I hate RUOK Day. Here’s why.

Jennie Hill Blocked Unblock Follow Following Sep 7, 2016

Today is RUOK Day. It’s the day each year we’re supposed to ask people we know if they’re okay, with a view to starting conversations and offering support, thus reducing mental health issues and suicide.

I hate it.

Yep, I know this won’t be popular. People will say how dare I criticise something that’s doing good, or trying to? They’ll say what’s wrong with more talking and more luuurrve for our friends, relatives and workmates? They’ll point to spiraling suicide rates and ask how could I possibly oppose something that might help?

Well, hear me out.

Since February this year, my young adult son has been seriously ill with the effects of a brain injury acquired at birth. He’s been in and out of hospital, and we’ve come in contact with many medical professionals and organisations. And because my son’s issues intersect with those of mentally ill Australians, we interact with those working in this field, and those using its services. And what we’ve learned about this alternative universe would shock most to the core.

If you know nothing about mental illness and its treatment, you’re not alone. Australians don’t want to know. But once you’ve seen what goes on, you can’t unsee it. And what we all need to know is that the single biggest issue in mental illness service provision is the disgraceful lack of funding and support.

Every service is overloaded and stressed — and still the budget cuts come. So services that do exist need to spend so much time trying to shore up their funding bases they have little time or energy left for actually providing frontline care.

A couple of months ago my son spent 6 weeks in a mental health hospital. While there, he befriended several other patients — all wonderful people who’d had the awful bad luck to develop mental health issues. What amazed me was how they tended to stay in hospital for a while then (usually as soon as their treatment had a slight positive effect) were discharged. Discharged to (as I now know) nothing in the way of out-patient support. So, a couple of weeks later they’re back, having (surprise, surprise) failed to adequately cope with life outside the ward. They stay another few weeks, and are then pushed out again. This is what I saw. Repeatedly. It may not be universal (I desperately hope it’s not) but I was led to believe it’s the norm.

Putting band aids on people with gushing severed arteries was what it looked like.

And this was in the private system, which we were lucky enough to afford to use. I don’t know what happens in the public system, but I can guess. The public services I’ve called to try to access extra support for my son don’t even have the staff to return a phone call, let alone offer any help.

Smack in the middle of this human disaster are organisations like RUOK. Beyond Blue is another, and there are more. I know them all, because I see their glossy brochure stands in the halls of the hospitals where I visit my son. I want to set fire to them, because they’re expensive reminders of a pointless exercise. Nobody takes the brochures, because every inpatient, visitor and member of staff knows full well there’s nothing in there for them.

Australia has a veritable glut of this — companies (and they ARE businesses, even if non-profit) whose major function is to “raise awareness”. Yet here’s the rub — the more they raise awareness, the more people realise they’re in trouble and try to access help. And once they do that, the more the system fails them. Because it doesn’t provide ongoing solutions, so people are turned away in huge numbers. They may be somewhat treated, but they’re not fully supported, and then they’re sent back into their communities on their own.

Their families are also unsupported, and may suffer secondary trauma from the stress of caring for a seriously ill family member. Once that happens the whole family is ill, and even less able to help each other. And so the downward spiral continues.

I know this. I’ve seen it, and I’m also living it. Through privilege and luck and above-average support, my family have so-far avoided the worst effects of this desperation, but at times it hasn’t been by much. And for families without the blessings I have, the load must be overwhelming. It is overwhelming. People fail to cope, and are then blamed for their frailty and vilified by press and government.

Imagine if we had a day each year when we all went around asking cancer patients if they were “okay”, yet didn’t fund practical medical help for them or give them any hope? The idea is laughable, yet the analogy is real.

I’m not against awareness raising per se. In many fields it does a lot of good and changes lives for the better. And most of those who work in these fields are passionate about their cause and want to help.

However, awareness raising on its own is probably making ill people even worse off, because it creates bottlenecks in the system. Too many people are calling, yet if they’re turned away by services that can’t cope with demand, this must make desperately ill people even more desperate.

Where do they go? Into alcoholism, drug abuse or gambling or other kinds of sad and often lonely coping mechanisms. Into homelessness, because it’s too hard to access government income support, as I wrote about recently. Or into suicide, because when nobody helps you when you need it, whatever feelings of inadequacy and pain you already had are amplified a thousand fold.

I know this is real, because my own brother did kill himself when he grew exhausted from the struggle, some eight years ago. He suffered from bipolar disorder. This is why to me, the issue isn’t just a slogan on a t-shirt or a jaunty logo, it’s my life. More importantly, it’s my son’s life.

In recent months many have written about why both homelessness and suicides are rising steeply in Australia. Well, wonder no more. A government vilifying desperate people and forcing cuts on an overloaded health service (which is then forced to triage funding towards those who may soon die and away from those not in immediate danger) adds up to a perfect storm of hopelessness.

In addition, a lot of awareness raising is only for people mildly and transiently depressed. Psychiatrists call them the “worried well” — they do need treatment, but aren’t as desperately ill as those with chronic depression, schizophrenia, bipolar disorder and some forms of OCD. Those with more serious disorders are as ill (or more ill) than those with cancers and other diseases. And there are treatment options for many, if they’re backed-up by good out-patient care. However, there are also many who have few treatment options, like my son and as explained in this brilliant piece by Anna Spargo-Ryan. But again — more funding would at least pay for research which may give these terribly ill sufferers hope and, eventually, more options.

Those with schizophrenia, for example, have a 10 percent suicide risk — ten percent — yet unless they can access expensive, private psychiatric services, funding is pathetic. And still, as a society we prefer to malign, laugh at, fear and/or hide them away, instead of providing secure, lifetime medical help. We still shoot them when they do strange things in public places, tell jokes about how OCD we are (little realising how debilitating OCD is and how terrible it is to laugh about it), and chuckle about the “schizo” down the street or the “mental” sleeping rough in our local park.

Nah, it’s much easier to take a minute to ask your mildly worried friend if they’re okay than to have to care about those living with constant, crippling, frightening mental illness.

I don’t blame the general public for this lack of awareness — you can’t care about what you don’t see. And I was just as bad, before I knew the truth.

But now I do know, I feel sick about the tens of millions of dollars in “awareness raising” that should be going to frontline mental health services. I feel desolate about the multi-million-dollar advertising campaigns, and how that money could provide hospital beds and medication for those broken by their pain. I feel rage when I think of the expensive dinners held, attended by smug neuro-typical people to raise awareness of the neuro-different, and all without a single sufferer in the room. And I feel broken-hearted about the souls I’ve seen wandering the corridors of mental health hospitals while visiting my son, and how they’ll soon be discharged (when the money runs out) to a world that doesn’t care.

Awareness raising without action plans for those whose awareness has been raised is cruel. Unconscionable. And utterly disgraceful.

But this is Australia, and this is what now passes for mental health care here. Those of us who aren’t sick can pat ourselves on the back that we’ve done something good today, and go on with our lives.

Happy RUOK Day.

Excuse me if I don’t join in the fun.

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(Please call Lifeline on 13 11 14 if you need to. And call your local member or Health Minister Susan Ley if you’d like to do something concrete, on Minister.Ley@health.gov.au or (02) 6277 7220 .)