Mental Health Connect

Chair: Maree Teesson

Speaker: Merinda Epstein

Please see below for link to powerpoint presentation download.

Merinda is a mental health consumer 

She will give a presentation from the consumer and expert/professional position

Works for Our Consumer Place – in Melbourne  - interested in BPD and self-harm

Has been lobbying around BPD for 24 years for most of the time have been on my own and failed to find allies who are clinicians and consumers are too scared. This is changing over past few years – more people are coming out and saying yes I have that label and with that may come self-harm.

-Shows cartoon where the person says ” I thought I would write my life story but instead I’m just going to photocopy my arms”

Discusses three different faces of self harm:

(1) self harm that others can see

(2) the self harm that noone else knows about – this is my story

(3) the self harm that is endemic (driving fast, drinking too much) wont talk about this as this is moralising

Discusses issue around attention seeking is nonsense.

She talks about her story and it comes from her family – she also talks about young people coming to her to discuss borderline BPD and they can’t find a big enough trauma – therefore they want to find a trauma.

Her Story

Father was a doctor who had bipolar lots of secrecy and lying – about his mental health – her sister died of cancer, mum was OCD hoarder – went to a posh school but wore old clothes- lots of extremes – brother had aspergers before it was diagnosed and he was violent and very happy. When her sister was 15 pushed a lot at school she didnt get into medicine and that threw her into a depression and suicided.  As a teen she was responsible for all of it.

The whole thing collapsed – in a way doctors daughter would do it – at getting sick and getting into hospitals – much safer at hospital than at home. She fell off a horse at 19 surgery on leg, got on a roll, infecting her wounds herself. Much safer than being at home.

She was addicted to self harm no one could get her off that boat because noone knew it was going on.

Discussion of the ‘ignored and judged nobodies’

National Institute of Clinical Excellence (NICE)

-Consumer perspective comments – discuss great work by Heather Castillo and Gillian Proctor – ‘The Haven’.

-Discusses controversial article by Dr Rachel James in the Guardian and a series of letters from Drs and psychiatrists on the doctors discussion board (UK) agreeing with her that those that self-harm are wasting the the health services time and should take more responsibility for themselves.

What people think clinicians think (as told by consumers):

• wilful
• disruptive
• difficultt
• timewasting
• dependent
• need punishment
• cries for help

(additional items not listed)

Research 2007 – Literature Review of writing on self-harm – health prof view

• these peole are attention seeksers
• Im afraid I lack sympathy
• we are not resourced to deal with this

(additional items not listed)

Why People Self-Harm

• to test that i am still alive
• to get others to see how i am hurting
• it gives me the ultimate control over my body
• to let him know he cant treat me like that
• to purge myself
• to let my mother know she should have protected me
• so I wouldnt suicide
• means of coping with life
• use it when i cant find any words
• managing anger – better me than somebody else
• it gives me a high – isnt that a terrible thing to admit

(additional items not listed)

Harm Minimisation

Discusses harm minimisation

Language

Discusses some of the negative language that health professionals use with consumers and how harmful it can be. Need ‘People First‘ language.

Chrissy’s Story – this is a friend’s story that was read out to the audience:

This is a story about a consumer called Chrissy. Brought up in a country town with a heart disorder and finger missing, sister died at birth, brother who left home. Born with probelms to stomach – her mum had postnatal depression, she lived with her aunty, and was abused and tortured – this is when she started to self-harm people told us we were lying when we told them , started cutting legs and stomachs. Abused by church elder but kept telling others about it – he went to jail and he is now out again. It happended at school with an art teacher diagnosed with mental illness. left the family – ended up on street, stealing, arsons,  doing feral stuff, counsellor said to her parents they needed to practice tough love, parents took door off my bedroom, she did well at school, straightened out in year 11 – got a scholarship to go to uni, loved children wanted to become a teacher, no trouble at uni with the work, at uni got counselled and saw her for two years, had a baby partner left, had first suicide attempt – bipolar and depression diagnosis – tried to get custody of child – since then had one or two major overdoses – another diagnosis anti social personality disorder. Got a fictitious personality diagnosis – he labelled her a liar.It does not worry her that there are labels. She finished university and started teaching had to leave straight away – the doctor said she was at risk of hurting children there was no evidence of this and had been a nanny- she fought hard but gave up took the major overdose and then started cutting my arms now continued all over my body. My cousin hung herself at 14. She was put in hospital before her birthday and held against her will  - Later raped again  she walked over a kilmoetre to a phone and police station – police said wasting there time – rape test done – case manager changed the story. Nothing hurts her anymore – in the court case her cousin pleaded guilty  and other cousins came forward with the same story. She has had 50 admissions and 6 psychiatrists.

Bill of Rights for People who Self Harm

By Deb Martinson.

Merinda lists the ten rights.

Discussion

1. Can you tell us what we should solve first?

Response: Consumer led education would be a good start, education in general but with mental health services – acute unit and accident and emergency

2. Comment – Mental Health WA looks like it could be leading the way – a family consumer client focus – that is the key place to start. Driven by consumers. Comment – interesting to see the traumas that lead on to self-harm and suicide – we can do all the research in the world – but the systems don’t change to take pressure off young people.

Response: The things that consumers want and need and know, we cant get funding for those interventions, there is a problem with research funding. Great majority of research is drug or government funded and while that stays in place we have major problems.

*not all discussion listed

Download Powerpoint presentation here.