seen the musical more than any other show. I love it. As a kid I would spend hours staring at objects trying to get them to move with my mind, and I feel as though I’ve had my own ‘Miss Honey(s)’ in my life too. 

Some of Matilda’s autistic traits include:

  • Strong sense of justice 
  • The loudness in her head and different way of perceiving the world (‘But I wonder if inside my head/ I’m not just a bit different from some of my friends […] And when everyone shouts / Like they seem to like shouting/ The noise in my head is incredibly loud’)
  • Different from her peers and family 
  • Hyperlexia (can read very well very early)
  • Special interests (reading)
  • Direct way of communicating 
  • Sensory sensitivity – to Ms Trunchbull’s shouting and the TV for example 
  1. Hermione – Harry Potter 

Mentioning Harry Potter can seem a bit of a tightrope walk nowadays, but it was a very important part of my childhood and forms part of who I am today. That being said, trans women are women – always have been, always will be. So let’s reclaim the narrative further and say that Hermione is autistic! I was so obsessed with Hermione that all the new clothes I bought at 12 were based on her costumes. She was super smart and didn’t let others put her down because of it, and as someone who was often ‘ahead’ in school this was so comforting to see. Also Luna Lovegood is 100% autistic as well and I love her. 

Some autistic traits:

  • Strong sense of justice 
  • Sensory sensitivity – notices details others miss 
  • Lacks social skills (at least in first few books) and skips social niceties 
  • Special interests and hyperfixations (intense devotion to studying)
  • Obsession with learning and following the rules 
  • Hyperlexia 
  1. Phoebe – Friends 

Another one of my comfort shows, I have watched Friends more times than I can count. And the more I’ve watched it, the more I’ve related to and appreciated Phoebe’s character. Watching it again after being diagnosed was really interesting because I remember wondering for the first time about how Phoebe was showing a load of those traits I had just been asked about in my assessment. I’m not convinced she’s autistic, maybe ADHD or something else – but she is definitely neurodiverse. 100%. 

Neurodiverse traits:

  • Doesn’t care about social niceties (will just leave or say she doesn’t want to do something)
  • Unique fashion sense 
  • Sensory sensitivity (she can hear music and voices and feel spirits etc, I’m putting this under sensory sensitivity, maybe it’s an extra sense)
  • Special interests – guitar 
  • Different way of communicating 
  • Moves her hands in different ways 
  • Wandering thoughts 
  • Hyper empathy 
  • Strong beliefs that don’t bend to social expectations

So there’s five there. Is that representation good enough? No, because it’s not really a representation. Is it a bit comforting to think about, personally? Yeah, it is. Can we do better? Yeah, we can. A lot. I’m not looking for a whole series about autistic experiences. But I’d like to see myself in the media occasionally, because there’s a lot of autistic people here in the world. Just for already autistically coded characters to maybe have a moment of recognition on screen, a single mention of it, would be huge. If I – a privileged, white, verbal, cis autistic woman – haven’t seen myself represented yet, how long will it be before we start seeing the Black autistics, non-verbal autistics, physically disabled autistics represented? It might seem like a little thing if you have seen yourself on screen and in books all your life, but it can have such a huge impact. I remember crying the first time I read a book with a gay woman. It meant I wasn’t alone. I enjoy a lot of the media I consume, because I can relate to lots of different people with lots of different experiences, and I can enjoy media I don’t directly relate to. So why are people so afraid to relate to us once in a while instead? 

Thanks for reading! Sending all my love and support today xxx

Posted in Advocacy, Personal Growth

Being Vulnerable

Posted on by Millie :)

Thought I’d share something a little different today. The text below is directly copied from ruminations in my diary about being vulnerable (specifically online). Half formed thoughts and unanswered questions, which is kind of the point of what I was writing about – allowing an ‘unfinished’ image of self to be seen. I’ve thought about it more and this quote in particular resonated with me: ‘Vulnerability is the least celebrated emotion in our society’ ~ Mohadesa Najumi. I’m a growing, changing person whose views will inevitably change, but I don’t think I want to live holding back because I may think differently in the future. All we’ve got is now right? So this post is a little less about mental health, and more about the process of learning to be a mental health advocate (if I can allow myself that title!). Please enjoy this copy of my wandering thoughts:

‘I think I naturally ‘overshare’ a lot, though keep some things very hidden. And it’s part defence mechanism, but also part not understanding what’s meant to be hidden. I don’t see my ‘personal life’ as any more personal or precious just because it’s mine. It doesn’t really bother me if more people know, in fact sometimes that makes it more special to me. But is that just a need for validation? Or am I broken, or missing something – because I don’t seem to understand the idea of personal life in the way the messaging of the world does??

