Thread by @jamesldowns

My experiences of #mentalhealth emergencies have been many and varied, but they have ALL been made worse by a huge fear of being misunderstood or not heard. The absolute terror of being dismissed or ignored when in a crisis has been worse than the crisis itself.

The fear is not irrational. For me it became embodied through experience - experience of being denied care, being completely misunderstood, being hung up on by 111 & 999 because unable to stop crying enough to say your date of birth. Of being left without a support net at all.

I can barely explain the terror of your compellingly urgent and totally life-threatening experience being unknowable, uninteresting, unimportant or un-hearable to others. It's traumatic and makes help-seeking terrifying for fear of it happening again

I can't describe the terror of being in a healthcare setting and having to beg for help because despite saying (for the first time in many years) that you feel unsafe and have intent & means to end your life, they say "well we can't keep you here"

I can't explain the long stain on your sense of self worth that comes from multiple, degrading experiences of being blatantly dismissed, ignored and wilfully misunderstood. It's quite the character-building bootcamp if you're lucky enough to access therapy for it afterwards.

Instead of recognising and holding fear of help-seeking as a symptom of a failing system rather than individual madness/badness, we blame people who have trouble with help-seeking, who struggle to ask for help within tightly defined parameters without fear

Patients do not simply dump all of their past difficult experiences of healthcare on the individual professionals they encounter. They carry their experiences, they live with them, they are often aware of the role of them. We are just trying to protect ourselves

Professionals need to remember that trust is earned and that where people are mistrusting it is often out of a legitimate fear. Understanding and respecting how someone has been let down/mistreated in the past isn't separate from the encounter in the present or irrelevant

In fact, working with this can be key to being helpful in the here and the now, and of working through some of the very real problems that come with fear of help-seeking that can be worse than any mental health problems themselves. Let's be insightful about this, it can help.

For me, the main thing I have wanted in a crisis (besides not to feel pain, etc etc) has been to NOT have to encounter invalidation. To be MET with compassion. What a sad situation when, for too many, the risk of invalidation is too high and compassion is not readily available

Reading stories today about preventable deaths from lack of access to #mentalhealth care has reminded me of all the times I've not had access to a guaranteed place of safety, care and compassion. These should never be optional, they should be ensured. It risks and costs lives.