Piles of paper and island mentality: an austerity story

I finished my final university exams last week, which gives me time to write this blog again. I also started a new course of medication recently, and wanted to share a story about it.
I went to the doctor’s, the day after the election. That day as I walked through Brockley I had the distinct, uncomfortable sense of being on an island.
Physically, of course, I’m always on an island. And in the UK, the siege-like island mentality is pervasive. But the gap between rich and poor people, middle-class and working class, and the other prejudices at work in our society – well, it’s impossible to ignore that gap any more. It’s hard to imagine a developed country where rich and poor are more isolated from each other.
My flatmate and I stayed up all night on May 7th, watching as the Tories swept the board and the map of England gradually turned blue.
I saw Birmingham, where I grew up: a small oasis of scarlet in the midst of a solid expanse of blue. I remembered the chasm between the area where I grew up, with its run-down terraces and ’60s tower blocks, and the smug mansions in the suburbs.
Then there was London, my beloved adopted city, showing up as a small splash of red (‘communist island’ I heard it called) in the middle of the solidly Tory Home Counties.
To me it had been solidly proved that nobody – in the surrounding counties of either of my cities – particularly cared about the suicides of people who had been told they were fit to work or had their benefits cut, the rapidly growing number of food banks, the rent crisis, the closed-down libraries, the overloaded health services – or, indeed, any of the problems affecting people who live in poor areas and don’t have much money.
We are in a social crisis, which the Tory government has fuelled and encouraged. But it seems plenty of people are doing well enough to afford not to notice.
How much can you shrink the island mentality?
You can keep shrinking it, down and down, till it’s just you in your living room.
Earlier that day I’d written “Once upon a time there was a smug couple, spiteful and narrow-minded, envious of their neighbours and afraid of the outside world, and their house was an island; they were isolated by their fear of the world and their greed.
I left the doctor’s with a small story, one that could be added to the great web of austerity stories people have been sharing.
So: this time I get a kind sensible female doctor.
She says I seem to be coping well; well, you learn how to cope with chronic lifelong anxiety, somehow. Medicine helps, and so do books. Then I explain that I’ve had a problem with the referral.
I say, “I’ve been trying to push the referral through all year. I have phoned the IAPT service and emailed them -” and also asked the doctor about it repeatedly; his response was to ask me to phone the IAPT service myself. I’d phoned them again, several times, and got no response. The doctor looks concerned and says she will ring them. “They’re very disorganised, I’m afraid. They need a lot of nudging.”
Because she is not in a hurry, I press her on this point. It turns out exactly as I suspected.
She says, “Unfortunately most of our referrals don’t go through.” Oh, why not? “Well, they’re very short of time and they have long waiting lists. Almost all the referrals have to go to people who are severely psychotic or suicidal.” Otherwise, the referral goes on a pile of pieces of paper in an office already avalanched with dead trees.
And what of all those people? People who are struggling, but not struggling enough. People who are suicidal, but not suicidal enough. People who are ill, but not ill enough. Medical abuse of extremely sick people is an awful thing, and so is systematic neglect.
It’s not enough.
Yes, it varies by area – some services have more funding than others. Nor should it be blamed on staff, who don’t control the system they work in. But NHS mental health services have been cumulatively overstretched for years, and the system is formulated so that mental health is shuffled down on the list of priorities. It has to be that way, said someone I brought it up with; if you come into A&E with a bleeding hand they’ll put you in front of someone with no injuries. But at least in A&E, everyone gets treated in the end.
Austerity is destructive. It was designed by politicians with no compassion for the mentally ill or disabled. (The story is still fresh in my mind of the disabled ex-soldier who was found dead in his flat, near a pile of CVs.) 1 in 3 people in Britain will suffer from a mental illness at some point, so why should help be so limited?
The doctor writes a prescription. We talk about possible solutions. She says if I have the means I should look for solutions outside the NHS. I say, “It’s not looking good at the moment, is it?”
No, she says gravely, it’s not looking good at all.

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