And also, of course I’m afraid of judgement. The biggest fears being that sharing I’ve had problems with alcohol – for example – will stop me getting a job in the future. But if no one speaks openly about these things then they remain something to be feared or judged. Right? Social media is so often used to show the ‘end product’ of healing, discovery, creation etc… the polished, acceptable version. But that’s not life! I’m ok being a flawed, growing person. I have to be because I always will be. I want to show that too. 

But is there a right and wrong way to do that? Or is that just more expectations? Or is social media in fact not suitable for that? Of course it will always be just a snapshot of life – does that mean we cannot snapshot the vulnerability too? Indeed – what is vulnerability? I feel we live in a culture where we are afraid to make mistakes, especially in changemaking settings. But mistakes are a part of life. It’s all very confusing, but I don’t want to be afraid of the journey of figuring it out. I choose to move forwards with love and acceptance.’

Posted in Advocacy, Mental Health

Write to MP About Mental Health System

Posted on by Millie :)

Writing letters to our MPs about important issues can feel like hitting our heads against a brick wall. I get it. Our government is failing us in about every way possible at the moment while continuing to introduce increasingly more constricting and draconian laws that limit our freedoms and right to democracy. Nonetheless, I still maintain that there may be hope to be found in raising our voices. The more people that stand up against issues the harder it becomes to ignore – and it could even be argued that it’s up to us to believe in hope even when they aren’t giving us much reason to. One of the easiest ways to raise your voice is by writing to your MP. They may not be able to do anything directly or immediately, but they are our representatives and can bring our concerns to the table. Imagine if every person in your district wrote in about the same issue – it would be pretty hard to ignore. Anyone of any age can write to their MP, and you can even email them. 

Our mental health system is in crisis; it’s built on harm and it is perpetuating that harm. And it cannot be fixed just by increasing its funding – you can’t fund a broken system and expect it to fix itself. So we need to raise the alarm and raise our voices. Below I have written a very short template for writing to your MP about the mental health system. To use simply:

  1. Use this website to find out who your MP is and what their email address is: https://www.writetothem.com/
  2. Copy and paste the template below into an email 
  3. Replace the generic details in italics with your MP’s name and your own information 
  4. Add in your own message or questions 
  5. Hit send 

It’s that simple. And it may seem small, but you never know if the small individual actions we take will add together as a collective. It’s worth a try if nothing else. And remember, if they don’t reply or give a satisfactory reply, you can keep writing to them! Don’t let this be an issue that goes unheard. So here’s the template (just a general content warning for topics relating to mental health here such as suicide):

Dear [insert MP’s name],

I am writing to you today because I am incredibly concerned about the state of our mental health system. It is clear to me that the mental health system continues to fail all of us, especially the most vulnerable in our society. As I’m sure you’ll understand this is an incredibly serious issue, with people’s lives at risk. 

The suicide rate in England and Wales was 6.9% higher in 2021 than in 2020, a trend that has been continuing over many years despite supposed attempts by the government to address mental health issues. For example – the rollout and continued expansion of IAPT that is meant to provide early and easy access to psychological therapies but has since been found to be skewing their own data by several studies. The University of Chester found their actual recovery rate to be just 23% by their own measures (which can include clinically insignificant improvements) as opposed to their claimed 46%. However a large meta-analysis found that 23% of patients with depression spontaneously overcome their symptoms in three months anyway which would render IAPT irrelevant. Despite this it continues to be heralded as a success with no one speaking up about the failures and the people it leaves to the wayside. 

That is the most basic level of treatment and doesn’t even begin to reveal the long waiting times, criminalization of mental illness and failures of the Mental health act, abuse within inpatient treatment, how risk of suicide actually increases after inpatient treatment, lack of appropriate and individualised care, lack of any support for young people, or obsession with productivity instead of personal happiness in recovery. Even within the last six months we have heard about the cases of more young people who have died while in inpatient care –  Christie Harnett, Nadia Sharif, Emily Moore, Charlie Millers, Beth Matthews, and Lauren Bridges. People are falling through the cracks, and being actively harmed by the system. People are dying. It is unacceptable and it cannot be allowed to go on. 

