Daniel Jarsdel who suffers from schizophrenia reveals what it’s like to seek help through the NHS
Mental health and Christianity have a strange and contentious history. And it’s not much better in wider society.
A 2017 survey by YouGov and the royal charity Heads Together found that men are less likely to talk about mental health than women and that those aged 18-24 are almost twice as likely to discuss it than those over 65. But fewer than one in five people who have had a conversation about mental health have mentioned it to their GP and less than one in ten have spoken either to a supervisor at work or a counsellor.
Whatever a person’s gender, age or religion, mental illness doesn’t discriminate. I come from a middle-class, non-Christian background. Twenty-one years ago, a few years after becoming a Christian, I was diagnosed with a mental illness. Mental health problems have been as close to me as God himself. But speak to those who struggle in this area, and you’ll soon discover that churches can be notoriously difficult places to belong.
For me, church has been a mixed bag – I rarely tell people my diagnosis, and on the surface I make a good play at appearing ‘normal’. There have been some comments about being ‘demon possessed’ (I’m not, by the way) and I’ve experienced both support and misunderstanding from fellow Christians. But, as with the mentally ill, you shouldn’t blame a whole group for the wrong actions of a few.
Recently I decided to seek outside help through the NHS – which had the advantage of being free as opposed to other options before me.
I’ve always been suspicious of therapy. No amount of Woody Allen films or royal backing (prince Harry spoke about seeking out counselling earlier this year) could make me feel that it was either desirable or effective. I think that becoming a Christian makes you question society more. And working with the medical profession which doesn’t believe in the spiritual concepts that you do can be frustrating. So when I decided to go through the counselling system, I began cynically. You could have even described me as paranoid. How far can or should a Christian trust a largely secular system which doesn’t seem to understand issues of the soul?
"Mental health problems have been as close to me as God"
My current diagnosis gives me the conversation-stopping label of ‘schizophrenia (NOS – Not Otherwise Specified)’. It is the kind of diagnosis that isn’t exactly easy to bring up at dinner parties. Don’t worry, the closest I come to violence is when I squash a wasp. The fact I even have to write that last sentence and reassure you I’m not a violent person reveals the level of stigma that exists around mental health.
Therapy with the NHS is not easy to get – there are questions to be answered and the wait is as long (if not longer) as that for any other kind of care. If you do manage to get therapy, they will let you know how lucky you are at every turn. You might complain you’re not that lucky because if you were, you wouldn’t have mental health problems in the first place so you wouldn’t need treatment. But taking that approach will always be met with a stern look which says, “count your blessings, loopy brain”.
There was only one way for me to handle the process I was throwing myself into. So I took my pen and notepad and wrote down everything. It’s my way of coping. Here is my diary:
First port of Call: Doctor’s surgery
Today I saw my doctor to request Cognitive Behaviour Therapy (CBT). The last couple of months have been too much of a struggle. It’s not just the low points in my daily life – I’ve had the occasional near panic attack at work too. I’m able to function pretty well (all things considered), but I need some coping strategies. I’m trying to approach this with open-minded scepticism, but if I’m honest, I feel far more sceptical than I do open-minded.
My doctor gives me a standard verbal questionnaire. Do I have any thoughts of taking my own life? No. Do I sleep well? Yes, most nights. Do I still take pleasure in activities? Yes, usually.
I score a very disappointing eight out of 20 on the “you’re really quite mad and need help” scale. However, my doctor knows my diagnosis is “the big S” and as a result she says I can get “fast-tracked”. In other words, a bad score on the test is not going to prevent the process from going forward. I feel as though I’m receiving preferential treatment. I’m to be referred to the local mental health team for an appointment. So I am to wait. I tell my mother about the therapy and she, in a mumsy way, refers to it as my “chat show”.
Forty-eight Days later: initial assessment
The big day has arrived. I think of it as a prechat show interview. Over the front door of the mental health centre is a canopy which bends down and looks like the face of a very sad man. And it is a depressing place. The building has a dual purpose – helping people with drug problems, and others like me.
There’s a burly male receptionist. He’s seated at a desk through a window, protected from any potential violence. I notice that on the desk there’s a roll of yellow and black coloured stickers with the word “Deceased” in a bold font.
Eventually a member of staff comes to meet me. He’s in his mid-30s and looks overworked. I walk with him through to the interview room where he tells me he doesn’t know anything about me as he’s not been given any information.
I spend the next ten minutes telling him as much of my story as I’m comfortable sharing. I explain how I spent some months in hospital after being sectioned. That happened after I ran away from home to pray. I was unbalanced, so the authorities came after me with sniffer dogs and found me alone in a field at night. I was standing with my face to the sky, begging God for help. I was taken away.
“I’d rather not be hospitalised again,” I say afterwards. I’m reasonably honest as question after question is fired at me.
“Do you use illegal substances? Do you want to harm yourself? Have you any children? Do you live alone? Do you work? What is your wife’s name? Do you feel like you’re being watched when you’re walking down the street?”
I feel pressured and assailed by these questions. Finally he says: “If I asked you to go into town now and buy me a paper, would you have any problems doing so?”
“It depends on which paper you want,” I reply. He seems confused. “What do you mean?” he asks, as if I have revealed something dangerous. “Well, if you wanted me to buy a copy of the Daily Mail I may have some problems with that.”
My answer seems to relax him. We talk about the pros and cons of getting a re-diagnosis. He says that I have two options – I can either be taken on by the centre or else I can be referred to “another place”. The place I sit is presented as the worse option. “If I have a vote I would prefer to be referred,” I say.
