Mental health has become a contemporary epidemic in Ireland. With the alarming rates of suicide, it’s time we begin to examine where we are going wrong.
The Central Statistics Office provided me with harrowing statistics. In 2014, 486 people died by suicide in Ireland. 399 of those who lost their lives were male and 87 were female.
However, although over four times more men take their own lives than women, Ireland has the highest rate of suicide in young girls in Europe. These shocking statistics begs the question of whether mental health services in Ireland are effective. What is causing the high level of suicide?
I spoke to two service users about their experiences with mental health in Ireland.
I met Carol* in her classroom, where she teaches English to young children. Her hair is as bouncy as her attitude; she’s not somebody who you would imagine to have suffered with severe depression. I’m always reminded never to judge a book by its cover.
“If a friend approached me for advice about anti-depressants, I wouldn’t recommend them. Do not take them, no matter what they say. They’re not worth it”, she said as she sits down at her desk to tell me her story.
Carol was on antidepressants for 8 years, from the age of 17. She felt that antidepressants ‘numbed’ her feelings and changed her personality. She suffered with many negative side effects from the medication such as severe weight loss, extreme tiredness and she began self-harming after she began taking the medication.
“The medication is meant to be helping you but it feels like its supressing you. You can’t express your feelings. I was living, but not living at the same time. There is a numbing effect on your emotions.”
She stressed the need to educate people about mental health and discussed the stigma that stopped her from confiding in friends and family when she was at her lowest.
“If you have anxiety or depression, you need to focus on counselling. It’s very hard to talk. I know, I’ve been there.
“It was a taboo to talk about your feelings or mental health while I was growing up.”
Carol’s relationship with her GP was cold and she felt that “my GP was doing all the talking, whereas she should have been the one listening.” She said that she felt that the doctor didn’t spend time explaining the nature of her illness and failed to help her to explore other options.
Do our GPs have the time to spend with their patients to help them fully understand how to treat their mental illness?
I spoke to Doctor Molly Walsh, a junior doctor working in Perth, Australia, for her opinion on this issue. Dr. Walsh stressed that patients need to take responsibility for their health but that this may be complicated.
“Sometimes self-care is difficult with mental health because if the disorder is of the mind, then it can be very hard to have insight or initiate self-care. That’s probably why mental health is so difficult to treat and manage.”
Martina* has spent many years trying to deal with her anxiety disorder. She leads me into her brother’s living room and sits across the room. She seems nervous; her hands tremble a little as she rolls one cigarette after another. Her story is a little more difficult to tell.
She has been admitted for acute mental care on three separate occasions. After spending many years struggling with addiction to prescription medication, she feels that doctors don’t offer any alternatives to patients.
“I don’t feel that people in crisis are helped when they enter the mental health system. You’re just brought in, highly medicated, stuck in a bed and can’t go anywhere.
“Then when you’re out, that’s it. There’s no follow up, there’s no help, there’s nothing. So you have to go about it yourself if you want things to change in your life.
“You have to take it into your own hands. That is very difficult to do when you are suffering with a mental illness.”
Martina feels that doctors simply treat the symptoms. She feels that psychiatrists don’t seem to care about the consequences of prescribing these types of medication for long term use.
“It’s a vicious circle because people trust their doctors when they prescribe them this kind of medication. You start to become reliant and your tolerance builds so you need a higher dose. Then there’s no way out of it and people don’t see that there are other ways.”
Martina was left a long long list of ‘labels’ to come to terms with following her first entry to an acute mental health unit. Her psychiatrist diagnosed her with borderline personality disorder, ADD, anxiety disorder, body dysmorphia, severe depression, alcoholism and addiction.
In light of these diagnoses, she was given a heavy prescription of medication. These included 250mg of Seroquel three times per day, 75mg Lyrica 3 times per day and 25mg Dolmain, to name but a few. She was taking a ‘concoction’ of drugs; antipsychotics, antidepressants, several relaxers and highly addictive sleeping tablets.
I was confused to see that Martina had been given so many addictive medications after being diagnosed with addiction. Are psychiatrists relying too heavily on medication to treat mental illness?
I spoke to Doctor Anita Halley, a GP in South Tipperary, about this issue. She pointed out that a huge portion of the people GPs see every day have psychiatric issues; however, they are constrained with the short appointment slots (averaging at 10-12 minutes). There is also a lack of access to counselling with an average wait time of 9-10 months.
“Most of us as GP’s find that psychiatrists over-treat with medication, but the counselling facilities are so limited which means they don’t have this option.”
Martina eventually managed to come off all the medication she was taking. She began learning about self-care, mostly with the use of complementary treatments and studying nutrition. She feels that medication shouldn’t be taken lightly and patients should consider their options very carefully before taking them.
“I just lost so many years over all the medication. It took me years to come back to normal; your mind isn’t right after all the tablets.
“There is no cure for what I have, there’s no magic tablet, there’s no magic wand. I still have anxiety, but it’s under control.
“I’m not going to get rid of it, but at least I’m not medicated anymore.”
*Patients names have been changed to protect their identities. Both service users prefer to remain anonymous.