[Insert any personal experience or thoughts here]

Therefore I implore you to research more into the truth of the mental health system and the harm it has caused to so many. And I ask you – what will you do, as representative of this community, to raise the voice of our concern about the mental health system? What will you do to push for change? What will you do to support the mental health of young people in this community? What will you do mitigate the compounding and intersectional issues with mental health (ie. racism, food insecurity, transphobia, poverty)? 

Thank you for taking the time to read this letter and I look forward to hearing your response, 

Kind Regards, 

[Insert your name, address, and contact information here – remember, without an address you will not receive a response!]

Glowing fluorescent blue triangles in a pattern
Posted in Advocacy, Mental Health, therapy

Issues with IAPT

Posted on by Millie :)

Disclaimer: Before I dive into the issues with IAPT I just want to clarify that this blog is in no way intended to discredit anyone’s positive experience with IAPT or discourage anyone from using the service. IAPT could still be a piece in the puzzle of helping you find the right support. I am purely highlighting issues that some people face because everyone deserves to have a positive experience of mental health care – if the mental health system can’t adapt to different needs, then it needs to change. This post is about raising awareness of the gaps within that system, and the plaster solution that IAPT has become. Because we all deserve better – it could be you or any of your loved ones needing a more comprehensive, long term and personal care plan. And I would hope that the door was always wide open for you to receive the support you need.

With that said, let me give you an introduction to what IAPT is. IAPT stands for Improving Access to Psychological Therapies. If you are an adult and go to the doctor with a mental health concern, you are likely to be referred to this service as one of the first ports of call. It was rolled out in 2006 and there are now around 220 IAPT services in the UK. It offers patients a limited number (usually 6, up to 12) of sessions with a counsellor using CBT – Cognitive Behaviour Therapy. And it’s true that rolling out this service greatly reduced the 8-12 month waiting time for psychological therapy in 2005, which is great, but that doesn’t mean it provides a greater level of care. 

So let’s look at the information I’ve just noted. CBT focuses on changing thought patterns and behaviours of individuals – which by definition is not suitable for anyone who’s mental health is being impacted by the situation they are in. It’s true that CBT skills can be incredibly useful in helping us cope with day to day life, giving us the tools to reframe our experience so it becomes bearable and our thoughts less consuming. But that doesn’t mean it’s perfect by any means, nor suitable for everyone. For example many autistic people have likened the approach of CBT to gaslighting; it just isn’t suitable for application with neurodiverse thought patterns in many. For many others too it simply doesn’t provide the all round support they need – the therapy sessions are not designed to hold space for the person, explore route causes that will continue to be present, or brainstorm ways to change the situation they are in. It can provide people with a quick fix to a singular problem, but lacks a long term approach. 

However, it’s the only framework offered with IAPT, already excluding many from the help they need. Especially because if someone goes through with IAPT treatment they may be seen as already having support and having to face longer waiting times; likewise if they refuse to continue this raises the issue of non-compliance. Non-compliance is a complicated label used in the mental health system sometimes that essentially labels patients as unwilling to try and help themselves and makes it harder for them to access support, simply because the support they refused was not suitable or accessible to them. This is a systematic issue of not providing individualised care, but instead it is labelled as a personal fault and the burden is borne by the individual. 

Even for the people CBT framework does suit, the IAPT programme offers such limited sessions that it’s arguable how much long term support and healing they actually offer. 6 sessions is simply not enough in my eyes. What about the people with more complex issues? The people that learn slower? The people that need time to build a secure relationship with a therapist before they feel confident to start working with them? They are all being left behind by the existing IAPT service. 

None of this is surprising when we look at the roots of how the IAPT service came to be. In 2005 Lord Layard – an economist by trade addressing the economic costs incurred due to mental health crisis – and David Clark – a professor of psychology championing CBT – pitched their idea for IAPT to a board room full of government officials. They pitched it through the economic benefits that providing a cheap service that got people back to work could reap, easing the £12 billion cost of depression each year. Though I understand why so often proposals have to be pitched through an economic lens rather than a moral or social one, I do think it’s very sad. And I think in many ways shows why this system isn’t working. We’re approaching the issue of the mental health crisis wrong if we’re approaching it from a perspective of getting people back to work. Mental health doesn’t exist in a vacuum and is deeply intertwined with all aspects of society which we cannot simply ignore addressing when looking to help mental health. Furthermore, healing is not actually about productivity – this is considering healing through the eyes of someone else looking in on a life trying to define quantifiable proof of them getting better in a way that is palatable to society. Healing is internal and personal; our current mental health system does not recognise or allow space for this in our society. 

