The two words you dread to hear when you rely on mental health services: budget cuts.
It’s not as bad as all that: the specialist service that supports Julie at the moment will now give her two years of support, not three. I mull it over – trying to get used to the idea of a second transition so soon after the last one – before she even finishes school. I do feel dismayed: this team is so good, especially compared to what went before. This team specialise in treatment of psychosis: they understand it, they are not afraid of it, they are confident and encouraging. When Julie was treated by mainstream psychiatric services for young people, psychosis was not well understood: it was either ignored or suppressed with ever larger doses of antipsychotics. But this service teaches you to just get on with your life, take the psychosis in your stride, make the best of it, work out strategies to cope with the difficult bits, and take control of your own medication.
I am not quite sure when our two years are up (the transition into this service alone took nearly a year); I am afraid of what will come after; and I want to hide some of this fear from Julie. But then I start to wonder: how much of this is just good old fear of change? This service was never meant to be a permanent support: it was always meant to lead to independence. She is changing so rapidly, it is really possible that within a year she (and I) will have learnt all we needed to learn anyway. A year ago she was managing just an hour a day at school, could not be left on her own for twenty minutes, and I was terrified the school would give up on her again. Fast forward to this October, and she loves her sixth form, cycles there unaided, has fantastic support and is forming a new group of friends. Every day my daughter grows a little more before my very eyes.
I am bound to fear for Julie’s future. She suffers from a condition which is life-threatening, and also stigmatised; she takes several psychoactive drugs which have serious side-effects, some of which are also life-threatening; she has missed years of normal life. I know that she has to learn not just to navigate through adult life, but also to manage her illness, and I know there will be mistakes ahead. One day she will have to take control of her medication, and some day I am going to have to trust her to look after herself. The illness may eventually recede, but it may also have some nasty surprises in store for us. She may need extra support and care from us for years; she may make a partial recovery into a rather vulnerable adult; she may make a full recovery into independence. There is no way of knowing what she will have gone through by the time she reaches sixty.
But she is just at that stage of life – poised before the jump into adulthood – where there are always risks and fears, even for the strong, healthy and confident, who have never known more sorrow in life than their acne. No one does know what life is going to bring. Of course in an ideal world there would be a safety net of services to catch people like Julie if they fall – but if we cannot have that, then we will just have to make her as self-reliant as we can. Then trust to the kindness of the future.