This was my first presentation. I was invited by James Creaghan from Derbyshire County Council Public Health. It was well received and opened many doors for further involvement in discussions on mental health in Derbyshire.
Around one in ten people with Borderline Personality Disorder, or BPD, end their own life. Up to 70% make at least one suicide attempt with many making multiple attempts. I’m not an expert on personality disorders and I don’t know the overall statistics. But I have BPD and have attempted suicide on two occasions. The first attempt put me in A&E and then the Hartington Unit. The second attempt put me in prison. On other occasions, I have self-harmed. These have always been impulsive acts at times of crisis and could quite easily have been fatal. I have had several close calls.
I have been asked what could have been done to prevent me reaching crisis point, and what may help others before they need to access statutory services. What I needed was someone to talk to. Not my partner, family members or friends. Not anyone close to me. I don’t know why. Maybe it’s because I was ashamed of how I was feeling. I don’t know. I think a lot of people feel like this. They don’t want to worry their loved ones and may feel able to open up more to a stranger, especially if that person understands their particular condition.
I know when I’m approaching crisis point and what I don’t need is people telling me to get a good night’s sleep, to go for a long walk, or to practice mindfulness. This might be good advice for some, and I know a lot of people do benefit from mindfulness. But it doesn’t work for everyone. Some of us need to talk through our problems.
I tried the only two crisis lines I knew about but didn’t find them very helpful. I needed someone to talk to face to face. I was forced to approach statutory services and I am not exaggerating when I say that the mental health services were bad for my mental health.
I wasn’t in crisis when I first asked for help. But I was palmed off with false promises of help. After many months of waiting for a CPN and a psychologist I asked where I was on the waiting list. I hadn’t even been referred. I soon approached crisis point but was then told that I was now too ill to treat. They didn’t know what to do so they did nothing. Eventually, they said my thoughts made me dangerous and I was excluded altogether. I have since heard several similar stories.
A social worker once told me that if someone says they feel suicidal she asks them what plans they have for the following few days. If they have made plans to go shopping etc, she knows they are not serious about ending their life. I think this is a dangerous strategy. I can’t speak for others, but I could easily have booked a holiday one day and attempted suicide the next. I got the feeling that she was under pressure and had to prioritise. We all understand there are insufficient resources within the statutory services. This is what makes the voluntary sector so vital.
It’s important to remember that most people in danger of reaching crisis point are not thinking straight and may not be able to get help for themselves. With lengthy waiting lists for IAPTs, and in the absence of one-to one contact, support groups are vital. I have set up a support group for people affected by BPD and I am promoting it as much as I can. We are now getting referrals from the mental health services, and they are more than welcome. But we, and other groups, exist to supplement, not substitute, statutory services.
Fortunately, drop-in centres and other initiatives led by the voluntary sector are becoming more widespread. This is excellent news, but people need to know about them. My group is going well but I know there will be many who could benefit from it but who are unaware of it. To me, the most obvious place to get this information is the one place where everyone goes at some stage, the GP Surgery. Unfortunately, many GPs refuse to promote anything that is not affiliated to the NHS. In the past, the general attitude seemed to be that ‘this is a shame, but nothing can be done about it’. I don’t believe we should accept that. I know that work is being done on this in the Erewash area and things are looking promising. So, fingers crossed!
The worst thing someone can hear when they need help is that nothing can be done. Historically, people with personality disorders have been denied help from statutory services because their condition has been regarded as untreatable. This belief is slowly changing. But in a climate of under-funding, budget cuts and payment-by results, there are those who believe money is better spent on illnesses that could have a positive, tangible, outcome.
I believe that with personality disorders, the positive outcome lies in the absence of something, the absence of a person in crisis and its consequences. Or, if someone comes through a crisis without attempting suicide or self-harming, or committing a criminal offence, then that is a success all round and worth spending money on. But it’s not all about money. It’s also about awareness, empathy, understanding and kindness. It sounds too simple, I know, and on its own it’s not the answer long-term. But in the short term, people need to be listened to and taken seriously.
I am doing well at the moment, but I know how easy it would be to be back to a position where I think the only option is self-harm, or even suicide. I have re-mortgaged my house to pay for private therapy. I’m lucky that I can do this. There are many who can’t. They continue to rely on others, and I worry about them.