Jesus would slowly and conscientiously smoke his way through a packet of twenty during our sessions. He would, quite literally, with shaking hands, light the next cigarette from the previous one and work his way through the whole pack like a child eating sweets.
I can relate Jesus’ story without breaching confidentiality as I was not a doctor when I met him, in fact I wasn’t even a medical student. At the time I was working as an English teacher in Madrid and he was one of my (very) mature students.
Jesus had been an architect and from what he told me it seems he had had some sort of breakdown. He attended the language school where I worked and paid for a one to one lesson with me, ostensibly to improve his English. However, in reality, I would just sit and listen to him tell me his story in heavily accented, but grammatically perfect English. He’d relate tales from his time living in London and some of the clients he’d worked for and the stresses he’d experienced in his work.
Looking back through medically trained eyes it’s clear he was suffering from a depressive illness and that my role at our weekly English classes was as his lay counsellor.
Fast forward 27 years and I meet several patients like Jesus every week; individuals who have simply become overwhelmed by the stresses of modern life, but do not have a ‘hard core’ mental illness as such.
With rushed 10 minute appointments I never have time to scrape away at anything but the most superficial layers of my patients’ problems and more often than not they get referred to counselling services or the mental health team, which in our area means weeks or months on a waiting list.
The crisis in mental health care is not news to anyone working in frontline general practice and I suspect it is very unlikely any large injection of cash from the government is going to be forthcoming to improve things any time soon.
So here’s a suggestion: how about we get some more lay ears on the ground? I’m not talking about expensive counsellors or psychiatric nurses, just sensible, patient lay people who’d be prepared to sit for an hour a week and listen to someone’s problems. Some may even be volunteers.
Because when all is said and done, if we strip away the antidepressants, CBT, psychotherapy and DSM classifications what most people, with the less severe (and commonest) mental health problems need is firstly someone to talk to who will listen.
This is one solution that would not be that expensive.
Dr David Turner is a GP in west London