Minister of Health Stephen Donnelly
An open letter to Minister for Health Stephen Donnelly from mental health service user Lisa Naylor.
‘I am a 35 year old mother of one living in Dublin. I won’t bore you with a lengthy backstory, but I have struggled with my mental health for the majority of my life. Depression, self-harm and a personality disorder are just a few of my difficulties. As a result, I have been accessing public and private psychiatric services for 17 years. I have been linked in with my current local mental health clinic in Coolock since 2014.
At the beginning of this year I suffered a pregnancy loss which negatively impacted my mental state. Shortly after this, Covid-19 hit and we went into lockdown and I deteriorated further, relapsing into old, maladaptive coping strategies.
Fortunately, the registrar assigned to me was incredible and offered plenty of support and guidance. She scheduled phone appointments with me every 2-4 weeks (if you aren’t aware, this is considered intensive support by the HSE).
I was still struggling to stay afloat, like many people during this pandemic, but at least I had that lifeline – the appointments with my doctor. Being honest and open with someone over the phone was difficult, but I knew my doctor and trusted her so it made the Covid restricted appointments easier. My depression was worsening but I was coping; I was surviving, with help.
When the phone rang on the 3rd of August I answered immediately. I was in desperate need of that supportive and rational voice on the other end of the phone. However the voice on the other end was unfamiliar.
The registrars had rotated in between my appointments and now a complete stranger was asking me how I was feeling. I don’t think I can accurately describe how unsettling and jarring this was, being asked to show my emotional scars and vulnerability to a stranger. A stranger who hadn’t read my file. The appointment ended with them telling me to continue doing what the previous doctor had advised. It was a waste of time.
My next appointment was scheduled for 3 months’ time. The intensive support had been withdrawn.
Life carried on, Covid continued, my depression and anxiety increased. I had another pregnancy loss. Then lockdown 2 was announced and the months of loneliness, despair and fear overtook me. I sobbed until there were no more tears, until I nearly threw up. Sharp objects started to look so appealing; I drank and ate more trying to quell the growing despair.
My appointment was scheduled for the 3rd of November and I knew I needed to speak up; to give my new doctor a chance to help me. I had to try.
I was sitting in the kitchen, my toddler running riot behind me, when the phone rang. I took a deep breath and readied myself to be honest and forthright. I told them I was struggling, that I was anxious, that I had had a miscarriage; that I was struggling. When asked about a scale of 1-10, 1 being the worst, I explained I was a 3 every day. This is a snapshot of the response I received:
“How is your child?”
“I hope you haven’t been binge-eating”
“Have you ever self-harmed?”
“Do you get irritable? Make sure you don’t let that turn to anger as it wouldn’t be nice for your husband.”
“Just wrap your child up warmer and bring him for a walk” (He’s 2 and it’s November)
“I was going to discharge you today, but given what you’ve said I will give you one more appointment in 3 months”
Minister, can you please explain to me how, in the space of a few months and in the midst of a pandemic, I went from intensive support to being ready for discharge? How a person who has never met me can decide that I no longer need help? A person who didn’t even know that I self-harm, who was more concerned with my son and husband than me. This is what happens when you underfund a vital service: Doctors who are poorly trained and/or have no incentive to do good work.
At this point in my life I am a veteran of the HSE’s mental health services so I was able to temper my reaction to being so dismissed. If that had happened 5 years ago, my response to being so horribly disregarded would been catastrophic.
I now apparently have one remaining appointment in the clinic in Coolock. I am severely depressed and fighting not to lapse back into self-harm and my eating disorder. I feel helpless and rejected.
How many other patients are experiencing similar feelings, with doctors being rotated when appointments are phone only? How can you expect people who are mentally ill to trust in a stranger when they can’t even trust themselves?
The mental health service was in dire straits before Covid-19 and we as a country were losing too many people to suicide as a result. If the current system continues, if you keep expecting those that are suffering (the ones lucky enough to be given access to psychiatric services) to ask a stranger for help through a phone, the number of suicides will rise exponentially.
You need to do better, for those that cannot do better on their own.’