Nonetheless IAPT was heralded as an astounding success in the mental health sector worldwide for its quick rollout and wide reach. But in 2010 Dr Micheal Scott – a clinical psychologist at the University of Manchester – began to question the success of IAPT when assessing its patients. He was hearing many stories of patients with bad experiences of the programme who found it useless, dropped out, or pretended to be better to make it end quicker. He decided he needed to look further at how the effectiveness of IAPT therapy was being assessed in order to discover if it was really as great as it was claimed to be. 

The first thing of interest he discovered was that IAPT was responsible for collecting all the data on its own performance – there were no external reviews or assessments taking place. I think many of us will know that this is a bad scientific practice for collecting and understanding data – there should always be peer reviews. So he conducted an assessment to discover the true recovery rates. 

He began by reviewing the cases of 65 people. I’ll admit that’s not a lot, but stick with me here. Scott used various procedures for a robust review including in-depth interviews, diagnostic assessments, and evaluating medical records. His results showed that no matter the condition, only 16% could be considered as recovering. This is woefully below the 46% reported by IAPT themselves – and with good reason. IAPT’s method of assessing recovery rates only included those that completed treatment with them and neglected to count the half of patients who dropped out of treatment. The fact that half of patients drop out of treatment at all is a huge indicator that the programme is failing anyway, but the correct way to conduct research would be to include them in the data. By omitting them IAPT are artificially increasing their recovery rate. I would also add here that even their self-proclaimed 46% could be much higher with proper individualised, socio-culturally aware treatment plans. 

Scott’s admittedly small study isn’t the only one either. The University of Chester’s larger study found a 23% recovery rate, still much lower than IAPT’s claim. And that’s before even considering what IAPT deems recovery to mean. I’ve already explained that IAPT was built around the idea of getting people back to work, and so it’s unsurprising that the programme focuses on getting people back to what are viewed as functioning members of society rather than personally happy with their healing journey. 

This is seen reflected in how IAPT reviews patients progress. At the start of the therapy questionnaires are conducted that rate how depressed or anxious you are, and then again at the end of the therapy. If at the end of the therapy you score lower you are considered to have improved. If you scored just above the clinical threshold for depression at the start of the therapy (let’s say the threshold is 10 and you scored 11) and by the end of the therapy you score just below (let’s say 9) then you are considered recovered by IAPT. But in reality you’ve only dropped 2 points and are likely still experiencing emotional complications in your life! They’re now just not considered inconvenient enough to others to be clinically notable, but that doesn’t mean they aren’t hugely significant to you. You might not feel ‘recovered’ at all. And the scale is really sensitive anyway – you can move around 5-7 points simply by sleeping and concentrating a little better. 

Furthermore , IAPT doesn’t even conduct a control group meaning there’s no way to know if the 23% ‘recovering’ would have improved slightly without IAPT at all. In fact a recent meta-analysis (meaning examination of lots of data from different individual studies) showed that a total 23% of people suffering with depression spontaneously overcame their symptoms within three months without receiving any treatment. Which aligns with the 23% recovering from IAPT exactly, suggesting that the service is totally irrelevant. Yet it is often the only service offered to those struggling, many of whom will continue to struggle unsupported. Real lives are in the balance, and the system is trying to stick a plaster over the issue that doesn’t even work. 

This doesn’t even begin to touch on the deep issues for workers within the IAPT services, who are struggling hugely themselves and being crushed under a culture of form filling and goal hitting heralded above actually providing support. An ex-IAPT lead said, in an interview with James Davies: “To hit the waiting list targets we’d offer people some minor intervention but it was not what they really needed – it was what we could offer to get higher results”. And there lies the problem in a nutshell – people are not being offered the help they so desperately need. And how could they in a system that values goals, productivity and economy above people’s lives? How could they in a system that is built on societal expectations, harm, and conformity? How could they in a system that isn’t working to face the deep intersectional issues of the day? How could they in a system that is underfunded and in desperate need of reform? 

