There is nothing more we can do for you’ says Christy Kenneally, Irish author, speaker, poet, TV presenter and scriptwriter. Of course he quickly follows that up – because we know these words are simply not true. They’re words that should never be said in health and social care, and yet they’re said all the time.
When people use them, it’s usually because they lack knowledge, lack skills or perhaps most sadly, don’t have enough time to give. Yet there’s always something we can do to help someone. When someone is told this, the system has failed them.
Right now in Scotland the system is failing people who are dying with mental health problems. Our research shows that four in five people who die, need some sort of palliative care. Estimates also show that more than one in three people are affected by a mental health problem in Scotland each year. These aren’t mutually exclusive categories.
For many people living with a terminal illness, mental health issues can often go untreated and unsupported. The impact of being told you or a loved one will die soon can have far-reaching effects on your mental health. If it’s you that’s diagnosed, you might suffer from depression, anxiety and increasing isolation. If it’s someone you love, and they die, without the right support your life can be affected for years to come – and what about the others around you who have also lived that loss? Your children? Your grandchildren? And I haven’t even touched on the types of support that are or aren’t available for people who have an existing mental health problem and are diagnosed with a terminal illness.
The one thing that is common though is that the effects aren’t always quantifiable, they’re often unreported – in short we simply don’t know enough about what happens when people are dying with mental health needs. This isn’t good enough, this needs to be something we’re focusing on now. We need to make sure, as a society that we’re not failing these people.
The good news is that the Scottish Government is in the process of producing their next mental health strategy for Scotland. The bad news is that the draft strategy, one that will inform mental health priorities in Scotland for the next 10 years, is forgetting these people, failing these people. The strategy has three streams – Start Well, Live Well, Age Well – but there’s no mention of Dying Well. Nobody is talking about dying with mental health issues, and many mental health organisations are focused, quite rightly, on preventative and resilience work around mental health.
Dying with a mental health issue is often overlooked, and that needs to change. This week Marie Curie held an event to look closer at how care is delivered for people with mental health issues arising from their terminal illness, and those with severe mental health conditions approaching the end of life. Christy joined us from Cork in the Republic of Ireland where he is well known for his work on mental health, bereavement and dealing with loss. He gave a very real and candid insight into the ways people die, the ways people cope with reality and he challenged the concept of normal. Nobody goes back to ‘normal’, whatever that ever was.
A dedicated room of professionals then talked about the ways that we can educate people, the ways we can harness communities to support people, the ways we can make a difference to people’s lives. We all agreed that a good starting place is getting these issues on the agenda with the logical first step being to include Dying Well in the Scottish Government’s strategy. That’s when the work can really start to get this recognised as a priority and we all can make sure no-one else fails to get the care they need.