Am I eligible for free mental health care? How would I know?

Alice O'Keeffe's "Squeezed Middle" column.

‘‘So how long have you been having these irrational thoughts?” I pause to think this through. It’s important to give the correct answer. I have to strike just the right balance with the kind lady from the Mental Health Access Team who has phoned to assess me. If she thinks I’m not mentally unstable enough, she will not refer me for free counselling. If she thinks I’m too mentally unstable, she might call in the social and tell them to take my kids away. Would she actually do that? On balance, probably not. Nevertheless, I must tread carefully.
 
I immediately decide against the honest answer, which is that I don’t think my depression is “irrational” at all. It is based on hard facts, many of them scientifically provable. First, our flat is too small for a family of four. Second, there is now officially no chance of us ever being able to move out. Third, our joint incomings do not match our outgoings and we have no savings or pensions. Fourth, the government has no interest in making things better for families like us – or, indeed, anyone other than their Old Etonian buddies. Fifth, the destruction of the environment continues unchecked, with consequences that are likely to prove utterly disastrous for humanity within my children’s lifetime.
 
I’d argue, on balance, that this is reason enough to feel legitimately less than 100 per cent zip-a-dee-doo-dah. On the other hand, whatever your circumstances, your glass could always be half full. No doubt it is partly the way I am perceiving the difficulties which makes them feel insurmountable. If I were more of a can-do type of personality, I’d be out there doing a jolly tap-dance on the grave of Europe’s bee populations.
 
“It started a couple of months ago. The baby stopped sleeping. We were buying a house and then it fell through . . .” I give her the sorry list of symptoms: the exhaustion, the creeping insomnia, the almost constant snivelling. She sounds pleasingly concerned. This is going well.
 
“Any suicidal feelings?”
 
Gosh. Funnily enough I did catch myself lying in bed the other day, thinking how nice it would be never to have to get up ever again, never to have to deal with another unexpected bill or another broken night . . . but it was more an idle thought than an active planning-to-kill-myself thing. Does that count as suicidal? I’m not sure.
 
“No,” I say firmly. “Not at all.”
 
“Good,” she says briskly. “So what I’m going to do is recommend that you come in for a full assessment session with one of our mental health nurses. You should receive a letter in the post.”
 
“Great. Thank you.” Result! I can’t wait for them to make me better again. “And how long will it take to get the appointment?”
 
“It shouldn’t be more than six weeks.”
 
SIX WEEKS!!! I can’t wait six weeks. Curly is on the brink of disowning me. I’m on the brink of disowning myself. I take a deep breath. “Right. Well, thank you very much for your help.” As I hang up, the tears have already formed a puddle on the keypad.
Alice O'Keeffe's "Squeezed Middle" column appears weekly in the New Statesman.

Alice O'Keeffe is an award-winning journalist and former arts editor of the New Statesman. She now works as a freelance writer and looks after two young children. You can find her on Twitter as @AliceOKeeffe.

This article first appeared in the 19 August 2013 issue of the New Statesman, Why aren’t young people working

Photo: Bulent Kilic/Getty Images
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We need to talk about the origins of the refugee crisis

Climate change, as much as Isis, is driving Europe's migrant crisis, says Barry Gardiner. 

Leaders get things wrong. Of course they do. They have imperfect information. They face competing political pressures. Ultimately they are human. The mark of a bad leader is not to make the wrong decision. It is to make no decision at all.

David Cameron’s paralysis over the unfolding human tragedy of Syrian refugees should haunt him for the rest of his natural life. At a time when political and moral leadership was most called for he has maintained the most cowardly silence. 

All summer, as Italy, Greece, Hungary and Macedonia have been trying to cope with the largest migration of people this continent has seen in 70 years, Downing Street has kept putting out spokespeople to claim the government is working harder than any other country “to solve the causes of the crisis” and that this justifies the UK’s refusal to take more than the 216 refugees it has so far admitted directly from Syria. The truth is it hasn’t and it doesn’t.

