Who’s on your team?

It is so important for you to know your mental health inside and out. Sometimes our illness seems so out of our control and our episodes seem random. When reflecting back on my mental health journey, I see signs of my illness, what I now think of as red flags, months before I have an episode. Through attention and recording, you can start to learn more about your illness.

Health charting can reveal a lot. Can you see patterns in your illness? Can you find triggers to an episode? Can you see things that improve your mood, or lower your anxiety? When you are well, what is happening in your life? If you start to identify these things, then you can start to move towards recovery. You can also communicate these insights to your health team, and it makes their job supporting you easier. If you are having trouble with health charting for any reason, ask a supportive person in your life to help you.

The number one thing which I wish I had been more consistent with in the early years of my mental illness was recording symptoms as well as significant health markers like sleep, exercise, and food. I also wished I had been followed up consistently with a team (including a counsellor) and stayed on top of medication and side effects. But I was young and very ill. Now, I am learning how to create this resilient net of support and have more awareness of my health.

Turning what you learn about recovery into action is ultimately your job. Of course, having a lot of support helps with this. It is important to note that movement towards recovery can be very hard when you are in an episode. I’ve been there quite a few times. I have felt exhausted, paralyzed by fear and anxiety, and unmotivated. Always, we need compassion towards ourselves. In fact, self-compassion is probably the first step to getting well.

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I would say your personal supporters are the next key players in your recovery team. This includes close family and friends who have shown up for you. Mental illness is not easy on families and friends. It is especially difficult when there are multiple people who are ill in a family. Supporters of those with mental illness learn, often the hard way, how to support their loved one. They see, day in and out, the ups and downs of your mental illness. They are often the ones taking you to the hospital, helping you pick up your medications when you are ill, and often providing you a place to live. Sometimes these relationships are not easy. Family counselling or having the family member supported by a counsellor or family support worker can strengthen the relationship between the one with lived experience and the loved one(s).

Some people with lived experience of mental illness may not have positive supports and must rely solely on the mental health system. I imagine for these people life can be harder. Just remember that there are many caring people working in the mental health field, despite the limitations of our system. Finding a peer support worker might be a good way to have connection with someone who understands what it is like to have a mental illness and may help fill in the gaps of a family or close friend.

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People with a major mental illness, like Bipolar 1 or Schizophrenia, often benefit from taking medications. I am hopeful that with all the other necessary components of recovery and more knowledge of mental illness, that medications will become only part of the picture. The main reason I wish this is that with higher doses of these medications (as well as the combinations of many medications), there is more risk of potential for side effects. My greatest hope is that once a person is stable in their mental health for a good length of time that they can use many of the kinds of tools I talk about, receive support from their team, and be able to live with lower doses of medications. However, mental illness itself can threaten your life so if higher medications are needed to move out of crisis and maintain wellness then they are necessary (this belief is from my experience and may not resonate with those that manage their mental illness without medication).

Whether you take medications for your mental health or not, a psychiatrist or a psychiatric doctor is a valuable member of your team. They oversee medications, but they can also be a regular check in point for recovery and other medical issues. They can monitor blood work, ruling out other contributing factors to mental illness. Sometimes they can help you access other members of your mental health team, such as a case worker, an occupational therapist or even a counsellor.

Coming prepared to your appointments is so helpful. Make a list of what you need to tell the doctor and/or come prepared with questions. Come with notes about how your mental health has been (sleep, anxiety levels, other symptoms etc.). It can be helpful to ask whether you need any updated blood work or other health tests. Always know if you need a renewal for your medication. If you need one of your supporters to come, that’s great. They can also be helpful by asking important questions, taking notes, or providing emotional support.

The psychiatric doctor I have had for the last couple of years exemplifies a good example of a positive working relationship. She has been kind, patient, curious, supportive, and has allowed me to have my own say in my own health decisions. She has encouraged all the healthy things I do for recovery and has emphasized how important they are. She has given me hope that through my lifestyle changes, I can mitigate some of the side effects of my medication and that lowering medication is possible if done carefully.

Unfortunately, this has not always been the case with psychiatrists I have had. I have had psychiatrists who were cold and lacked the ability to create a space where I felt safe and understood. I have had a psychiatrist yell at me when I had a repeat episode when I was a young woman. I have had a psychiatrist not hear me that my kidneys were being negatively affected by my medications (when I was switched to another psychiatrist it was discovered that my kidneys were headed towards failure and I was able to switch medications). I know psychiatrists often have huge case loads but I still believe that they should treat clients with respect and be open to hearing what a person is telling them.

Many people feel that their psychiatrists do not listen to them and aren’t receptive to their ideas on recovery. This is a challenging because it is so hard to access a psychiatrist. Having a choice to change psychiatrists might not be an option. In this case, I would go to a community mental health agency and see if someone can help advocate for a second opinion. Also, perhaps seeing the psychiatrist as only a person who manages medications and getting other supports elsewhere might be a helpful strategy if the main issue is not medication-related.

Another issue is just being able to see a psychiatrist. Many people can only access a psychiatrist once or twice and they may have to wait months for this. They may be turned away at the emergency even if they are suicidal. The system is overburdened, and mental illness is growing. Also, a doctor is needed for a referral to the main mental health centre in my area. Many people do not have a family doctor and have trouble at walk in clinics, where they may not get the referrals that they need.

However, a mental health clinic in Victoria, the CARES clinic, now offers same day counselling for those in mental health and substance use crisis and they also are a place to go to get screened for mental illness and/or substance use issues. Although I haven’t used this service, I imagine it is a good starting place for people who need to access the system and get some support in crisis. Again, nonprofit community agencies may be another place to access support to get services.

