A better mental health system

Anxious Activists! Graham here.

I had a chat with a Very Important Person last week.

I sat down with Penny Armytage, the Lead Commissioner of the Royal Commission into Mental Health in Victoria. 

Here in the Big Feels home state, the Royal Commission is our latest attempt to ‘do something’ about our mental health system. For those of us who’ve tried seeking help in this system (many times over many years) we can probably all agree, there’s plenty to be done.

So this conversation was a big deal - one of those rare opportunities to tip the scales just a little. 

But ten minutes before the zoom call started, I still wasn’t sure I was gonna even do it.

Healthy skepticism

When I first heard about this Royal Commission, I was skeptical. 

I’ve worked in mental health since 2006. I’ve seen a lot of attempts to make things better. Some have genuinely helped, but most of these grand schemes have created as many problems as they’ve solved.

If I’m honest, this time around I wasn’t just skeptical. I was pissed off. 

When the first details of the Commission came out way back in early 2019, rightly or wrongly my overwhelming thought was this.

‘Are they going to fuck this up?’

A glaring gap at the top

This wasn’t just burnout talking. In my opinion, this Commission had a major hurdle to get over from the outset, because of a glaring gap in the top level appointments. 

Amazingly, not one of the four Commissioners chosen to lead the enquiry had disclosed first-hand lived experience of mental health issues. That means, there’s no one at the top who is explicitly talking from the perspective of someone who’s actually used the system we are seeking to reform.

To put this in context, in the Disability Royal Commission established last year, at least two of the seven Commissioners have disclosed first-hand experience of disability. 

When my home country of New Zealand went through a similar(ish) process, it appointed Mary O’Hagan - in her words, our first “openly mad” Mental Health Commissioner. 

And here’s the thing. That was twenty years ago! Yet here we are in Australia, still playing catch up.

The importance of leaders who've lived it

Mary is one of my mentors. She went from being in and out of psych wards through her 20s, to advising the UN on mental health. (You can hear more about her pretty amazing story in this short mini-doco I helped make with filmmaker Nikki Castle.)

Most importantly, Mary’s work had a real impact. In New Zealand, she’s one of a handful of prominent sensitive cats who helped establish at least a few genuine alternatives to mainstream clinical services. Services that are led by people who actually ‘get it’ (because they’ve lived it).

This is why I was so angry when I first heard about the Victorian Royal Commission.

‘There’s not even a single one of us leading this thing?? Are they going to fuck this up?'

It’s never just anger

My Big Feels co-pilot Honor Eastly would eventually end up working behind the scenes at the Royal Commission. She’s one of the brave souls in there helping to add some (in my view) much-needed lived experience leadership.

And to be clear, what I’ve written in this post are purely my views on the whole thing, not hers. Honor and I don’t talk about the Royal Commission because a) now that she works there, it’s confidential and b) I really haven’t wanted to talk about it anyway. It's like I have PTSD for mental health reform.

Even early on, when she was first considering whether or not to get involved, I wasn’t much help. 

‘I don’t want to talk about this fucking commission,’ I’d tell her. ‘I’m still too pissed off about it.’

Helpful!

And underneath all that anger? 

The usual things. Fear (‘what if they really do get it all wrong?’). 

And the biggest one? Hurt. 

Fucking ow! They’re doing it again. Making it ‘about’ us. Doing it without us.

It certainly helps knowing Honor is in there, pouring everything she’s got into the work. Everything she’s learned from her own trips through the mental health system, from years of working in mental health, and from helping to run this little club of ours. But from the outside it looks like all the real power still sits with people who’ve never been through this stuff themselves.

The sad-angry spiral

So the night before my chat with Penny, the Lead Commissioner, I was lying on the couch feeling awful. 

I was in a kind of sad-angry spiral. The kind where you can’t sit still, but you also can’t think of a single thing you actually want to be doing right now.

At first I didn't even make the connection. I’d spent the morning preparing for my meeting with Penny the next day, but it only slowly dawned on me. 

Ohhhh... that’s why I feel like shit.  

All that anger and sadness, all those years of disappointment about trying to make change in this system, here it was bubbling up again.

So right up until the chat with Penny, I was still considering pulling out altogether. I'm really glad I didn't.

An important conversation

A while back, I gave official evidence to the Commission in the form of a written Witness Statement, outlining my vision for how we could make a better mental health system (you can click through to read that below). 

This one-on-one chat with the Lead Commissioner was a chance to explore those ideas further. And I found her very receptive.

She asked insightful questions. She asked to extend our time together well past the scheduled hour, and it did genuinely feel like she was able to hear a lot of what I was saying. 

Based on what she said at the end of our chat, I think it was an important conversation for her to have had.

So we’ll see what happens

I don’t expect the Commission’s recommendations to really provide ‘the answer’. But I am cautiously hopeful about seeing at least some movement on the changes I’d most like to see.

Nothing happens quickly in mental health, but how about this? 

We’ll know we’ve made real progress if, by the time there’s another big process like this, there’s no way the government can get away with not including lived experience leaders at the highest levels. 

We’ll know we’ve made real progress when the definition of an ‘expert in mental health’ very much includes those of us who’ve actually experienced this stuff first-hand.

If there’s one message I want this little club to send the world, it’s this... 

Us sensitive cats? Not only are we not alone in our big feels, together we are a magnificent, shining resource. Even at those times when we feel like we’ve learned absolutely nothing! 

(Especially at those times even!)

We learn a hell of a lot from going through this stuff. We even learn how to keep living when we have absolutely no answers, when we’ve taken one step forward and ten steps backward.

We learn all this because we have to. And in the right conditions, we can share that wisdom with other sensitive cats, and with the world. And I think that is fucking profound. 

So let’s make more spaces for that, yeah?

Read my prescription for the mental health system

To read my ideas for a better mental health system, check out my official witness statement. It’s publicly available at the link below. 

I quote a number of Big Feels Clubbers (anonymously) in the statement. So if you’ve ever sent in your thoughts about what Big Feels means to you, thank you, it very much helped shape this piece. 

A lot of what’s in here is also what I’ve intended to put in my book (if I ever finish it). So if you read my statement you’ll hear a bit more about my personal big feels ‘origin story’, how I went from being convinced I’d totally fried my brain and would never work again, to being a fancy consultant in mental health, to writing a newsletter about feelings.

You can also read Honor’s witness statement. It’s a heck of a read. And click here to see all the witness statements.

Why did I share the emotional roller coaster behind all this?

Why not just share the link to our witness statements? Because this is how it is to work in mental health when you have skin in the game. 

The emotional roller coaster. Hope and despair. Responsibility and guilt. 

I’m not complaining about this. I think it’s essentially the nub of any activism. You never know for sure where to put your precious energy. You never know for sure if you’re actually helping, or just burning yourself out.

But I do need to acknowledge the roller coaster. For myself. For any of you out there working in the system with your own big feels. And for anyone doing what you can to carve out a little space for sensitive cats outside that system. Whether it’s initiatives like the Big Feels Club, or simply being available when you can be for honest chats with close friends.

So whatever happens with this Royal Commission, we’ll keep doing what we can. The big ‘we’, that is. The ‘you and me and all of us, in this together’ we. 

Because we’re a resource for one another, in big ways and small. Even if they haven’t quite figured that out yet.

P.s. Do you work in mental health?

On this topic... If you work in mental health and have your own big feels, we made a thing for you! It’s called Big Feels at Work, an audio resource for mental health workers with big feels.

You can check out all fifteen episodes here.