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Mental Illness is so difficult for everyone who suffers, or who cares for someone with mental illness. The illness is unpredictable, behaviour can be erratic, in many cases you lose your loved one even though they are still living with you, functioning on some level but not by a country mile the person they were.

It would be naïve to think that the carers aren’t equally harmed, changed, little wonder there is often so much stress, tension and anger in carers.

I know the problems, you know the problems, it is simply not rocket science, it is obvious to everyone who will put aside their own ignorance and prejudice against mental illness…. Everyone who does not accept the stigma that is still so damaging to people with mental illness and their carers. People with mental illness and their carers need understanding and support.

It is so sad that the NHS service providers do not usually understand this simple fact.

We have to educate them, and that is a key target of our activity.

First of all, I have often heard the statement that for a nurse, on a psychiatric ward or A&E it is not easy, there is a lot of stress, and you are often faced by difficult people. You also may find a challenge going from treating someone who has been an innocent victim of a road traffic accident to treat someone who has deliberately cut themselves, either to mask the mental pain or to experience some sort of feeling, any sort of feeling. I accept that can be difficult and that the job is not easy. Is it any excuse for being rude? For being scornful or patronising to a patient? For not understanding their plight?

Compare it to a customer services officer in Marks and Spencer. They spend the whole day dealing with tetchy, rude and unreasonable customers, and the problems being brought to them are seldom of their making? Would you, as a nurse, accept that they snap at you or belittle you? Of course you wouldn’t, you’d get angry, the person woulod be disciplined, maybe dismissed. But within the NHS the defence that it has been a hard day is still used. It is simply not acceptable, it is seriously below the standards required, and adds additional stress and pressure to the most vulnerable people.

Ah yes, but it’s all theoretical. Can you give any examples of how the NHS staff mistreat mental health patients and carers? Without that it doesn’t mean anything.

Oh yes… the following examples are all true, all within our local Mantal Health Service, whether adult or Children/Adolescent… and they display the total lack of understanding, acceptance and care for the mentally ill and their carers.

The most vulnerable carers, and indeed the most ill treated within the service are our young carers. Imagine being born into a family where your earliest memories are of a parent who is suffering from acute depression, or bi-polar, and for you, life as a carer comes as naturally as breathing, because it’s all you know. By the time you are 15 you are probably burned out, you have sacrificed your education, you have devoted your life to looking after a parent, and the odds are it is now a single parent family, if it wasn’t to start with, what have you to look forward to? The only job you can think of is as a care worker, because you are skilled in that already, and don’t have the education to do much else. You cant however do that because the work is too close to your reality, it puts too much pressure on, and you simply don’t have the piece of paper showing you are qualified, even though your experience is worth more than any number of NVQ’s. Even if you do get a job, you will find that the levels of care you are expected to deliver are way below what you want to give, because you have seen it from the other side, you do understand the issues, and know how much harm little or no care can cause.

Imagine then that you have a crisis with your parent, you need help, desperately need support… you contact the appropriate service providers, who respond professionally and effectively to bring you the help you and your parent so desperately need. That’s what they’d have you believe… of course it doesnt happen like that.

The person who should be helping you identifies you are a child… you are not taken seriously, how can you trust a child with stuff this important? Don’t forget that you have already been happy to leave that young person in total control for the situation, fully responsible, for years probably, now he needs help, he is just a kid, you don’t take him seriously.

How does that make the carer feel? I’m sure know know… bloody angry and bloody frustrated… to say nothing of being scared because of the lack of support when needed. How does it affect the patient? I’m sure you know that as well.. a patient desperately needs help, you are effectively not prepared to provide it… can’t be good can it?

The other example I want to highlight relates to self-harm. Imagine through no fault of your own, being so mentally unwell that you have no emotions left, no feeling, no motivation… nothing positive to focus on except the hours of blank despair staring you in the eye… the last resort is to cut yourself, to draw blood, to feel pain, for you it is better than no feeling at all.

So you cut, you end up in A&E because the wound is deep, wide and potentially infected, you need support, comfort… is that what you always get in A&E? Of course not… the staff think that you are seeking attention, you have cut yourself to make their job busier, they think that compared to what they think are innocent victims of accidents you don’t deserve the same level of care. They are professional, they should know better than that, but for the most part they have no understanding.

The cut is a symptom not the problem. Unless the staff identify the cause for the cut, you are always likely to be back, again and again, with the same issue. Each time you go in you become more and more a regular, just cutting yourself for fun… they just don’t understand, and they show it. What is worse the staff will often openly show contempt for you.

It is important to treat the person, not the cut… it may be that A&E is not the place to make the further investigations, in which case, for gods sake, refer on to someone who has the knowledge and understanding, don’t just put the stitches in and pack them of with a patronising “now don’t do it again”

Maybe I expect too much from the NHS, I know Mental Illness is difficult, and a specialist area, but surely everyone working in a role which will bring you into contact with any level of understanding must have the understanding that there is more to it than what you see on the surface, must understand that mental illness is an illness or condition the same as cardiac arrest, cancer or a sprained ankle, and needs to be treated at all times with the same thoroughness, tact and integrity.

Why is it not treated the same? Simple… ignorance. If the staff are ignorant of the implications, we have to look to the management of the NHS, the ethos and attitude within the service. Only when the policy makers understand and acknowledge the truth will they be able to educate the staff, and make them accountable for their behaviour mental health patients.