TW: Mentions suicide, self harm, anorexia, and voices inside the head. PLEASE DO NOT READ IF IN AN UNSAFE PLACE EMOTIONALLY.
The final episode of Don’t Call Me Crazy throws a spotlight on to males with mental health problems. I think mental illness can be particularly difficult for men given the myriad of social expectations and stereotypes around them. Bullshit like men don’t cry or men bottle things up. These stereotypes also have a negative effect on men as they are so ingrained into our culture. If men are trained not to talk or speak about something bothering them then places like the McGuinness unit may be a last resort after a build up of problems.
Firstly we meet Matty, who was brought to the McGuinness unit after his lecturer found him at college writing suicidal thoughts on the Internet. He has a fear of being killed on his 18th birthday and has plotted out in great detail his own solution to the problem. Chillingly he has worked out the cost of a gun, and intends to use one to kill himself.
In an art therapy group where patients are using pictures taken from magazines to illustrate their problems Matty chooses the emboldened word ‘THOUGHTS’ and a picture of red boxes all close together. He is able to articulate to the art therapist that the word represents his thoughts and the boxes close together represent the voices all shouting at him at once..
I think the visual aids helped him to consolidate initially his own problem. They can come upon him at any time as is shown when he has to leave the room abruptly when the voices begin. Voices from my impression of Matty seem to be really crippling things. Imagine trying to move with a heavy weight on your back. You would probably move slowly and slightly fearfully due to the pain. It seems that this is how it is for Matty. He cannot predict when the voices will strike so has a constant crippling fear gnawing at him and in many ways it becomes easy to understand why faced with this scenario he would want to kill himself.
I am not saying anyone should; nothing of the kind but it is easy to understand why somebody in the grip of depression thoughts of suicide and psychosis would want to. It seems like a temptation, and a way of escaping the problem. But that said also there are healthier ways of achieving this.
After having home leave cancelled Matty begins to open up to Mental Health Nurse Pete about his regret over not talking to somebody before he felt the urge to self harm the previous night.
Mental health is not about perfection straightaway, it is about as Pete says learning lessons for the future. The two then bond over a shared love of the Red Hot Chilli Peppers song ‘It’s My Aeroplane’ and the tattoos of the lead singer Anthony Kiedis.
Such bonding is important as it helps to build up trust and rapport. I share Matty’s love for music and it is definitely one of my techniques for de-stressing too.
Later in the programme we see Matty with occupational therapist Vicky. The group are talking about support and are asked to name five people who support them. Matty is initially unable to think of anyone and writes that down. However by the end of the session there is progress as he has managed to name five people and the voices have not emotionally crippled him this time.
For Dr Andy Rogers, Head of Psychological Therapies at the McGuinness Unit, hearing voices is nothing more dramatic than a common response to stress when the mind races. I think that the lack of sensationalism around mental health has been a real strength of this series. Practitioners such as those in the McGuinness unit deal with situations as they are rather than how they would like them to be. Understanding the story around the voice helps a lot according to Dr Rogers both for the patient and medical professional alike. I think I know that nothing mental health wise ever happens in a vacuum. There is always a trigger and as I said previously it is about walking alongside people while they figure out what that trigger is.
After Matty is restrained he meets with case manager Maureen to discuss his anger. He tells us that he attended anger management. This failed him though and only served to make him more angry. This is not unusual. In my own experience when I feel pissed off I tend to feel anxious first. Anger is a visceral strong emotion and does not appear generally as a first response. Rather the anger is precipitated by other events. Matty actually getting to grips with what he is dealing with is a powerful moment for him and a powerful moment for me as a viewer.
In this episode too, we also meet George, a gifted rugby player who won a prestigious rugby scholarship to a top boarding school. Far from home though he became depressed and began to hear a man’s voice telling him he was worthless and should quit rugby.
As psychiatrist Dr Ihenacho suggests any kind of competitive pressure can cause depression and anxiety . Competing against people who are equally talented as you are can break you as you are always comparing and contrasting your abilities with those of others. He shares time with his father reminiscing about happier times on the rugby field. He speaks tenderly about a card he has received from the boys in his House at boarding school.
For George the McGuinness unit is a safety blanket. He feels safer than he did before and he knows he is with people who understand. His mental health assessment helps him to understand his problems better. Matty too echoes these thoughts. So then, the act of listening is so simple but rarely practised to any great effect. We must listen more, much more and be there for people when they need us most.
George confides in Gill about a wall he punched and how he was given diazepam. Gill is not shocked, nor does she condemn him. What we need to do is to harness such attitudes and to spread them out into the wider world. A better more compassionate humanity is what is really needed here. We need greater empathy too. Empathy is not the same as sympathy. People say I am very understanding and very empathetic and I listen. Yet it saddens me that this should be something so wonderful and remarkable. Why can’t more people do it?
An attraction developed this week too between George and Beth. They have a good laugh but wind each other up as well. A funny moment occurs when Beth throws George’s slippers out the window. To say sorry she makes a pancake. At least she cared even if George didn’t fancy touching the pancake!
For Beth the overriding narrative of this week is one of progress. She is eating more, being weighed and for the first time is allowed to eat on her own. Ultimately, she is speaking more positively than ever before. This is heart warming to see and gives you a kind of happy feeling. However such transformation is not without its problems. A difficulty comes for Beth when the review team makes a decision to stop her Zopiclone and replace it with melatonin. We see her in distress at this development, begging a nurse to reverse the decision with one of the doctors.
