The Return of the Double Bind, or, It's Some Catch that Catch 22.

Some years ago now I wrote a blog entitled, "Domestic Disturbance", which examined the role of the family in mental illness. As I remember, I quoted from R.D. Laing's book, "The Politics of Experience", alluding to the so-called "double bind", a situation in which a person receives contradictory or conflicting messages, thus placing them in a position where no matter what their response, they will always in some way be wrong. Some would say that an example of a double bind can be found in Joseph Heller's World War II novel, "Catch 22", which examines the sometime sheer craziness of bureaucracy. Heller creates a situation where those who are deemed insane should be judged not fit to fly missions, but the very fact that they declare their insanity shows a rational concern for their own safety. This contradiction means that anyone judged insane is still sane enough to fly. This edict is referred to as Catch 22, and as the main character John Yossarian states, "It's some catch, that Catch 22."
I don't know what it is, but of late I seem to have been coming across my own little Catch 22s, or double binds, crazy little bureaucratic anomalies that, quite frankly, are mind-blowingly frustrating and, indeed, I would argue are impeding my progress in the world of the "normals".
For instance, in Stoke-on-Trent there is a primary care service known as "Healthy Minds". Healthy Minds deals with people experiencing mild to moderate mental health issues, usually relating to depression and anxiety, but which can encompass other diagnoses like PTSD.
After my dad passed away in January, I felt that my mood dipped somewhat, and as I knew that one could self-refer to Healthy Minds, I thought I'd ring them to see if I could get just a little support. I was not having a full-blown manic or psychotic episode, but was, to my own  mind, simply a bit deflated and prone to negative speculation. A mild or moderate problem, I thought, and so suited to the sort of care provided by Healthy Minds. However, little did I know, and when I rang up I was told in no uncertain terms that because I'd been in secondary care, I wouldn't be able to be treated by them. I explained that my problems were only to do with a mild feeling of depression, and that I'd been judged fit enough to be discharged from secondary services, but to no avail. Apparently, once you've been referred to secondary care, Healthy Minds becomes decidedly out of bounds. So, it seems I found myself in a situation where I was somehow not ill enough to be under secondary services, but too ill to be treated by a primary care service. It's some catch, that Catch 22.
As if this weren't enough, the voluntary work I do has been on the wane somewhat of late, and so I looked around to see if I could get any support in finding new activities. The Trust where I live does have a scheme, somewhat akin to a job club, called "Step On". However, I soon found out that access to Step On is by referral only, and you have to be under secondary care to be referred. Having been discharged, then, I am not, as far as I'm aware, able to access this service. It seems to me that the time one would need such support, though, is precisely when you've been discharged, as surely this is the time when one has been deemed fit enough to be able to do such things. But no, the Trust, in all it's wisdom, disagrees. It's some catch, that Catch 22.
I am told that there is a similar scheme run by the local mental health charity, Changes, in conjunction with the Job Centre, but after a little digging, I found that I can't get access to that either. Apparently, you have to be receiving ESA to get in. I do receive ESA. But, here's the catch, you have to be in the WRAG (work related activity group) of ESA, rather than the Support Group, which is what I'm in, to be eligible.
I would also just say that all this is going on when the DWP is veritably breathing down everyone's neck, WRAG Group, Support Group or otherwise, by reassessing them for their benefits, oftentimes with the initial conclusion that people are fit to do some kind of work. So which is it? Am I too ill to do anything? Am I too ill to even get treatment from a primary care service? Or am I, in fact, fit and ready to work?
To say that there are contradictory messages out there, then, may be something of an understatement. Sadly for me, all this leaves me with not a lot of anything, either way, other than perhaps a creeping feeling that I'm getting a little bit too used to my own company. In the end, all I can really say is, it's some catch, that Catch 22.    


bazza said…
Hi David. I was sorry to read this. It seems that you have fallen between two stools. A clear case for some umbrella organisation that would act as a safety net for someone in your circumstances. I would suppose that several of the services that you mentioned have some sort of autonomy. A local authority aught to be the go-to- place for this.
I am meeting a former IAPT colleague for lunch in a few days and will bring this up with him; even though it is a Primary Health Care service, we were constantly referring people to other places both within and without the NHS.
CLICK HERE for Bazza’s strange Blog ‘To Discover Ice’
David said…
Hi bazza,
Thanks for your comment and continued interest in my little blog.
I entirely agree that there should be some kind of umbrella organisation that I could turn to. I was under the care of secondary services for a total of around 18 years. To simply be discharged and left to cope after so long is daunting and very difficult.
I also have further bad news (if that's possible!). The local mental health charity which I have volunteered for recently may be due to close in December because of a withdrawal of funding from the Trust. If this does indeed happen, it will only increase my hours of unproductivity and sense of isolation - not conducive, methinks, to a healthy recovery from a serious, long-term mental illness.
Still, we live in hope, bazza, and just maybe there's change on the horizon.
Very Best Wishes,

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