Some people have mental health difficulties that don’t go away - so why do we provide care and support that does?

an article by Mark Brown, Writer in Residence to the Centre for Mental Health

The issue of long-term care and support for people who experience the kinds of mental distress and ill-health that don't go away has become one of the more baffling contentious issues within mental health.

Not every mental health difficulty goes away. Not every challenge that mental health difficulty creates can be ‘cured’. Some people have mental health difficulties that don’t go away. That reality is not a failure of treatment; it’s a statement of fact. Some of us are lucky enough to have mental health difficulties that are episodic. They come and go. When they're there, they're there and when they aren't we don't notice them as being anything different to the everyday experience of being us. This isn’t true for everyone. For some of us, everyday life is struggle against the things that happen in our heads. Times are not divided so much by illness and health but by being better and being worse. Sometimes what makes a given period better is support or trea ment. Sometimes it's the absence of that treatment or support that makes things worse. Some challenges never go away. Some only go away because support or treatment mitigates their effects.

Highlighted comments

• For some of us, everyday life is struggle against the things that happen in our heads
• People talk of discharge from services; of no longer meeting the threshold for care; of seeking help and finding themselves turned away.
• Accepting that you will never be fully free of things that cause you difficulties is not a defeat
• What makes it so hard to accept that severe mental ill-health can be an ongoing experience that requires ongoing care?
• The logic we have arrived at suggests empowerment is found in needing the least amount of support and resources.
• Our binaries of ‘good and bad’ or ‘progress and regression’ are not perfect platonic forms. They exist in times, places and circumstance
• What people advocating freedom from services couldn’t have foreseen was how the pendulum would shift away from wanting to provide ongoing services as a matter of course, toward a country where any form of long-term need was viewed with suspicion
• Well-meaning ideas of ending exclusion have mixed with the withdrawal of financial and social/medical long-term care
• People with the kinds of mental health difficulty that do not go away remain marooned between hospital and prevention
• Many well meaning people have contributed to a hostile environment for people who might thrive and grow if only they could receive support

Full text (PDF 13pp) or, if you prefer, you can read it in six HTML episodes here.

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