Survivor's Guilt

The Guardian's on a mental health kick again.

A couple of weeks ago, it put out a request for people's experiences with Child and Adolescent Mental Health Services (CAMHS). In the UK, it's a specialist service which helps under-18s with difficulty with emotional or behavioural wellbeing.

I filled in their form for a laugh; I'd had a pretty bad experiences with my local CAMHS branch. I certainly wasn't expecting an interview request to come my way. (Fingers crossed!)

I've written about mental health many times before. This is because having a chronic condition is something which affects me every day. What I've never really done is written about mental health for anyone other than myself, and certainly not for old media. I've only done a couple of old media things before, but I'm worried that if I keep doing them I'm going to be seen as part of the media establishment rather than someone who just really likes hearing the sound of her own voice. (Incidentally, being visibly Jewish and being thought of as part of old media would screw me over! Yay!)

The upshot of writing about mental health so much is that I've crystallised a narrative in my head. For storytelling purposes, this is excellent. But I also find myself questioning it.

My local CAMHS branch handled things horribly. That is not a fact; that is my opinion, but an opinion backed by evidence. They said that there was nothing they could do for me; that is a fact. I was at a very low point, if not my lowest point; that is my own evaluation of my situation at the time.

That makes for a sad and scathing story to put in a newspaper; that's my opinion. It wasn't fun to live through; that's my evaluation. So far, so bad for me, so good for creating a narrative to tug at readers' heart-strings. (Journalists: I am very cynical about the business of curating information and presenting it in a certain way. Sorry.)

There's only one problem with this sad and scathing narrative - all this took place when I was sixteen. I am now twenty and in a far better place. In those years, something must have happened to change my situation. And because I'm obsessed with seeking after truth, I'm uncomfortable about concealing that something.

The something is that I'm a rich kid; my parents are well-to-do. In particular, my mother is friends with a psychologist. Somehow, they managed to pull strings and get me in with an excellent psychodynamic psychotherapist. It still took me two years to put together some measure of sanity, and I now have a very idiosyncratic way of looking at the world - one focused on analysis and confronting problems rather than outward shows of sympathy. Plus working with her gave me an awesome death glare. If I hadn't had recourse to that something - if I hadn't exploited my privilege to the hilt - I don't know where I'd be, but I might have actually been dead at this point.

It must be difficult for you to read this, especially if you care about privilege and unequal access in our society. It must be difficult for you to read a bald acknowledgement, with no explicit condemnation, of how I received excellent care because Mummy and Daddy had money. So I will tell you how I felt about this.

My overwhelming emotion was not guilt; it was and is anger. I am angry that people who desperately need help are not able to get it because of the multiple failings in the way the NHS deals with trauma and mental health problems. I am angry that getting good care reasonably quickly depends on your finances, not your need. I am angry that the onus is on mentally ill people to navigate a horrendous system at precisely the time they are least able to deal with ableism and red tape.

Fine, you might say, but if you're so angry, why did you undergo private treatment in the first place?

My answer is not going to make you happy.

Let me just say that I don't believe I had any special right to private treatment. I don't deserve it more or less than anyone else. If I had the money, I would have paid for multiple people to have private mental health care. I would have liked for the specific treatment I had to not be so ridiculously inaccessible, especially in a crisis (long-term talking treatments like the one I had can be helpful but are very difficult to get on the NHS; I'd wager that many people don't even know they exist). I underwent private treatment knowing full well that it was an egregious exercise of my privilege and that I deserved none of it.

I did it because I believed that the consequences of not undergoing treatment would have been worse. At that point, I was so anxious and suicidally depressed I was finding it difficult to function. I began self-harming, a habit I still haven't kicked completely. (Kids, never start self-harming. You have to resort to ever more destructive behaviour to get the same endorphin rush and you may eventually become psychologically reliant on it. If you must self-harm, be very careful with dosage and sterilising wounds.)

If I hadn't sought help privately, it wouldn't have made anyone else's life better. Nobody would have been better able to access care on the NHS because of me. Nobody more deserving would have had their care funded. The NHS red tape would not have magically dissolved because of my refusal. Nobody's life would have been materially, tangibly improved because I decided to sit on my privilege instead of exploiting it. Nobody's life was made worse by me taking things I did not deserve. I'm not egotistical enough to suggest that I actually made anyone's life better by exploiting my privilege, but there's certainly a case to be made for it.

Of course I've felt guilty that I accessed high-quality care simply because I had money, but my guilt doesn't make anyone else's life better. Signposting people, trying to help them through tough times (though I suck at that) and doing my best to campaign against cuts makes people's lives better.