Coping with borderline in a time of healthcare cuts
Posted Tuesday 28 June 2011
Guest post from Glen, on the difference one caring mental health professional can make.
In 2009 I moved to London and to the care of a new support worker at the local Community Mental Health Team (CMHT). Annie was my third support worker that year, but she was amazing from the start.
Annie was there at every turning point as I settled back into life in the city. She helped me get over the hurdles of getting housed by the council, researched welfare rights advice for me, and even helped with my housing repairs. Above all, she was always there for me. In my very rough patches, she helped me to get back up, dust myself down and gave me the encouragement to fight another day.
Five months into my care with the CMHT, I found out (from the back of a sicknote) that I had been diagnosed with Emotionally Unstable Borderline Personality Disorder. Despite having had several diagnoses for the two years previously, this was a real shock to me.
Annie sat me down, and went through each of the characteristics of being borderline. No one had ever done that with me in the past. When she had finished, I didn't feel like I had a label hovering above my head. She taught me that there were issues that made up my diagnosis, and helped me to understand them. I would see Annie every two weeks or so for a cuppa, and a pat on the back for getting as far as I had done.
Towards the end of last year, Annie told me she was leaving. My heart sank. I felt as if I had just been dumped. There was an overwhelming feeling of loss. A month later, I met Annie for the last time. She gave me a hug and told me that she was proud of me. A year of her support, encouragement and warm smile was now over. I walked home almost unaware of the pain caused by biting my bottom lip to stop me from causing a flood with my tears.
Three months after Annie left, I received a letter from Julie, my new social worker at the CMHT. The first thing that glared out at me from the letter was that she had 'agreed to offer some short-term support' - wow, thanks. I phoned Julie, and asked her why it was deemed 'short-term': my borderline hadn't gone away (boy do I wish it had done); I was still suffering and it was getting worse.
Julie told me that as I was on the waiting list for therapy, she would only be supporting me until I started the CBT. She wasn't very considerate about the explanation. When I asked why it had taken three months to get a new worker, she told me it was all down to budget cuts. She said I needed to get used to standing on my own two feet, so wouldn't be seeing me that often. Yes, I thought, I need to stand on my own two feet, but at my own pace.
At my last meeting with Julie, I asked what would happen when the CBT ends. BPD can't be cured, you just learn to live with the emotions. She asked me what I meant. 'You will need to see your GP if you have any problems' she eventually replied. I asked about the care of my partner — could he talk to someone about caring for me? 'Budget cuts mean we don't have the staff to do that, but he can speak to me and I can refer him to a charity'. My feeling inside was clear — you can't even speak to me with care, how do you deal with someone that is watching his loved one virtually self-destruct as he bounces off the walls?
When the therapy ends, I will be alone, having to fight through my GP's automated appointment line to see him for having a 'wobbly five minutes'. It's clear that the care and compassion I received from Annie back in 2009 has gone.
I feel like I'm just seen as a diary entry, and a chance to air a grievance about cuts that are already obvious to me. Since when was care and compassion from a fellow human being something that came out of a financial budget?
It's true that I often see things in black and white, but this has never been clearer to me: my care shouldn't be black and white, it should have colour and warmth. Like it used to.
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