What comes after R U OK?

This piece was originally posted on R U OK Day 2017.

Facebook’s On This Day feature — typically useful for reminding us of questionable fashion or relationship choices we’ve made in the past — recently showed me a status I made on the day Robin Williams died. I remember feeling torn apart that day — heartbroken by the news. I wrote a status that ended with “please seek help”, a phrase that now stings when I read the words.

It’s a common catch cry attached to conversations around mental health, said with the best of intentions, but I now understand there are some problems with the narrative.

Sometimes seeking help is not easy, and sometimes seeking help is not enough.

We Need To Talk About What Seeking Help Actually Looks Like

In an ideal world — and what many people believe actually happens — the process might look something like this. Let’s call this theoretical person Bob.

Bob notices they need help with mental health. Bob does not feel shame or stigma for doing so. Bob visits their GP who is attentive and knowledgeable about mental illness pathways. Bob has no co-existing physical or psychological conditions that affect or interfere with his mental health treatment. Bob receives a referral to a specialist who is available soon with no lengthy waiting period, located nearby, and who has experience with Bob’s specific mental health concerns. Bob discloses their issues with family, friends and their employer, who are all supportive. Bob and the specialist develop a great therapeutic relationship and work collaboratively to address Bob’s symptoms and goals. The specialist bulk-bills or does not have a huge gap between Medicare costs, so Bob is able to easily afford these sessions. Alternatively, Bob has a stash of solid gold wedged inside a mattress. Bob feels better and does not need more than the allotted 10 subsided sessions. Hooray for Bob.

Can you see how every little step of the way can have its own major obstacles?

If we look at Bob’s journey, the first three steps are fundamental. It’s easy for some of us to forget that saying “I am depressed” does not come easy for a lot of people. Although my decade of seeking help has been incredibly difficult and confusing, it was not hard for me to notice I was and there was no shame for me to admit I needed help.

For some folks — depending on their age, location, gender, cultural or religious background — admitting they are not doing well and stating that is a huge achievement. Campaigns that address stigma and promote awareness-raising are absolutely vital for these people.

That being said, we need more. If “just seek help” is not followed by easily accessible and affordable services for people to attend once they’ve overcome the fear of disclosing a mental health issue, it’s meaningless. Treatment pathways can be expensive, convoluted and lengthy.

Many People Are Seeking help, And Have Been For A Long Time.

While there are people suffering without obtaining any support, there are many of us engaged in treatment and still suffering. The assumption that people are not already trying to get better is surprisingly common. Many people are doing all that they can.

I don’t want to turn this into a listicle of ‘Things You Should NEVER Say To Someone With Depression’, accompanied by amusing gifs. We all make mistakes and can be clumsy with language. But it can be painful to hear “have you thought about counselling or medication?” when it’s literally all you have been doing for a decade or more.

When a symptom of your illness is disproportionate constant self-criticism, it makes you feel like you’re failing. I’m already investing so much time, energy and money into getting better, and I’m still struggling. What’s wrong with me? We need to remember that recovery is complex and never, ever linear.

Just like that crop top I ordered online and could not squeeze over my large head, there is no such thing as one size fits all with mental health treatments. I have been essentially conducting a one-person trial-and-error project for a decade to find something that benefits me. This includes countless medications, several different therapists (encompassing varying psychological modalities such as psychoanalysis, cognitive-behavioural therapy, acceptance and commitment therapy, and dialectical behaviour therapy, three psychiatrists, inpatient hospital stays, two dietitians, one hypnotherapist, and a course of zapping my brain with magnets.

It’s worth noting the majority of this is not covered by the public system, so a large portion of my income is put aside for private health insurance that still does not cover specific costs. Despite being broke I recognise it’s a huge privilege to be able to do this and am thankful I was able to move back in with family as I couldn’t work or pay rent.

Moving away from social supports has its own setbacks, but I never take for granted the support I have. Many people have nothing. I also know I’m not alone in this — almost half of all Australians will experience a mental illness in their lifetime. I still struggle every day but remain hopeful that recovery is possible.

What Comes After R U OK?

We owe it to ourselves and to our community to advocate for more funding for mental health. Only 5.2 percent of the health budget is allocated to mental health. We need to advocate for less workplace discrimination and better supports for early intervention.

We owe it to ourselves and our community to be there for each other when the pathway to professional help is met with obstacles, and when the recovery process stretches from months into years.

We owe it to ourselves and each other to do more than just say “please seek help”.

This is part of an ongoing series about mental health in Australia. Check back on Junkee for more.

Deirdre is a Melbourne-based writer and social worker. She enjoys writing about politics, feminism and mental health. You can follow her at @Figgled