I recognise that criticising the mental health system is a complicated thing to do, because it’s where we hope to find help. But the reality is that it falls short. I do have hope it can improve; I have hope in our communities and our efforts to see better care. And I do know that despite a failing system people can recover – by their own standards – and live bright lives. But I know too it shouldn’t be so hard to get support, for anyone. 

So here are some calls to action! What you can do to help: 

  1. Most of the information in this post comes from James Davies’ book ‘Sedated: How Modern Capitalism Created Our Mental Health Crisis’. I would recommend that everyone read this book to educate themselves further 
  2. Sign up to Mind’s newsletter to find out about their campaigns for better mental health care 
  3. Write to your MP about the failing mental health system and demand care that is individually tailored, socio-culturally aware, and focuses on personal healing not productivity 
  4. Share this post and have conversations with people in your life about the mental health system – all change starts with a conversation 

Thank you so much for reading! Please let me know any thoughts or questions you have in the comments below. Sending so much love and support to you all today 🙂 

Sources:

https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/iapt#:~:text=What%20is%20IAPT%3F,with%20anxiety%20disorders%20and%20depression.

‘Sedated: How Modern Capitalism Created Our Mental Health Crisis’ by James Davies 

https://www.madinamerica.com/2022/06/uk-iapt-abject-failure/#:~:text=We%20identified%20a%20series%20of,of%20misdiagnosis%20and%20inappropriate%20treatment.

Layard, Richard (2005), ‘Mental Health: britain’s biggest social problem?’, paper presented at No. 10 strategy unit seminar on mental health, 20 January 2005 

https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/cognitive-behavioural-therapy-cbt/

Griffith, Steve, Steen and Scott (2013), ‘Improving access to psychological therapies (IAPT) programme: setting key performance indicators in a more robust context: A new perspective’ 

Whitford, H et al, (2012), ‘Estimating remission from untreated major depression: a systematic review and meta-analysis’

Posted in Advocacy, Happy Notes, Mental Health, Personal Growth

OHN Hopes for 2023 (and beyond!)

Posted on by Millie :)

I struggle with the idea of New Year’s resolutions. After all, New Year’s Day is simply just another day. The sun will continue to rise and there will always be new tomorrows; new opportunities for change and growth – in fact it happens every day. However I do realise that years are markers of points in our lives and our developments, so I wanted to share some hopes and aims for this space in the coming year and beyond! In the interest of transparency, I don’t have a clear plan on how to achieve everything on this list. But I’m working on it. Just like I’m working on learning more and listening to more voices on mental health and its intersections every day. My hopes will change, my perspectives will change. And I am so glad to have all of you along for the ride. 

Thank you all so much for your support of this space and mental health advocacy in 2022. 

If you would like to be more directly involved with Our Happy Notes – whether on the blog, instagram, or something else! – please do reach out. I would love to hear from you! You can fill out the contact form on this website or email ourhappynotes@gmail.com 

So without further ado, here are the hopes for Our Happy Notes in 2023:

1. More tangible actions 

2. More pressures on governments and organisations 

3. Consistent blog posting

4. Regularly get back to how it started – distributing happy notes!

5. Create connections

Posted in Advocacy, Mental Health

Actions to Support Mental Health Nationwide

Posted on by Millie :)

Here are some tangible actions you can take to support mental health in your community and nationwide, but there are so many more! Follow this blog to get notified of new posts and ideas in the future.  

Write to your MP

Imagine if everyone in the U.K. wrote to their MP in the morning demanding more mental health support. While it’s unlikely that will happen, small actions over time DO add up – it’s worth a shot. When writing to your MP make sure to mention mental health system reform, not just more funding. Writing and protesting other issues such as the cost of living crisis also supports mental health, as it is not a stand alone issue! 

Join the Young Voice Network at Mind

If you are aged 11-24 in the U.K. join this network! They constantly send through information and opportunities for young people to get involved and shape the direction of Mind and the mental health support for young people in a meaningful way. 

Protest

If you’re able to – protest. We don’t hear a lot about protests for mental health system change and support. But that doesn’t mean it doesn’t happen. CPA in London held several last year for example. And the protests and shows of solidarity for other issues such as Black Lives Matter and fair pay are all interlinked with mental health support too of course! If you want you could even set up your own protest or vigil. 

