May’s Artist in Residence, Durre Shahwar, invited various people to share their experiences of mental health in a series of blogs. Here, Rabiah Hussain writes about the effect of local geographies and mental health services on her personal battle with depression. Throughout 2017 artists, including Durre Shahwar will take a leading creative role in what Wales Arts Review publishes, centring their skills on a challenging project over the course of a month. We were inundated with applications, receiving hundreds of emails about the positions, and it was no easy task whittling down all that talent to this final eleven. Our team of six editors debated long into the night, and in the end, we decided on a collection of people who we most want to work with, and whose work excites us. We think you will be excited by them too.
Local Geography and Mental Health Services by Rabiah Hussain
As a chronic sufferer, it’s difficult to pinpoint exactly when my depression started. At the age of 19 or 20, I started to feel some of the symptoms I now know to be associated with depression, not realising at the time how much of an impact they would have on me in the future. I had lived my entire life in Newham and spent the next few years seeing my GP for physical ailments that hadn’t been identified as signs of depression wearing my body down. With absolutely no knowledge of the complexities of mental health, it wasn’t until I was 26 that the pieces of the puzzle started to come together.
For the following years, I remained in a cycle of desperately trying to access the medical resources and support I needed to get better, but having to simply wait in line to get them. It wasn’t until I moved to Bexley, in Kent, that the road to recovery started to feel achievable. But this was by no means simply a matter of patience or hard work on my part. My battle with depression took a turn as a result of moving to an area where my mental health could be treated in a way it hadn’t been previously. The dark clouds started lifting because of geography and the politics of local borders.
Under the recent budget changes, with an 8.9% cut in spending power. £1.9 million was withdrawn from Newham’s public health spending alone, particularly affecting preventative care. In the context of mental health, this is frustrating because of the link between mental health and socioeconomic factors. Those from deprived areas are three times more likely to suffer from mental illness and those from BAME communities are both more likely to be diagnosed with mental health problems and to experience a poor outcome from treatment. My own personal experience of trying to access mental health services in Newham are reflective of how the strain on resources and lack of funding are neglecting the well-being of people in the poorest parts of the country.
The first step in my treatment was the prescription of anti-depressants with no focus on providing much-needed therapy to work through the psychological reasons for my depression. Despite being on medication, my mental health deteriorated leading to severe breakdowns, hospital visits and an inability to hold down a job or pursue my dream of being a writer.
But during the toughest period of my life, I found myself in a battle against more than just my illness. As my depression progressed, referrals led to me being pushed back and forth between different IAPT services. When I was paired with a specialist psychiatrist, who I only saw once, I was told to continue with tablets and put on a waiting list for group CBT, not individual. It was one whole year before I was offered a place, and was at the end unable to attend because of a change in my work commitments. During a particularly difficult period, I was told by the receptionist at my surgery that I would have to wait 2 weeks to see my doctor because there were no available appointments. I was in the most suicidal phase of my depression at the time. In short, it felt like I was alone in this battle against my illness.
Two years ago, I temporarily moved to Bexley in Kent. A relatively affluent suburb, with a low minority population, fares better on the poverty deprivation index. It has a lower population density and has ring-fenced spending on public health. It is here I found the degree to which the difference in resources improved my mental health.
At my surgery, I have never had to wait for more than a couple of days for appointments. I was able to sit with my doctor and create a recovery plan, which involved changing my anti-depressants to see if another would suit me better. This is something I had not been offered as an option previously, not because my previous doctors didn’t think of it, but because controlling my depression was the priority rather than helping me to overcome it. Receiving therapy via a single IAPT service took no more than a couple of weeks to book and with the combination of the right treatment and services, my life has completely changed in just the last year alone – something I’d been trying to do for over a decade in Newham.
There is a sad and underlying truth that is a painful reminder to me of all those who are in the same position as I was not so long ago. Despite always thinking about the time that depression has taken away from me, I’m fortunate to be in a position of social mobility. But government cuts have led to an extra strain on resources, leaving local health services unable to provide the level of individual care needed to prevent and support the recovery of mental illness in deprived areas. In trying to access specialist psychological services or simply trying to get an appointment with a GP when you need it, people from the poorest areas of the country, particularly from ethnic minority and immigrant backgrounds, are suffering the brunt of cuts to spending on healthcare.
This is what local politics can do to an individual. It was a responsive service, where help and resources were available that changed my life in the last year. But with the changing political climate and the uncertainty around the economy following Brexit, it is the poorest areas that will suffer the most. Once again, those most in need of support are marginalised.