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Does mental health affect access to physical health checks?

Sam_AlumniSam_Alumni Scope alumni Posts: 7,731 Disability Gamechanger
edited February 2019 in Guest blogs

Our theme for the next fortnight is around women's health and we are talking about barriers to accessing healthcare and today, our guest poster shares the issues around mental health and how it can become a challenge to receiving cervical screenings, reproductive healthcare, mammograms and other health assessments. We understand that this may be a difficult and sensitive issue for some of our members, so please be aware that this post contains talk about mental health challenges, rape and sexual abuse, so it be not be appropriate for some. 

Our guest would like to stay anonymous but we share their story here.  

“I am a survivor of child sexual abuse and rape through my life span and have complex PTSD and a dissociative disorder as a result. Although mental health may be a ‘hidden disability’ it's not in my case because of the severity of my dissociation disorder. I'm always be quite upfront about it in relation to any physical health and the cause to physical health services. Touch me or say the wrong thing and I can completely shut down, I think this upfrontness helps.” 

image of a hospital corridor with the words Does mental health affect access to healthcare? on it

Severe mental illness (SMI) affects close to an estimated 551,000 people in England. These individuals have a life expectancy of up to 20 years shorter than the general population. 

People living with mental illness are particularly vulnerable to experiencing inequalities including the lack of support to access health and preventative care.  

Our anonymous guest poster continues to say:

“From my experience, NHS services relating to physical health have been excellent. In relation to GP and smear tests, this has not only been in the physical examination but in terms of psyching myself up. My GP was upfront and saying that he wasn't going to remind me that a screening was due even though we could both see the flashing alert on his computer screen when I was seeing him when in mental health crisis. Whether it was right or wrong that he encouraged me to wait, I think for my long-term sanity and ensuring that I would continue to have a smear test through my adult hood was probably more important than the timing for that particular test.  

But this experience isn’t the one that everyone receives, especially people with severe mental illnesses. How do you get a smear test if you're sectioned under the Mental Health Act or even an informal patient? I know that's one of the health questions they now ask during the admission process on my unit but I've never heard of anyone having a smear test whilst I psychiatric inpatient.  

In those places, I feel that physical health doesn't matter. I have been left laying with a fractured patella before even the doctor has visited me on a psych ward. Left for hours without migraine tablets. Had patients screaming in agony with dental issues for days before getting emergency treatment. If that is the situation for acute physical health treatment in mental health services, then what priority do they give to a test for an early detection of cancer?  

There is an initiative called My Body Back, it is a service aimed at providing smear test for women who are survivors of sexual abuse and rape. I went to them, thinking that it would be less off a burden with my GP this time round, just because of the extra time and support that I might need.  Unfortunately, my experience of this service was not a positive one, I felt they weren’t set up to support people like me with complex or chronic mental health conditions and I have spoken to other people who felt the same.” 

All the female staff are trained to work with women who have experienced sexual violence. We’ll discuss your needs with you, and how to ensure you are comfortable throughout the smear test. For example, if there are certain body positions you don’t like, places you don’t want to be touched, or phrases you would prefer are not used during the test – then these will not be used. We can also discuss grounding techniques to make the test easier for you, breathing exercises, and optional aromatherapy services as some women have reported this helps them feel calmer during testing. You don’t have to be referred by a medical professional and it’s open to all women and trans men. 

cartoon image of two women embracing

Our guest poster tells us:

“It is difficult when you feel that even the targeted services don’t offer you the level of support you need and so I feel that it is often more down to individual health professionals who are willing to take the time, understanding and find creative solutions together.
  
Many healthcare professionals may not have the time and resources to build this sort of relationship with their patients but for people with mental health challenges, it can mean the difference between accessing vital healthcare and being excluded from the right to proper health and preventative care.” 

We understand this is a sensitive and potentially triggering story, but we feel it is an important one to cover. If you are struggling right now, you can contact the Samaritans for free on 116 123 and if you need more support around accessing healthcare, then do contact your local GP. If you feel able, talk to your nurse or GP to explain how you are feeling. It may be helpful to book an appointment with your GP beforehand to talk through what will happen at the test and ways they can make it easier. Ask as many questions as you need and make sure you are fully aware of what is going to happen during the test and after. Remember, you are in control during your smear test. You can ask your nurse to stop at any time during the test.  

What has been your experience of accessing healthcare when you are also dealing with mental health challenges? Have you ever felt that your mental health has created a barrier to you having the tests or support you needed? Have you had positive or negative experiences and how did you deal with this? 

