Waiting games

A mental health struggle

Nikki Mattocks has struggled with her mental health her whole life, owing to experiences such as bullying, trauma and abuse.

She has struggled to find the care and help she needed, including access to talking therapies.

Teenage trauma

When I was 14, I experienced some trauma. I was on a downward spiral of, like, self-harming, taking overdoses, and hearing voices.

They say that I’m useless, that I’m worthless. They pick up on things that have happened in the past, where I’ve been bullied, they can repeat the same things.

"When they asked me to wash up, I’d leave my sleeves down."

Right now, they’re saying, ‘you shouldn’t tell people what you’ve been through, no wants to hear it’. I’ve got to constantly challenge it.

The way I see it, my brain kind of just broke. I tried to hide it as much as I could. But then, I was put on the spot by my dad or sisters. When they asked me to wash up, I’d leave my sleeves down. They’d be like, ‘why don’t you pull them up because you’re getting wet’.

Imagine you’re in a concrete basement. You can’t get out. There’s no doors. There’s no windows. You’re in a room with 20 people. They all hate you but you just can’t get out.

"Imagine you’re in a concrete basement.
You can’t get out. There’s no doors.
There’s no windows.
You’re in a room with 20 people.
They all hate you but you just can’t get out."

It was really my dad pushing me to get help. I wasn’t too bothered because the main thing I wanted really was to die.

A school counsellor referred me to CAMHS (child and adolescent mental health services). But they said: ‘No, you’re not quite severe enough.’

Nikki with her Dad, age 14

Nikki with her Dad, age 14

I was referred to CAMHS again and then they took me and they saw me. But the whole process took months and in that time I was still self-harming, I was still taking overdoses, I was still distressed.

"The way that they classify ‘bad enough’ is when you’re in absolute crisis."

If you’re not bad enough, you don’t really get much help. The way that they classify ‘bad enough’ is when you’re in absolute crisis.

For me, I didn’t really get the help I needed until I was in crisis.
I’ve no idea how many times I went to A&E. There were so many. I went all the time because I didn’t feel safe in myself.

Red for danger

I had this system where I’d text my dad, saying red, green or yellow, to let him know how I was.

When I text him red, it meant I was really bad and that I was wanting to hurt myself, so he would take me to A&E because that’s what he was told to do.

Either that or I’d taken an overdose or something of that sort. I’d self-harm or something.

We’d go to A&E and we’d just wait around for ages. I’d be told: ‘No, it’s not quite bad enough, go home,’ and it was awful.

I remember one time my dad thought I was asleep. I was just resting. A doctor came and talked to him and he said, ‘please can you help her because I’m worried I’ll wake up and she’ll be dead’.

"You’re told that’s where you go if you need help. But in reality, you don’t get any help there."

The whole process of going in and out of A&E is just exhausting. You’re told that’s where you go if you need help. But in reality, you don’t get any help there.

So I was put off from even going there. When I had taken an overdose, I just wouldn’t tell anyone. I just let it damage or do whatever it did.

It got to the stage where I was not safe to be on my own any more so I had a lot of inpatient admissions. I was a day patient at a hospital for about six months.

Nikki, age 13

Nikki, age 13

From when I first got referred to CAMHS, to when I got DBT (dialectical behavioural therapy), which was what I needed, was about a year and a half. Something like that.

"I don’t think they ever really told me there was a list. I knew I was waiting for something but I didn’t know what was going to happen or if it was going to help."

In the meantime, I did have a psychologist but it was just like chatting, trying to keep me safe. But it wasn’t the specialist therapy I needed.

They did think about DBT early on. But it takes a while to get through the waiting lists and stuff. I don’t think they ever really told me there was a list. I knew I was waiting for something but I didn’t know what was going to happen or if it was going to help.

Desperate waiting

Waiting for something you’re so desperate to have is really painful. It can make everything else seem worse. I didn’t want to wait. I wanted to have it now or I wanted to be dead. I just wanted something to happen. Because I was depressed at the time, I kind of felt like I didn’t deserve it any way.

"I hadn’t had the chance to learn how to deal with my emotions healthily. I always had to suppress them."

