I don’t want this to be an audition for the Oppression Olympics, but a mere summation of the facts: I have Borderline Personality Disorder (super rare, apparently) and have been hospitalised three times because of it (I’m in my hospital room writing this actually).
I’ve had to drop out of uni twice now, reduce my hours at work, all but cease my drinking, stop starving myself or buying $20 worth of junk food whenever my self-esteem plummets, and start a cycle of medication that occasionally leaves me with memory loss and mild cognitive impairment.
I’m only really open about my illness when I’m drunk. I have innumerable scars where my BPD rearing its ugly head and externalised my pain. I’ve wasted six years of my life and I’m not quite sure that the end is in sight.
Anyone with a mental illness could tell you that there is a cost to being ill. Medications, appointments with psychologists and psychiatrists and GPs, outpatient therapy, inpatient programs, and so on. Not only are there the “positive” elements of spending, but the “negative”: bottles of vodka to quell the depressive voices, days you have to take off work because being a functional person is just not an option, courses that you couldn’t finish added to your HECS-debt because your brain burned with the effort of doing something productive.
A friend of mine who suffers from bulimia estimates that she would spend $30 or more a day on food to binge and purge. When she applied to an outpatient treatment, the wait was unfeasibly long and allowed her illness to fester. I was rejected from Maitland Private Hospital, five minutes from home, for being too high risk and had to stay at Warners Bay Private Hospital (where I am now), 45 minutes from home. When services are at capacity or not capable enough to treat you, what are your options but to try to treat yourself?
When I first started seeing my new psychologist outside of hospital and explained that I had received treatment in both public and private hospitals, she said, “Public hospitals are where they send you to keep you alive; private hospitals are where they send you to actually fix you.”
However, the prohibitive cost of private healthcare is a massive impediment to students with mental health issues, leaving them with little choice but to suffer or suffer with a group of other mentally ill people who aren’t receiving quality treatment.
According to NIB, a single student would pay at least $759.46 for basic private healthcare and $1845.18 for top range private healthcare for a year. Added to the cost of textbooks, groceries, rent, petrol, car registration, internet, utilities, phone bills, and at least 10 $4 drinks at Argyle on a Wednesday, it seems more and more inaccessible.
Being in a private hospital was laissez-faire and laid back. My friends and I would skip group therapy and sit in the smoking section under the hospital, a plastic round table of manic-depressives and anorexics. We had our own rooms with a view of the bay, a TV, and an en suite, something like a Hilton Hotel.
The only difference was that I didn’t have room service, but kind nurses bringing me a cocktail of anti-psychotics with a few anti-anxieties for good measure. I was smoking a pack a day out of boredom, interrupted by the odd game of table tennis, hour long sessions with psychologists and psychiatrists, and meal time.
Public hospital, on the other head, was bleak. The nurses’ station was an impenetrable fortress of sorts, surrounded by unbreakable glass with a little slot to talk through, like at a bank or a train station. I had a spartan room for two nights, sharing it with a man in his late thirties, who would wheeze when he did push-ups while I was trying to sleep. Rude.
I was still in the slough of depressive ennui: I slept, but I didn’t eat or shower and only went to the toilet once a day and only when the coast was clear. I begged my parents to get me out and thankfully they delivered. It was like something out of One Flew Over the Cuckoo’s Nest. Or American Horror Story: Asylum for the less literary readers.
About two weeks ago I went to see my GP to get an updated Mental Health Care Plan, which you need to claim Medicare payments when seeing a psych, and to get my prescriptions refilled. That set me back $104. Then I needed to get my bloods tested to make sure the medication I was on hadn’t enabled a chaotic degradation of, oh, my thyroid, or caused a potentially toxic rash.
For me, the short-term memory loss and the perpetual cognitive impairment is the worst, apart from said toxic rash. But what is the alternative? A pale imitation of life, oscillating between thrilling highs and depressive lows. There is a literal cost to medication, but a physical cost too.
A certain medication I’m on – lamotrigine – is used primarily as an anti-epileptic, although its secondary usage is a potentially curative medication for bipolar and BPD.
For whatever bureaucratic reason, when lamotrigine is used to treat mental illness it’s not subsidised by the Pharmaceutical Benefits Scheme, meaning I pay for the full cost so I don’t descend into chaotic madness, defined by mood instability, drug abuse, and pathetic crying into my wine (which does make it taste better, I will admit).
Back to private healthcare: it’s not that I think it’s intrinsically bad, in that you only get the best if you can pay for it, which disadvantages working-class people, students, the LGBTQI community, and so on. What I think is that all healthcare should be at the standard that I received in private hospital, even if taxes have to go up at the price of a few jets here and there. Maybe less tax concessions to big business.
I’m not an economist, okay? Perhaps it’s an unwieldy suggestion that would never happen, but a boy can dream, although I may as well be like poor, dirty Fantine from Les Miz singing ‘I Dreamed a Dream’.
As of May 2016, it was estimated that the Turnbull Government was eliminating $140 million of mental healthcare services, some 70% of early psychosis intervention programs like headspace. According to the Liberal Party’s website, $26 million will go to Primary Health Networks, a sly attempt at privatisation and removing agency from organisations like headspace in the name of business efficiency, not for the concerns of the mentally ill.
For any efficacious progress to be made in addressing mental health issues in Australia, the gap between who can afford proper healthcare and who can’t needs to be closed.
On a tangent, Turnbull’s divisive show trial, aka the equal marriage rights plebiscite, will no doubt trigger a homophobic mud-slinging match that will affect the mental health of the LGBTQI community, a community already inundated with higher risks of mental illness, of drug abuse, of eating disorders, of homelessness, and of suicide.
Of course, none of this matters to Mr Multi-Millionaire and his cabal of right-wing, hate-filled political wannabes pontificating from the backbenches. Not only is Turnbull lighting a hate-filled fire, but he’s let George fucking Christensen, a turgid ball of myopia, steal the fire extinguishers. So much for Malcolm Turnbull’s renaissance of moderate governance.
Anyway, I digress. These are my borderline proposals for better mental health care in Australia: increase the numbers of therapy sessions subsidised by Medicare; divert all federal funding from chaplaincy programs in schools to improved mental health education in schools; re-evaluate the efficacy of programs like headspace (despite its advantages) and introduce a better model of care to mentally ill teens and young adults; fund mental health care institutions and services directly, instead of relegating funding decisions to Primary Health Networks; establish incentives for nurses to specialise in mental health; and reject any privatisation of healthcare services.
In writing this I feel like I have exhumed my own corpse and read my own eulogy, but I’ve paid the funeral costs and I’m still here.
Oh, well – fuck it before it fucks you.
There is no stigma strong enough to stop me from telling it how it is. This is the reality of one in four young Australians. It may cost a lot for Malcolm Turnbull to listen to us, but I bet you we’ve paid more.
If you are struggling with mental health issues, please reach out to Lifeline by calling 13 11 14.