Goodbye, You Will Not Be Missed: An Open Letter To NHS Mental Health Services.
[Content Warning: mention of suicide, mental health service abuse, brief mention of child abuse]
Dear NHS mental health services,
As of today, I am discharging myself from your service. I have tried to leave you before, but you have repeatedly snaked your way back into my life. I will not let that happen again. This is my final goodbye. If I am ever unfortunate enough to be under you again, it will most certainly be against my will. I hope to God that day never comes. I must leave you so that I can survive. If I stay, it’s likely I will die.
I used to think you had the answers…because you said you did. I was first directed to you over 10 years ago, by a well-meaning GP, when I was struggling with PTSD symptoms. Those first years I was repeatedly turned away, bounced from service to service, left rotting on waiting lists which seemed to go on forever. But I waited and I longed and I continued to seek you. Like a siren, you called to me, singing sweet songs filled with promises and hope… but when I was finally able to approach, my ship was wrecked on the rocks of your lies. You had no answers, no keys to the locked doors I was desperate to get through, no solutions to my problems. Worse still, you refused to accept that you had no answers. Your failure to help me was my fault. Your inability to explain or solve any problems reflected on me. I was too complex, too difficult, too resistant, too avoidant, too dependent, too demanding… I followed all your rules, jumped through all your hoops like a prize show dog, but it was never enough. I was always wrong. Everything was always my fault. And I believed you. For years I believed I was fundamentally bad and broken. I tried so hard to do everything right. I took your pills, I agreed to your assessments, I worked hard in your therapies. I religiously attended appointments, arriving early, sitting quietly. If the appointment was late, I made no complaints. I have sat in your waiting rooms for hours on end, for appointments that never materialised, I have waited for days by the phone, for calls that never came, been falsely promised emails, texts, letters, visits… but there was not a whisper of complaint from me. I have had severe, life threatening, adverse reactions to your drugs, and apologised to you for my failure to tolerate them. I have been made more unwell than I could possibly imagine by your therapies, and enthusiastically agreed with you that I had not engaged properly. I have been placed in situations where I have seriously harmed myself when I should have been protected, and not argued with you over your conclusions that I had done this on purpose to upset you. I have been an unending fountain of patience and understanding – “oh don’t worry, I know you’re very busy”, “its no problem at all”, “it’s absolutely fine, I understand how much you have on” “you couldn’t possibly have predicted this” – but rarely received anything like an apology, and never had my patience noted. Nothing good is ever noted. You never noticed the lengths I went to to keep you happy, to make staff comfortable, to ensure I wasn’t bothering anyone or getting in the way, to keep trusting despite your obvious untrustworthiness, to allow you to blame me for your own poor insight. I withheld the uncomfortable truths of my past and my pain, protecting you from feeling bad, cloaking my world in euphemism, softening the edges. I have laughed at a thousand bad jokes, let obvious rude comments and insults slide, forgiven serious professional mistakes, performed my mental illness and trauma in a way which was easier for you to understand and cope with, laughed off times you left me to die. But you never noticed. Reading my notes, without meeting me, a person would be forgiven for believing I am some kind of hell child. My thanks, praise, compliments, patience, kindness, understanding, humour, flexibility, the nice conversations, the thank you cards.. they never happened, because they have not been documented. But every sigh; raised eyebrow; every moment I struggled to hide the pain of trampling my self-respect to allow your behaviour to continue; every occasion I hinted that there was at least a miniscule possibility that you may be wrong; every hesitation before agreeing with you; every perception that my tone of voice or micro-expression conveyed a negative thought or emotion; that is all down on paper. Every word I spoke which didn't match the words you picked out for me, every breath I took which wasn't in synch with yours, every non-approved thought I thought, you harvested and stacked them for the bonfire you would later light - I didn't know at the time, but I would be the Guy burning in the centre.