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After a psychiatrist and/or doctor, how you create your mental health team and what you need becomes more individualized. It depends on where you are at in your recovery and also what you need for support.

After a mental health crisis, people might need a case worker to help with life activities, and things like securing housing. My own experience with case workers has been varied. Mostly, the negative experiences have had to do with the system trying to get me living independently when I was still very ill. Once out of hospital, for me going to stay with family has been a better way for me to stabalize and then transition into independence. This has been a gift that not everyone has and for some people living independent of their families is a better option.

There are mental health group homes, semi-independent living and other options for people needing more support. Having done my practicum in one of these sites, I see both the positives and challenges for people living in these places. I have seen people get positive support and opportunities to socialize and be connected to a health team. I have also seen workers judge and belittle persons with lived experience of mental illness. Stigma and burnout of staff contributes to these kinds of behaviours. Again, having an advocate from an agency or family member can be so crucial to finding the right housing.

Social workers, case workers, mental health workers, peer support workers (within the mental health system) and occupational therapists overlap in some of their functions and are accessed either through hospitalization or through a psychiatrist and mental health centre. Social workers often focus on finances, like helping someone get on disability. Mental health workers might help a person in the community. Occupational therapisst might provide recreation opportunities in the hospital or in an oupatient setting. Peer support workers typically go for coffee with you or a walk and provide emotional support.

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The next level of a mental health team can be found in the community. There are mental health agencies that provide system navigation, counselling, peer support, recovery groups, work preperation and much more. These services are often free in nonprofits. Not only do they support those living with a mental illness but also have services for their supporters.

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I have talked about the following holistic supporters in my other posts so I’ll just do a quick summary here. I have found other professionals not in the mental health system to be essential members of my mental health team. A good counsellor has been a lifesaver. A naturopath has helped with health-related issues. A physotherapist has helped me with stress-related ailments.

But these are costly and I have to plan my appointments around my resources. These services are often just not available for people with mental illness. Sometimes you can find these practitioners offering services at discounted rates. For example, you can access counselling for free or low cost.

You can also learn a lot about health through reading and the internet. Things like breathing techniques, meditation, and other relaxation techniques are easily taught via videos. However, there is also a lot of stuff on the internet that might not be helpful for mental health. Searching for information and support might be overwhelming. I think keeping it simple when accessing help from the internet is a good idea or having another person help sort through information with you.

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I moved each year from 1995 (when I had my first episode) to 2021 and during this time I wasn’t followed consistently by a team. I wasn’t on the right medication or went off it because of the weight gaining side effects. Had I had more support in place, maybe I would have worked with a team to come up with a medication dose that didn’t cause the significant negative metabolic side effects. I would have benefited from a counsellor as well. These years were rocky with one large episode each year from ages 18-20.

Let’s jump ahead in time to 2021 when I first lived on my own and went to collage and worked part-time. This was the first time I had a mental health team. I had a psychiatrist, an occupational therapist who worked like a case worker, and a counsellor. I was on medications which were monitored.  I felt supported in many aspects of my life by this team. I also had family and friends close by.

What I started learning from my first mental health team was how to monitor myself for signs of anxiety and insomnia and to turn to the people who were supporting me so they could help. Regular check-ins with a supportive team can make the world of different.

My greatest hope is that, as a person with lived experience of mental illness, you have people who help you in your recovery. The more people who you trust and who can support you with your mental illness the better. If you are struggling to find people, reach out to your communities mental health resources. If your town is small, see if you can access resources in a nearby city. Ask a family or friends if they can help you research and access services. I know how hard it is to get stable when your are in an episode and in initial recovery. As I have mentioned before in this blog series. small steps of wellness are helpful during this time. Also, for those with lived experience and their supporters, keep hope in your heart in these difficult times.

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Okay, are you ready to dive into making some art? 🎨 

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Therapeutic Arts Activity 

It is important to consider qualities of the people on your mental health team. This activity has you picking words and/or phrases that best describe what characteristics of your health team that you value the most. You can even reflect on how you want to show up for your own mental health.

Here are some ideas of qualities…

• Listens well
• Compassionate
• Wise
• Good with boundaries
• Proactive
• Considers all opinions
• Promotes hope
• Is knowledgeable about recovery
• Incorporates a holistic perspective in recovery

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Instructions 

Brainstorm words and phrases that reflect qualities you’d like to see in your mental health team. If you feel inspired, you can make art with these words, including images. Remember therapeutic art is not about making beautiful art. It is about the process and then how the piece might “speak” to you. As you’ll see my piece below, it is simple and was completed quickly.

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Materials Needed: 

• Pen and paper
• Any art materials (optional) 

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Once you’ve completed this activity, here are some questions as guidelines for your personal explorations:  

1. What was the first word or phrase you picked? Do you think it is your most important quality of someone on your mental health team?

2. Can you see some of the qualities you named in your current mental health supporters?

3. Is there someone missing from your mental health team? Do you feel like you have enough support? Can you brainstorm ways to find other people who might provide you the support you need?

4. How did you feel about the post and activity? If difficult emotions surfaced, how could you offer yourself some self-care?

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I made this quick and simple therapeutic art piece on the vision of my mental health team. As you know, hope is important to me, as well as wellness. I also want my mental health team to feel like a safe group of people working to help support me in my mental health🥰 And I wish the same for all of you.

❤️❤️❤️  With care and kindness, Meegan 

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