Anyone who truly wants to solve the causes of the nightmare that is Syria today must look beyond the vicious and repressive regime of Assad or the opportunistic barbarism of ISIL. They need to understand why it was that hundreds of thousands of ruined farmers from Al-Hasakeh, Deir Ezzor and AL-Raqqa in the northeast of that country flocked to the cities in search of government assistance in the first place - only to find it did not exist.

Back in 2010 just after David Cameron became Prime Minister, the UN Food and Agriculture Organisation warned that, after the longest and most severe drought in Syria, since records began in 1900, 3 million Syrians were facing extreme poverty. In 2011 the International Institute for Strategic Studies published a report claiming that climate change “will increase the risks of resource shortages, mass migration and civil conflict”. These were some of the deep causes of the Syrian civil war just as they are the deep causes of the conflicts in Tunisia, South Sudan, Somalia, Libya and Egypt. So what about Cameron’s claim that his government has been working to solve them?

Two years after that Institute for Strategic Studies report pointed out that conflict as a result of  drought in countries like Ethiopia, Eritrea and Somalia had already claimed 600,000 lives,  the parliamentary Committee on Arms Export Controls found the UK Government had issued more than 3,000 export licenses for military and intelligence equipment worth a total of £12.3bn to countries which were on its own official list for human rights abuses; including to Libya, Tunisia, Somalia, Sudan, Egypt and Syria. That was the same year that UK aid to Africa was cut by 7.4% to just £3.4billion. Working to solve the root causes? Or working to fuel the ongoing conflict?

A year later in 2014 home office minister, James Brokenshire told the House of Commons that the government would no longer provide support to the Mare Nostrum operation that was estimated to have saved the lives of more than 150,000 refugees in the Mediterranean, because it was providing what the government called a “pull factor”. He said: “The government believes the most effective way to prevent refugees and migrants attempting this dangerous crossing, is to focus our attention on countries of origin and transit, as well as taking steps to fight the people smugglers who wilfully put lives at risk by packing migrants into unseaworthy boats.”

In fact the ending of the rescue operation did not reduce the number of refugees. It was not after all a “pull factor” but the push factor – what was happening in Syria - that proved most important. Earlier this summer, David Cameron indicated that he believed the UK should consider joining the United States in the bombing campaign against Isis in Syria, yet we know that for every refugee fleeing persecution under Assad, or the murderous thuggery of ISIS, there is another fleeing the bombing of their city by the United States in its attempt to degrade ISIS.  The bombing of one’s home is a powerful push factor.

The UK has not even fulfilled Brokenshire’s promise to fight the people smugglers. The Financial Action Task Force has reported that human trafficking generates proportionately fewer Suspicious Activity Reports (SARs) annually than other comparable crimes because the level of awareness is lower. Prosecuting the heads of the trafficking networks has not been a focus of government activity. Scarcely a dozen minor operatives pushing boats on the shores of Turkey have actually been arrested. But it is not the minnows that the UK government should be concentrating on. It is their bosses with a bank account in London where a series of remittances are coming in from money transfer businesses in Turkey or North Africa. Ministers should be putting real pressure on UK banks who should be registering SARs so the authorities can investigate and begin to prosecute the ultimate beneficiaries who are driving and orchestrating this human misery. They are not.

That image, which few of us will ever completely erase from our mind, will no doubt prompt David Cameron to make a renewed gesture. An extra million for refugee camps in Jordan, or perhaps a voluntary commitment to take a couple of thousand more refugees under a new European Quota scheme. But if the UK had been serious about tackling the causes of this crisis it had the opportunity in Addis Ababa in July this year at the Funding for Sustainable Development Conference. In fact it failed to bring forward new money for the very climate adaptation that could stem the flow of refugees. In Paris this December the world will try to reach agreement on combating the dangerous climate change that Syria and North Africa are already experiencing. Without agreement there, we in the rich world will have to get used to our trains being disrupted, our borders controls being breached and many more bodies being washed up on our beaches.