Then he says: “We may need to put you on antidepressants.” I’m already on low dose antipsychotics and I feel that there’s an implied threat in the words. I do not want to be put on antidepressants as well. I just want a talking therapy to help me.
I get up and leave, back out through the locked doors, past the burly receptionist and out under the sad face of the entrance. Then there is a wait. A long wait.
Forty-nine Days later: Community Counselling Centre
I sit and look around the new waiting room. There are five other people here and they leave one by one when called through a bright green door. On the table in front of us is a bowl full of potpourri. Eventually, a man comes to meet me and introduces himself as “Colin”. He seems friendly enough.
I’m led through one of the many green doors into the therapy room. The door seems to act as a kind of portal.
I’m presented with some forms, including a disclaimer that they will give records to the NHS. Everything is confidential except in the cases of “Suspected terrorism”, “Suspected crime” and “Reason to believe the patient will harm themselves or others".
The next form is a self-analysis on my level of low mood, feelings of anxiety for the future and the past and any feelings of wanting to harm myself. I mark the feelings of low mood and am told that the scores indicate that I am more anxious about the future (a score of twelve) than concerned about the past (a score of nine). “They are good scores,” says the counsellor. I feel strangely pleased.
Colin tells me that the session is all about me and that I will do most of the talking. In the end he does most of the talking. He talks, in layman’s terms, about feelings of anxiety and triggers for anxiety. “Anxiety and low mood don’t respect anybody,” he says. “They are the bullies. Parents don’t teach you how to cope with anxiety and neither do schools.”
Then he says that he would like to continue to offer therapy to me. I become cynical and wonder if he gets paid for taking people on, but I hide it. Of course, I do not have the choice to ask for a Christian counsellor. The choices are limited because it is free. I briefly wonder what happens if I mention God? Or the devil?
I ask Colin a little more and he says, finally, that he’s going to use “Exposure therapy”. I don’t like the sound of that, it sounds like psychological flooding. But it’s the only therapy offered to me.
I do not want to face my fears. It already feels as if God is highly supportive of this method as I feel I have to face my fears constantly. God seems to almost constantly allow me to be in situations in which I don’t want to be. For example, I don’t like driving at night in the rain in cities, yet it always seems that for one reason or another, I’m forced to drive in stormy nights through built-up areas.
Suddenly the clock reads 11am and the session is over. I feel a little relieved and am swept out through the green door portal. Once again I have to wait.
Twenty-two Days later: first therapy session – the Chat show proper
My first therapy session is scheduled for 3:30pm. I spend the day feeling anxious and drained. I force myself to go. It is not something I want to play truant with.
When I arrive I feel strangely calm, as if someone, somewhere has prayed for me. I’m left alone in the waiting room listening to the radio which is playing Pharrell Williams’ song ‘Happy’.
Eventually Colin arrives and this time we go through to a small room through a different green door. There’s very little in the room except for two chairs. The blinds are drawn.
The session begins and Colin talks for half an hour without much interruption. He offers to teach me breathing techniques which he claims work for those who “come to service”. He makes it sound like I’m a car. I listen to try to engage but can’t get around the fact I still only trust the therapist to an extent.
Perhaps Colin is used to this. I imagine I underestimate him. But I open up and admit to negative feelings of guilt, catastrophising and many other things. I ignore my cynicism and decide that he’s here to help and hope that there’s no negative agenda at work.
“Be the person you want to be,” says Colin. To be fair on him he is encouraging and he doesn’t seem to do anything wrong. I kind of like him. The fact that he uses the techniques himself suggests that he has struggled with mental health problems too.
I’m given “homework” in the form a handout to read. After an hour I leave for the train and I still feel calm. I feel better than when I went in, as if I’m making an effort to fight back.
It was not what I expected. I hope it works but I’m realistic. If my expectations are low I can’t be disappointed. Is it sad to think that way?
The therapy is ongoing. And I’m still cynical. In some ways it seems as if it is the recourse of our age, along with medication. Would I be better off with prayer and Bible reading, like those before me? Am I lucky? Prayer can help and the Bible can be a comfort, but it only goes so far. For me, the things that help the most are experiencing love, respect and care from others in words and actions. I always see God in that care. Wherever it comes from.
It occurs to me, in one of those crazy, illogical thoughts which fill my days, that everything between sessions is therapy, but that it has somehow been extended out into the world beyond the counselling room. The rest of my life will be one long therapy session involving both storms and gentle sunshine. I’ll face moments of suffering and fear, but happiness too.
What is the measure of a person’s life? Success? Riches? Healing? It is not so much that I feel I am being monitored or watched or that an unseen angel is taking notes of everything I do or say. But in recognising the delusions and the temptation to believe them, I can progress.
My main delusion is that I think people can read my mind. I know that this is madness. Or at least, most of the time I know it’s madness. But a strong delusion works like propaganda, by an idea coming back again and again and again. I have to resist it. I do resist it. But on my bad days I believe it.
I’ll admit it. The NHS therapy has been helpful. But the therapy session this side of the green door is the rest of my life. I am still in the world, still subject to the same forces as I ever was. And so I wonder if everything is therapy and that God is the therapist taking notes. A ridiculous thought. A foolish, silly, butterfly thought.
And yet, I still feel I am within all kinds of systems. Including the NHS.
Daniel Jarsdel is a Christian living in Derbyshire. He works part-time, helping disabled people in the education sector. He likes walking and loves reading. His favourite author is CS Lewis