Natasha Swingler

Natasha (Tash) is 21 years old and has experienced mental health issues for over half of her life. She began self‑harming at the age of 10, and at 17 years old was taken to hospital because she was suicidal. Following a period on a waiting list to access services, Tash worked with a clinician at a youth mental health service before being referred to a psychiatrist.

Despite taking medication, Tash deteriorated further and was admitted to a private inpatient unit for two months. Upon finishing school, Tash was referred to a tertiary youth mental health service where she was diagnosed with borderline personality disorder, depression and anxiety with psychotic features, and was experiencing substance abuse. Tash was admitted multiple times to various public and private units and had a number of interactions with emergency services.

Tash received good results from school and has gone on to study at university. Tash said that ‘being ‘high functioning’ can be a curse as to many people I speak rationally and can perform tasks, which leads them to conclude my distress isn’t that great’. This means she does not always receive the care she feels that she needs. Tash would like to see distress recognised in the same way as function.

I have experienced and witnessed that mental health services and clinicians often assess your wellness based on your ability to ‘function’. If you function, then you can’t be unwell, when in many cases being busy is a trauma‑response.

Tash has since experienced a re‑emergence of symptoms while at university and has transitioned into adult mental health services due to time limits on access to some youth mental health services. Tash said, ‘the strict time limits … are not helpful for young people, and risk breaking good relationships with services and placing young people inappropriately into adult services’.

The adult mental health services team was hesitant to support Tash, but agreed to treat her after speaking with the clinical psychologist. Tash did not have access to private supports at this time as no one in the private sector was willing to treat her due to risk and complexity. Tash feels pressure to be discharged by the adult clinic and said ‘at times their practice is not as good as youth services but I realise that all services work and deliver their care differently’.

Since then, Tash voluntarily went to a Prevention and Recovery Care (PARC) centre for support following heightened suicidal ideation and self‑harming. While her experience there was positive, she was ‘clearly the youngest by at least 20 years’. Tash describes the challenges of being a younger person in an adult service:

It’s disheartening when you are surrounded by adults who are critically unwell—you question whether that’s what your future will hold. Will I always be so unwell? Will I ever amount to anything?

Tash says her experiences have highlighted varied approaches to care and limited support for young people in the adult system. She would like to see better transitions between youth and adult services and a young adult mental health service that ‘specifically targets the needs of young people who are legally adults however have varying mental health needs’.

Tash also spoke about the additional challenges the COVID‑19 pandemic has brought for her wellbeing and ongoing care. During this time, she has experienced uncertainty in employment, complications regarding safety in the workplace and has felt there has been a ‘disinterest in protecting young people in certain industries’.

My hours at work were reduced, and I was forced to take annual leave (which I was lucky to have as a part time worker). Working in fast food puts me in close contact with hundreds of customers, and then I go home to my parents, who are of an age vulnerable to COVID‑19 and its complications. This is not a fear I can easily put aside. We have already had one confirmed case in my store, after which I was tested and isolated.

Tash said the heightened exposure to COVID‑19 and ‘waking up to new information regarding work closures and COVID‑19 related impacts day after day’ has affected her mental wellbeing.

I began to see panic attacks re‑emerge and increase to a point where they were a daily experience.

Currently, Tash’s usual supports and treatment are either reduced or accessed remotely.

At the moment, I am receiving care primarily via phone or telehealth. It is difficult to have safe appointments over the phone as I don’t feel comfortable speaking about my wellbeing or challenges I face whilst at home.

In addition, Tash was recently assigned a new clinician at her public mental health service. Tash said she has found this difficult when only being able to meet virtually.

Changing to a new clinician who I had never met in person and would not be able to meet in person for a significant time period exacerbated my paranoia, my fears regarding potential use of treatment orders, alongside concerns about how I would engage with this new person.

The restrictions on being able to see my clinician in person have meant that our relationship has not yet developed to a point where we talk openly and comfortably about some of my most challenging topics, including disordered eating, self‑harm and suicidal ideation.

Tash said that while she feels somewhat supported, ‘I often feel stuck, as though I cannot continue to recover in this environment, but I do not want to go backwards either.’ With reduced access to her psychiatrist and vocational worker, she has not been able to change medications, as planned before COVID‑19, or find employment she finds more consistent and meaningful.

While she has struggled with the impacts of COVID‑19, Tash is happy to see the additional attention paid to mental health and the additional Medicare sessions and hopes workplaces will continue many of the changes that have allowed people to work from home.