 

 

 

 

Scope
Senior online community officer

Replies

  • Trudie28Trudie28 Member Posts: 3 Listener
    edited February 2019
    My life from 4 years been a living hell I was sexually abused from 4 years old my mum used to hit me with a belt if I did eny thing wrong locked in my bedroom with a potty I was 4 years old when I was 11i was raped by my mum boyfriend I told my mum she did not believe me my life has been one thing after another my mum still hit me with the belt locking me in the house until I was 16 I walked out free from her at last was homeless September 1983 went into a children home it was horrible when I was 19 i give birth to my daugtor [removed by moderator] not seen my mum for a few years but she was there My mum past away December 17 th her funeral was Christmas Eve taking all the info to her grave my dad she did not tell me eny thing about him been looking for him since I was 16 years old 35 year not found him yet he know about me his name is [removed by moderator] just want answers 
  • Sam_AlumniSam_Alumni Scope alumni Posts: 7,731 Disability Gamechanger
    Hi @Trudie28
    It  must have taken a lot to share such a traumatic experience, I am so sorry that you went through this. It is a lot to deal with and perhaps it would help you to talk through this with someone who is trained to support you? 
    The National Association for People Abused in Childhood (NAPAC) have a helpline on 0808 801 0331 and is free from all landlines and mobiles and open Monday to Thursday 10am to 9pm and Friday 10am to 6PM.
    As for looking for your father, Im not too sure but perhaps you could contact the local authority where you grew up and ask them for information?

    Scope
    Senior online community officer
  • Jean EveleighJean Eveleigh Member Posts: 117 Pioneering
    until 2008 I was diagnosed with mental health issues, whenever I complained about a physical symptom 9/10 it was presumed and assigned as a symptom of my mental health or as me being a hypochondriac - it took 17 years to prove my condition was physical and hey presto 6 months after getting the correct medication and management plan for my physical condition my mental health one was gone.

    In my experience and anecdotally in m y friendship circle when your primary diagnosis is mental health then you are automatically seen as a time waster, trouble maker, hypochondriac (or other negative) rather than being listened to and treated as a "normal" patient.
  • heymanchickheymanchick Member Posts: 1 Listener
    I totally agree with Jean. I am diagnosed autistic and PTSD. Ive had a lot of negativity with GPs as they just seem to see me as an attention seeker and awkward. Some doctors have been very rude and basically said "what do you want me to do about it" on a few occasions. Another has shouted me down for asking for wanting to see a psychiatrist. ItsI made me very reluctant to visit my GP at all
  • happy91happy91 Member Posts: 101 Pioneering
    Yes, my mental health has definitely restricted access to health care for me.

    One GP I saw about my mental health said "Are you keeping busy enough". Whether I was busy or not, if I have mental health challenges and I need help with those then it's your job to help.

    I was registered with one GP that was absolutely terrible. I felt anxious before going in a depressed when going out. I had ongoing problems with my skin and they left it and left it before referring me. The doctor I saw had no bedside manner and saw my visits often as an affront to her ego rather than me needing genuine care!

    Thankfully I am with a new GP now that is amazing. Remember it is your legal right to choose a GP.

    I did eventually access mental health services and had some amazing therapy. I am looking to reenter mental health services but my physical health has gotten worse so I am hoping to move to somewhere better before going back.


  • debbiedo49debbiedo49 Member Posts: 2,906 Disability Gamechanger
    My barriers to physical health care is my Avoidance issues with my own personal health care. It doesn't matter to me that I missed my last smear test or rescheduled my diabetic appointment.. In my head that's okay as I couldn't face it. When it goes into months and years passing then it's a problem. Which it has done. I find the system particularly at my health centre and practise restricts me and people like me from quick and easy access to services. For example, to see a doctor at my practise you have to phone at 8:30 am only to make an appointment going through the Receptionist who is now triage. "What is your health issue? You don't need to see the doctor you can see the physio, the nurse etc etc"  For someone like me who gets anxious about using the phone and talking to others about my health this is a big red flag. I just put off doing it even more. They also have introduced an online service. Unfortunately my details don't work. So that is another barrier. They did this to save money on wasted appointments and budget cuts. It started off as a trial then it just became the norm. There are no other health centres near me so I can't change it. 
    Anyway, recently I hurt my shoulder. A couple of weeks in, I phoned to see a doctor I was told you go to the physio.. I go to physio, they do their thing. They know nothing about my other health issues. I come away with exercises. 2 weeks later I'm back at the doctors getting my pain meds reviewed and the correct advice on taking them and feeling better. Also given correct advice regarding further pain relief contrary to physio. So that should have happenned at the start. In the 4 week interim my other health issues escalated unnecessarily.
    It's just wrong.
    They say you can be your own worst enemy which is true in my case and getting help with my health issues, the NHS comes second.
    💜🏴󠁧󠁢󠁳󠁣󠁴󠁿
    I am a fibro warrior !💜♏️
  • happy91happy91 Member Posts: 101 Pioneering
    With ongoing conditions there needs to be regular reviews and a care package. Not constant persistent seeing the doctors at the right time.
  • BenistmonkBenistmonk Member Posts: 343 Pioneering
    edited March 2019
    @happy91 Exactly, you shouldn't have to go cap in hand for help, the NHS is a pile of [edited by moderator] in that respect.
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