8 months ago, I was recommended to stop working with the private therapist I had been seeing for 6 years, and was put on a waiting list for dialectical behaviour therapy (DBT) at the Adult Mental Health Services of Galway University Hospital. DBT is recognised internationally as being the most effective therapeutic intervention in managing the symptoms of a particularly debilitating mental illness known as borderline personality disorder (BPD), which I was diagnosed with two years ago.
In the last eight months, my situation has gone from barely managed damage limitation, to the point of almost complete mental breakdown. Within three months of finishing with my therapist, I was signed out of work on sick leave as I was no longer able to function effectively. I am regularly suicidal, and self-harm is part of my reality. When I’m at my worst, however maladaptive it is, it helps me cope. My world has gotten very, very small. I drop my kids to school, I do bits and pieces around the house on the days that I can. Sometimes I’m able to handle being around people, others I’m not. Those days are particularly tough, those are the ones where I hang on by my fingernails. But, dragging us through all of this difficulty was the promise of eventually getting onto a treatment programme that would help me to turn it all around.
My family and I have spent the last 8 months putting all our hope in DBT. Today, just weeks before the anticipated start date, I’ve been told that it’s not actually going to go ahead at all, because the hospital does not have the resources to provide the programme. They’ve lost six out of ten therapists from the DBT team, and they have not been replaced. I don’t know where to begin to describe how I feel right now, because the words I have aren’t big enough. Angry, disappointed, let down – they don’t come close. I’m absolutely gutted.
I always had my doubts as to whether or not DBT would go ahead as I’ve been fighting with the extremely under resourced public mental health services for years, but I still can’t quite believe it has genuinely come to this. I’ve waited 8 months. I’ve been told time and again that this is the best thing for me, the only thing that really helps with bpd. To have that hope taken away at the 11th hour is unspeakably cruel. I realise that this is not my psychiatrist’s fault, and I do genuinely believe that she has done everything in her power to make this happen for me, but right now, that does nothing to change the fact that I’m further than I’ve ever been from getting the help I need.
How is this fair? We are weeks from an election, and yet services are falling into a worse state than ever before. The therapists who have been lost from the DBT team are not likely to be replaced. My fear, aside from the obvious impact that not getting DBT will have on me personally, is that the whole programme will just be let slide, will fall way down the list of priorities, and will eventually be dropped. I’m only one of countless numbers who will be impacted by this, because this goes way beyond the individual. The difficulties of living with and supporting someone struggling with a mental illness are often overlooked, but the impact is very real. Not getting DBT doesn’t just affect me, it affects my entire family.
I wonder do the powers that be know the unique sense of utter hopelessness that comes with being told that your last available option is in fact no longer available? I want to be angry right now, but I can’t summon up the energy. I’m swinging so fast between moods and emotions that I’m almost meeting myself on the way back. One of the key features of BPD is emotional dysregulation, which means we find it very hard to maintain a stable mood and can swing from elation to the depths of depression and back again several times on any given day, never mind a day when I’ve been hit with such a phenomenal disappointment. It’s exhausting. I have a headache from crying and am having to work incredibly hard not to let myself be utterly defeated by this
Mental health services in Ireland are in a state of absolute chaos, there simply aren’t the resources available to provide the help that is so desperately needed. How has it come to this? How have we reached a point where people with devastating mental illnesses are being told that there is no help available? Mental illness can kill, and worse, it does kill. It needs to be taken every bit as seriously as physical illness, and the resources have got to be put back before more lives are lost.