to Tuonela or not
I’m going to write about the importance of good mental health care. It will stress the value of individual treatment and regular fixed meetings with doctors in which you jointly develop a plan for recovery and actions plans for your future that aim to alter and improve how you live.
In many ways what I write below is praise for the Finnish system and criticism of the threadbare service given to a suicidal person I know, and will call H, who lives in the UK.
Before we begin, don’t get too proud Finns, your system is being eroded by self-serving, short-termist money junkies, who see people as units of production – yes, I do mean Sipilä and his government. It there a collective lack of empathy in this government, which hides behind the attractive way Sipilä can sound when he speaks?
Ignore that. Let’s get back to mental health. The first time I saw my current doctor and therapist, I was once again suicidal. It was December 2017. I had written my note, started on my final will. I had begun to sort out my finances and affairs. I had left social media. Loose ends in my life were being tied up and packaged away.
I really couldn’t see the point of my life. I was in a repetitive cycle of hope, despair, abyss and void (maybe I still am). I could see no future that did not involve unbearable anguish amongst short periods of serenity. Despite being loved, having great sex, doing fun things, marvelling at my children, most of the time I was wretched and faking the happiness of my face. I cannot give an adequate answer to your question: “Why?”
The answer is composed of many things: bills, money, jobs, shit jobs, chasing money, no thanks, no recognition – I felt utterly replaceable and insignificant. Problems arose relentlessly, nobody was really listening to me and I couldn’t communicate; my life lacked simplicity and direction.
But I had lived through this feeling before. Thus, even though the causes were different this time, I was able to discern a rope – there was no longer a void – a rope to take me across the void and not into it. That rope was sick leave
Having less money didn’t matter because either I wasn’t going to be here and if I was still here, maybe I would have a different perspective on myself – as I did after the therapy I needed when Ex and I separated.
The upshot was: with sick leave and social income support from the state, I could possibly relax and be with the children over the holidays.
At the first meeting at the psychiatric clinic with a therapist and a doctor (this is after seeing the Finnish equivalent of a GP), we jointly drew up a plan to counteract my suicide ideation.
Medication was given and discussed. Phone numbers for emergencies were given. Through their empathy and understanding they became part of that group of people I didn’t want to let down by killing myself. They advised me about social assistance and programmes I could take to find a new career, so I didn’t have to return to what was killing me.
Forms and processes were explained and a meeting was arranged at which I would meet an expert who would advise on claiming for state financial assistance and job support and retraining programmes. They helped me fill out forms to claim for financial support, even phoning to enquire as to what was happening with my claims.
Over the months since then they have monitored me and my startling mood swings and recommended treatment. As of today’s meeting, I’ll continue with the therapist and I’ll soon begin work with a doctor who will teach me breathing and other exercises for the body. These exercise will reduce the paralysing or mania inducing anxiety I feel when overwhelmed.
If that treatment doesn’t work my neurological processes will be examined.
In addition, because I feel I have had to go back to the work that drove me insane in the first place (a clear sign I’m a letter short of a keyboard – though I now say “No!” to shit jobs), the therapist and doctor both understand there is a strong danger of the cycle of depression resuming . Thus, I will receive training for a new job and be put in contact with firms that could employ me.
They even sent a letter to KELA (Finland’s welfare state) to explain this and ensure that I can apply for this retraining and job search support.
I will continue having therapy with the psychiatric clinic’s therapist until August/September. This goes alongside the three years of state support I have had for the therapy I receive from the private sector. It’s not insubstantial.
As I wrote previously, the time from phoning a doctor (GP) to meeting the therapist and psychiatric doctor took ten days.
In contrast, in the UK, when H went from being depressed to being suicidal and calling the doctor, it took ten long weeks to a first meeting with a therapist. During that time H paid to see a private therapist. I went through a list of those available and I helped choose one for H, the health service supplied fuck all. There had been no advice about who to see, what type of therapist to work with.
H was saved because a fortuitous event meant I was able to put her in contact with someone involved in suicide prevention (called SP). However, the rules surrounding that meant that SP had to phone me after being contacted by a third party. I then phoned SP.
It had to be established that I was an intermediary that had permission to approach SP on H’s behalf and had to set a time when H could call SP.
To give SP background to the case I described how I had counselled H and then had to involve H’s other-half that same day. Other.half rushed home to intervene while I kept H on the phone line. The first phone call with H that day had ended with threats of suicide and the words: “I love you, goodbye!” Words H had never spoken before.
All of the subsequent conversation with SP took place while The Choir of Young Believers played live behind me. They didn’t play Hollow Talk, but the lyrics would’ve resonated: “And then you cut. You cut it out. And everything. Goes back to the beginning…Never said it was good, never said it was new. Muted whisper of the things you feel.”
Crucially, H’s hidden despair was out and recovery could begin.
SP, myself and other-half then set up a support group for H. After 10 weeks (not 10 day), H finally met a state therapist and received five sessions, enough to set a mind at ease, time to solve nothing. There were slips back into despair, Therapy with the private therapist had been discontinued because there was no state support for that. I took on the role of therapist to H.
Also of interest was that SP works in another part of Britain, meaning SP couldn’t advise H beyond that initial and essential help and advice. Besides, UK, not EU, bureaucracy means SP might have technically broken the law while doing the morally right thing, so the relationship had to end there. Thank you, SP.
Apart from the too-long-to-wait-for therapy, the drugs the GP prescribed would have affected H’s ability to work. That was not good. H ran a business, H drove, H had to be sharp, H couldn’t afford to take the anti-depressants during the busiest season. H’s business suffered. There was no retraining, no financial assistance. H’s business declined and closed.
H really needs therapy and life advice right now. H needs someone to describe the skills H possesses and give H confidence. H is being wasted because there is paltry investment in mental health and people in the UK.
Finland has helped me, in return I’m once again helping researchers and scientists, companies and organisations advance. The work I’ve already done today could generate the overseas sales and taxes necessary to repay my health care and keep people in jobs. You lift me up and I’ll lift you.
In contrast, H seems to be met with the attitude of: “Your skills belong in the last century. You have no value. How dare you become another statistic to damage our austerity drive. We’ll make you become another victim to blame.”
Investment in mental health care, as in other areas of life in the UK, is required. Without some pretty fortuitous events, I’m not sure H would be here.
The Finnish state’s safety net ensured I am still here.
That is a huge difference.
H lives in Blackpool, England. Blackpool had the second highest rate of suicide of any upper tier local authority in England, for all persons, during the period 2013-2015.
Is it any wonder.