I cannot explain the pain you have caused me. I cannot describe the damage you have done to me. I have lied to myself for years, convincing myself that you were helping me, while dismissing all evidence to the contrary. As I have steadily become more and more unwell under your care, I have blamed myself. I have gaslighted myself. I have treated myself with so little respect, with so little care, with so little love. I have now reached the point where each interaction with you makes me want to die, and yet I still sit, waiting for proper care. If I have ever brought this lack of appropriate care to anyone’s attention, you have spun it round to reflect my unreasonable expectations. You told me that mental health assessments were support, that waiting lists were support, that self-help leaflets were support, that being ignored was support. I had a conversation once with my psychiatrist about money. I said I was going to apply for universal credit, because I was fast running out of money while off sick. He said that seemed sensible. In my notes it says he supported me through the benefits process. It seems all you need to do to be supportive is theoretically exist in some form, somewhere. While all I needed to be classed as demanding and unrealistic was to expect more than that.
The power you have had over me is immense. You have taken my soul, torn it to shreds to examine the pieces, and yet all you have seen is your own reflection. You have never listened to me; I don’t think you have ever really even seen me. I exist in your world as a reflection of your negative expectations. I am nothing but a stack of paper to you. A pile of words you invented. You have labelled me, lied to and about me, assassinated my character, discredited my words, belittled and rewritten my experiences, deliberately misinterpreted my words and actions, assumed the worst in me, pushed me into corners, ignored me, refused all my requests for appropriate support while telling me it was ok for me to choose to die, you have made me feel utterly and completely worthless, to the point that it has been hard to keep living. You have pushed each and every one of my buttons, winding me up tighter and tighter, waiting for me to snap, and when I have broken down, you have triumphantly paraded my inability to cope as my personal failure. I do not have the language to explain how and why it has reached this point. I cannot do it justice with words. I have experienced incredible evil at the hands of men who wanted my body for themselves. But you hurt me more than they ever could, because you knew the evil I had endured, and you used it against me to drag me down further. I can't escape the words you have written. It's as if you carved them into my skin.. I cannot unsee the looks in people's eyes as they coldly and calculatedly withdrew all empathy and compassion from my world, like letting the air from a balloon, until I couldn't breathe. I cannot have my records wiped clean, they will always sit there, and knowing that you will always consider them a more accurate representation of me than my actual living being, hurts more than I can say. I am a human, but you have never treated me like one. How much can one person be expected to take without breaking? I don’t know if it’s what you were trying to do, but I broke a long time ago, and you swept up my broken pieces and displayed them as proof that I am a bad person, undeserving of care, undeserving of respect, undeserving of life.
You have made me the fool. Insisting that I need you, but turning me away when I asked for the answers you claimed to have. You have repeatedly sent me away, with the understanding that I will not cope without you, leaving me a trail of breadcrumbs so that I can crawl back to you and grovel for forgiveness. You twisted my world around yourself to such an extent that for the past ten years I believed I could not exist without you, that my life would never improve if I went it alone, that if I could just be good, you would eventually give me the secret to recovery. But it was a sick joke and I was the punchline. I have wept endless tears of self-loathing, not knowing how to be good, not understanding what I was doing wrong. Why call to me, demanding I come to you, if you never wanted me? My existence has served as part of your games for so long. You reeled me in and tossed me out over and over again, until my spirit was broken.
In the end, you have never helped me, you have never come through for me when I needed support, you have never given me a reason to carry on living, rather, you have continuously been the reason I want to die. To remain within your walls, I have been forced to chip away at myself, and ten years down the line I have run out of self-belief, respect, and love. I feel like a husk. I cannot take any more.
Yesterday, I had an appointment with my private therapist, and she told me that I have an incredible, unending determination to survive. There is an innate fire within me which has continued to burn, despite your best efforts to extinguish it. Over the years, I have worked with you to put this fire out, because leaving it burning has made it hard to end my life, even when I have wanted to. I realised how terribly sad it made me to know that you have never celebrated this fire. Never nurtured it. Never encouraged me to build it. You have only ever used its existence as reason to withhold care from me, deem me “low risk”, unworthy, and discredit my pain and suffering. There is something tremendously wrong with a “helping” service which actively encourages people to destroy themselves in order to be believed, validated and cared for. It was with that thought I realised that you are, in fact, not a helping service, you are an abuser, and I am leaving you. You never cared about me, and by pursuing you, I was forced to not care about me either. No more. It will take me a long time to believe this statement after the way you have treated me, but I will say it to myself everyday until it sinks in: I have worth.
Goodbye, you will not be missed.