Early help ‘key to tackling mental health problems’
Reading this article reminded me of a young man I saw recently. Both his parents had died: his father a few months ago and his mother, tragically, on Christmas Day. In the eyes of the world, Charlie was an adult aged 18 years old, but the man who sat in front of me was like a child, cast adrift and desperately in need of help.
Charlie had initially come to us to seek medical assistance under the pretext of an ankle injury. As we talked however, he changed tact and mentioned that since his mother’s death he was having thoughts about self-harm. Cutting himself was a coping mechanism that he had employed in the past; in fact when he was younger he received care from mental health services for the problem. Once again thoughts of cutting were ever present in his mind as he felt that his recent bereavements were too painful to bear. He told me that he had a girlfriend for the last few months, but that she had no idea how desperate he was feeling inside. Charlie was typical of many young men who find it very difficult to admit when they are feeling overwhelmed. He couldn’t talk to anyone. Having no brothers or sisters, and now no parents either, left him with no one to trust with his deepest thoughts. At least he recognised the warning signs and came to a treatment centre for help ~ which was a huge step in itself.
The problem though, is that treament centres (and emergency departments) aren’t great environments for people with either acute or enduring mental health problems, they are mainly a sign-posting point. Generally speaking we see our patients in these departments quickly and either provide emergency treatment or refer them back to their GP for ongoing care in less urgent or long-term situations. Problems such as Charlie’s require a long term investment in intensive counselling and behavioural therapies for example, and most emergency staff have very little training on these issues. Such services are usually accessed through the GP. But, Charlie didn’t have a GP as he had moved around a fair bit during the previous year; in fact he was currently relying on the goodwill of his girlfriend’s mother and being put up on the sofa at her house.
It’s hard to know how to best help someone in Charlie’s position. I gave Charlie some phone numbers for groups such as The Samaritans and other charities that offer counselling services to young people in the area. After discussing it with Charlie I then also spoke to the Psychiatric Liaison Team; Charlie was happy to go and speak to them voluntarily and they kindly agreed to see to him that evening.
A little later I phoned to check that Charlie had arrived at his appointment but I was informed that he hadn’t turned up. Unfortunately he had not provided a phone number when he booked in so I couldn’t call him to check that he was ok. I was really worried and so I spoke to the police who kindly agreed to do a ‘welfare check’ at the address Charlie had given. Thankfully, Charlie was found alive and well, but he had changed his mind about talking to anyone.
People like Charlie fall through the net because they haven’t really got anyone to look out for them, yet I feel with the right help and support Charlie could do quite well. Sadly, I’ll never know.