The dialectical behavioural therapy was really helpful. The whole point of it is to help people with borderline personality disorder, to relearn healthy ways of doing things and learn to accept your emotions – rather than always acting on them, learning to let things pass. It gives you the skills that you’ve never had, so you can deal with how you feel.

Nikki, age 14

Nikki, age 14

I learnt so much that I made like a book of things I can do if I’m feeling a certain way. It’s so useful to have like an instruction manual. If I feel sad I go to my book and I know I could watch a movie or I could call a friend. Things that I can do when I’m angry: I can break up sticks, or I can crush recycling or I can do some exercise. I know that’s going to help because it’s helped me before.

I hadn’t had the chance to learn how to deal with my emotions healthily. I always had to suppress them. The way I knew how to deal with them was to lash out or do something that would make myself in pain. My way of coping was to self-harm or to take overdoses.

"A few days after my 18th birthday, I took another overdose, then I was referred to the services again."

I was discharged from CAMHS when I was about 17. Then, two months before I turned 18, I was finding things difficult again. But because I’d been discharged for six months, I couldn’t skip the waiting list. I heard nothing.

A few days after my 18th birthday, I took another overdose, then I was referred to the services again.

In the past few months my mental health kind of dipped a bit because my nan was quite unwell and she passed away. A team came and saw me every day. I had a couple of assessments for therapy appointments. After I’ve had one more, I’ll be on another waiting list. I wonder whether it’s worth being on it.

Ticking boxes

You have to tick boxes for mental health services. It’s really weird. There’s like a level where you have maybe mild depression and anxiety and you get the help you need.

"It shouldn’t be that way. It should be easy to get help because it takes so much for someone to go to someone and say, look I’m struggling'."

Then there’s another level where you just jumped in front of a train and survived, you get really intensive help.

Everything in the middle, you’re not bad enough or too bad for cognitive behavioural therapy. And then you’re kind of left. You’re either not bad enough or too bad or the correct amount of bad.

If you’re like me and you move around a lot or you’re not quite 18 or if you’re struggling but you don’t tick their boxes then it can be an absolute nightmare trying to get help.

It shouldn’t be that way. It should be easy to get help because it takes so much for someone to go to someone and say, ‘look I’m struggling’. If you do that you shouldn’t have to face more challenges.

"I’m 20 now. I’ve had ups and downs in my mental health but overall it’s been OK."

I do feel like I missed out on quite a lot of stuff. When I got to high school, I did have a couple of friends but a lot of the time, all of my time, was consumed by… I was just consumed by anxiety and depression, this uphill battle that I just couldn’t win.

Nikki at school, age 16

Nikki at school, age 16

A lot of people enjoy their teenage years, even though there’s struggles, a lot of people still enjoy it in retrospect. I absolutely hated it. My friends were all going to parties and having fun, and I’m in A&E just desperate to get help.

It’s hard and it affected my GCSEs. I’d always been academic and before the age of 14 I was doing really well at school.

Time to make a difference

There’s all these people that are desperate and while people are waiting, people die in that time.

"People in that time lose friendships and lose relationships with their families because there’s a lack of understanding."

People in that time commit suicide, people in that time self-harm to the point where there’s a change that they’ve made to themselves that they can’t change back.

People in that time lose friendships and lose relationships with their families because there’s a lack of understanding. And it’s all because there’s not enough crisis services, enough therapies, there’s not enough awareness or prevention.

Nikki on her 15th birthday 

Nikki on her 15th birthday 

It would have been amazing if I had got access to DBT sooner. I wouldn’t have tried to kill myself so many times. I wouldn’t have self-harmed so much. I would’ve got better GCSEs. I would’ve been able to actually enjoy part of my childhood without feeling so nervous and on edge and suicidal. So much would’ve been different.

Read the BMA News feature on talking therapy services

Nikki, January 2018

Credits

Reporter: Keith Cooper
Sub editor: Chris Patterson

Designer: Tim Grant

Video production: Mary-Lane Friday, Matthew Saywell
Additional video: Practical, iStock video


Photography: Matthew Saywell, iStock Images