Promote mental health support at your school or work

Mental health support starts at an everyday level, and we can build communities of support. Have a look at the support available at your work or school, even your local community, and join meetings, boards, unions etc to demand better mental health support be available to fill the gaps. Suggest support groups in community centres, accommodations and counselling available at work – the sky’s the limit, and you are not powerless. Of course do not risk your own security to do this, but often a gentle conversation can be enough to plant the seed and get the ball rolling. 

Reach out to friends

Simply reaching out, offering a listening ear, and being non judgemental can make such a huge difference. If someone has been isolated for a while, welcome them back without criticism. Send a letter or a funny picture that reminded you of them. Just reach out. 

Educate yourself

Educate yourself on the intersectionality of mental health and the issues in our mental health systems today. Have a look at new ways of looking at mental illness and support. And always approach with an open mind. I would recommend always making sure you are listening to survivor stories too, not just psychiatrists or professionals. Because people living with mental illness are the expert on what it’s actually like to live with a mental illness. Being better educated can empower you to make changes in your life and community and to raise your voice. I’ll be posting more resources on this soon. 

Drop off some goodies at an inpatient ward

Being in inpatient mental health treatment can be a terrifying, traumatising, and lonely experience. Drop off some cookies and notes of encouragement if you can (nothing that poses a ligature or safety risk). Letting the people inside know they are not alone and that there is a world out here rooting for them with love is so so so important. 

Talk about it

Talk about mental health with your family and friends. Talk about how you are feeling, talk about the stigma, talk using the terms you are learning. And talk about the system and what you think of it. All change starts with a conversation. 

I know how hard it is to know where to start making a change when it comes to mental health. It can feel like we’re not allowed to question the narrative or talk about certain things. But there are actions that can be taken on a personal level and beyond. 

This is only part 1 – follow for more!

Posted in Advocacy, Mental Health

Over Pathologisation of Mental Health

Posted on by Millie :)

We hear a lot nowadays about removing the stigma from mental illness, and that is incredibly important. After all, we all have mental health. But I also I think it’s essential while advocating in mental health spaces that we not only call for destigmatisation, but we also question the systems; call out the injustices of the systems meant to care for us. We must question whether medicalisation of mental health really helps us. Would it be necessary if our society wasn’t structured the way it is in the west? Does it further the link between mental illness and criminalisation? Because destigmatising mental distress isn’t only recognising that it exists, it’s asking why it exists, is the language we use to describe mental illness helpful, what does healing really mean, and how are we failing to learn the lessons from our madness? So here are some of my musings on the over pathologisation of mental health:

It individualises our pain without individualising our care – that is to say it tells us we are broken, it is our individual chemistry that is flawed, and we are to blame, yet also not putting us at the forefront of understanding our pain and choosing how we heal. It tells us we are too sick to know what’s really good for us, or that we don’t know ourselves well enough. It doesn’t allow us to learn who we are and what’s really at the root of our pain; doesn’t encourage us to put it into a sociopolitical context, and the context of what has informed our life. Doesn’t allow us to heal with others.

There is no community. No value given to peer support, to healing with others who are experiencing the same things or similar things or completely different things, but feel safe to heal with. Doesn’t encourage the connections that are vital to long term healing and alternative methods of care. If you want proof that peer support methods of healing work, look at AA – it revolutionised care for alcoholics. What was a death sentence became an opportunity for hope and healing.

Our pain is shunned and labelled, pathologised. Instead of learning to embrace the madness as part of who we are, we learn shame which in turn births more pain. Instead of learning to see mental distress as a natural human reaction, however difficult, we learn to be afraid of it. Language that could be used to free us is instead weaponised against us to strip us of our wholeness and our identity through clinical rotes.

But it doesn’t have to be that way. I don’t have all the answers. I listen to psychiatric abolitionists and I think, yeah, they have the answer. I listen to amazing healers in other cultures outside of the west and am filled with inspiration and hope. Then I look back at the world as it is and wonder if we don’t need to adapt our goals to be a little more realistic within the current frame of society here in the UK. I don’t have the answer nor a clear label for my ideology surrounding this all. But I do have hope. And I do know things are already changing. 

We don’t have to wait to build communities. We don’t have to wait to create new ways of healing. We don’t have to wait to find hope. 

You can also find a version of this post on my Instagram @our.happy.notes