Guest post by Christina Ivey
The writer of this guest post was paid for her contribution thanks to sponsorship from period and leak-free underwear brand Modibodi, and donations from Hysterical Women readers. Thank you to all of them for their generosity in supporting this #BlackWomensHealthMatters series.
My experiences with the NHS were largely positive for the first two years I lived in the UK. As a Jamaican international student, I paid a £450 immigration health surcharge to use it but, even so, it was a fairly good deal to me. Medication that would have cost me upwards of £250 a month back home was just £9. I had blood tests every three months instead of once every two years. But everything went to hell shortly after I was diagnosed with bipolar disorder by my Jamaican psychiatrist, who I’d been seeing for five years.
I was already well aware of the challenges within NHS mental healthcare before my bipolar diagnosis: the long wait times, overburdened staff, and racial bias affecting care outcomes. I still went ahead and got a referral from my GP. I thought that, since bipolar disorder is more common amongst Black women than any other UK demographic, I would have reasonable care for my illness. I waited three months for an appointment – a relatively short time, because someone had cancelled and I was offered their place. I felt lucky, almost.
When I explained my situation to my new psychiatrist – that I’d been diagnosed by my psychiatrist at home – she delegated the responsibility of medicating me back to him. I had a ticket booked to go back home in a little over two weeks from that appointment, and she explained that it would have taken up to six months for them to come to a decision themselves about which medication to prescribe me. Plus, she said, he probably had a greater knowledge of my needs and challenges, given the length of our association.
I went back home and was prescribed sodium valproate, which causes birth defects. This wasn’t a dealbreaker for me since I’m not planning on having children for the next decade. In any case, it worked, with the mild side effect of making me sleepy for the first few weeks. It put an end to my racing thoughts, my hotheadedness and my impulsivity. I honestly thought I had life sorted during those first few weeks. I didn’t even mind that I had to stop drinking.
Everything ground to a halt when I tried to get a refill back in the UK. At first, my GP sent my script off to the pharmacy, with the caveat that I’d need to go on a reliable form birth control. My psychiatrist back home had said the same thing, but I’d run out of time to get any back home. In any case, it wasn’t high on my priority list to go back on birth control; I was single and the hormonal types make me suicidal. When I went to pick up my valproate prescription, I was flatly denied.
The pharmacist told me that I absolutely had to be on birth control first before she could dispense my medication. I freaked out for a few hours before scheduling an appointment to get a contraceptive injection. I would have preferred the coil, but this wasn’t available at my GP surgery. Almost immediately after the injection, I went back to collect my prescription. I was denied again. This time they told me that there was essentially no chance of me getting a refill for sodium valproate. They explained to me that, as a woman of childbearing age, I’d first have to prove that all the other bipolar medication did not work on me, and use reliable birth control, in order to take valproate again. At that point, I felt my world fall apart.
In the time between the first denial and the second, I’d run out of pills. Worse, I’d gone back on hormonal birth control, which sent my mood in a downward spiral. I was in the midst of my final year of university and barely managing to keep up with my classes enough to avoid being deported. I felt betrayed, and this feeling only deepened following further conversations with my NHS psychiatrist.
I can’t remember how many times my NHS psychiatrist called me, but the gist of our conversations informed me that she had no clue about how badly she was screwing up my life. She had been the one to issue the order to my pharmacy not to dispense my medication. When I told her about the awful effects of being taken off valproate cold turkey, she told me she had no idea that I’d run out of medication. When I told her that, no, I didn’t want to try new psychiatric medication in the midst of my university term, she suggested I interrupt my studies even though this would have put my scholarship in jeopardy.
She challenged the wisdom of my Jamaican psychiatrist for having prescribed me this medication, despite having only known me herself for a little over two months. She even questioned the validity of my diagnosis, since I wasn’t diagnosed here. When it came down to it, she said she just couldn’t ‘trust’ me not to get pregnant.
I cried through all of those phone calls, and she did nothing to relieve me of my fear of being sectioned. The only people helping me sort through this mess were my psychiatrist and family back home. Within the NHS, everyone simply shrugged their shoulders and told me there was nothing they could do. The last recommendation was that I pay for private psychiatry, which was a slap in a face since I’m already paying to use the NHS. I eventually lucked out. I had a family member arriving from Jamaica, and she carried six months worth of sodium valproate back for me.
The entire ordeal left me with no desire to continue with NHS mental health services. I would rather eat a pair of denim jeans than receive more questionable care from people who harmed me through their ignorance. Throughout all of this, they tried to convince me of the superiority of their advice whilst actively worsening my mental health problems. My psychiatrist’s Jamaicanness was enough for them to dismiss his professional opinion entirely, despite the fact I was only in this situation because they’d delegated to him.
The root of it was that they didn’t trust the opinion of my psychiatrist at home, didn’t trust me with my own body, and valued an imaginary foetus over my mental stability. At every step I was dismissed, cast aside, or actively harmed by the system.
Throughout October, Hysterical Women readers can get 15% off Modibodi’s collection using the discount code HystericalWomen. This excludes sale items and bundles.
Modibodi’s sponsorship of #BlackWomensHealthMatters has paid the contributor fees of three of our five guest bloggers this month, while donations from Hysterical Women readers helped to fund an additional two paid guest posts.