In institutional settings, any change in routine can be destabilising. Its significance can also be increased. Beth feels the staff are against her and are letting her down. The reality is she’s sleeping effectively without the medication and no longer requires it. But when decisions are made for you and not by you it can be hard to see that they are in your best interest.
We see this later too, when home leave is cancelled due to Beth self harming close to discharge. For Dr Rogers though, blips are not unusual. Think about it if you have been in an enclosed space for several months, going back to familiar spaces may not feel so familiar at all. It is natural to resort to a way of coping when we are scared often the way of coping we fall back on most, even if it is not the healthiest.
But the best thing is Beth herself realises that self harming may not be the best way of coping as in no longer has the same effect for her and in her words “doesn’t even hurt, [and] was just annoying when it wouldn’t stop bleeding.”
Beth was then happily discharged soon after and according to narration had not self harmed since leaving the McGuinness unit. Matty was discharged into the care of an adult mental health unit after turning 18 and is now back at college.
George made the decision not to return to his boarding school and to study for the same scholarship locally to his family in Essex. For me this is no way a retrograde step. Sometimes we can all feel a huge amount of guilt over our decision-making since it can have an impact on others too.
However we are all built differently, and whilst one decision may suit one person it may not suit another. I am glad wholeheartedly that George did the right thing for him – well not only for him but also for his mental health. People say you only get one body, and there is a plethora of health and safety advice about looking after your back, for example. You only get one mind too, and that needs looking after also.
In closing let me just say a few words on the series and mental health in general. You may be wondering why I decided to dedicate three blogs to this series. Why mental health matters to me so much. As regular readers will know and new readers may not up until 2012 I was in counselling every year of my life for various things. The bulk of it was due to depression around my disability and my stepfather’s abuse. I have devoted enough time to transsexuality elsewhere in the blog’s are not going to discuss it here.
But you see, when I was first sent for counselling all those years ago, I felt crazy. I knew it was something everyone did. It’s not like an after-school club that everyone goes to. I would shoot off in my school uniform to the offices of my local Social Services Department. Nobody ever knew where I was going. But talking helped, talking to a stranger who did not judge who did not think badly of me who would just listen and allow me to talk, not sharing preconceptions even if they had them. Talking and being heard was vitally important.
Latterly I went to college, and things were pretty bleak. I was boarding away from home and just felt really lonely. I was having counselling and had managed one session with my new counsellor, when she said to me;
“I can’t work with you till the fog clears. I want you to go and see the doctor about antidepressants.”
Antidepressants, I thought. What the fuck! I’m only 18! I later told the deputy care manager that I was scared people would think I was a nutter.
But it turned out I wasn’t alone. There was a special set of appointments after the main general medical ones for students with mental health problems. You see, we reflect our own stigma. My attitude of choice towards mental health problems is informed by my own depression. Nutter is a value judgement. Yet instead of being kinder to ourselves it is these value judgements which we are most afraid of. Having a mental health problem is scary and isolating. But it is far easier to go through it with kindred spirits than alone. Mental illness is not having to walk on eggshells. Mental illness is not feeling pissed off we all feel pissed off. But imagine if that’s the only feeling you feel.
That is mental illness. The worst thing you can do it to tell somebody to cheer up or to snap out of it. This may be something you do to ease your conscience, and maybe your way of wishing that the person’s suffering would go away. But the best thing you can do is to listen and hear.
For I tell you people can understand my disability in a heartbeat. They can see my wheelchair. They can see I can’t walk. But depression is less well understood.
Eating disorders and self harm too present their own unique challenges. A friend at uni told me they had an eating disorder. They were shocked by my understanding. Their explanation of it from their world and their perspective made perfect sense. I don’t judge that perspective nor think about it for when somebody is disclosing something it is their voice and theirs alone which is important. My task then is to shut up and listen as counsellors did for me. Empathy is very important.
It saddens me that many do not understand even belittle or make fun of mental health problems. They are not fun and not a joke..
People with mental health problems deserve our respect our love and our care. Even if you can’t directly empathise with a problem, learn about it read and listen.
I’m so proud of all the participants in Don’t Call Me Crazy. I think it has achieved its objective of showing other young viewers they are not alone. Places like the McGuinness unit are a much needed safety blanket of love and support, sometimes tough love but love all the same.
The thing that saddens me though is the act of listening is not rocket science. We can all do it, yet sometimes I think we choose not to. Let us make better choices and not ascribe pariah status to those with mental health problems, especially the young.
Let us open ears, silence preconceptions and opinions and listen. Many of the young people sounded as though the McGuinness unit was the only place they had felt truly listened to. Does that not disturb you? It smacks of a huge deficit in society and it is not a financial one either. It is a deficit of humankind and only humankind can solve it.
Asking for help should never be the wrong choice. It is not a weak choice either. Sometimes it may be the only choice, the best choice and the strongest choice you ever make.
And for others, make the choice to say this:
“Yes okay. I may not understand everything but I am willing to listen. For the person with mental health problems, those may be the best words they ever hear.
The irony of this show for me, and the irony of mental health from the bottom of my heart is that people with mental health problems often make the most sense.