Mental illness - dealing with anxiety.
One in four of us will have to deal with a mental health problem at some point in our lives. In the past many patients would have ended up in an asylum. Today hospital is seen as the last resort.
Severalls lunatic asylum in Colchester closed 11 years ago - it used to have over 2,000 patients.
Barry Lavelle once nursed at Severalls and has seen the mental health system change over the decades.
Today he works for the the North Essex Mental Health Crisis Team where treatment emphasises home-based care.
He recalls the early days of mental health provision:
"The Victorians wanted to sweep the streets clean of the good, the bad, the mad and the sad...
"So they were placed in asylums for the so called protection of society - and because society didn't want to see these people around them."
Now he is part of the Mental Health Crisis Team which deals with people on the edge.
Wherever possible the team offers treatment at home.
All emergency calls comes through to an operations centre where the crisis team will assess the risk, whatever time of day or night.
As well as phone calls the team also deals with 650 visits every month.
Hospital treatment - a last resort.
With an ever increasing workload the decision about which treatment to offer is always based on risk to the patient and to others.
The team can use its powers to section patients under the Mental Health Act where admission to hospital is the only option
But it is the last resort.
Barry Lavelle says, "Sometimes when people get admitted to hospital, they see it as a very negative and their self respect is damaged.
"Where possible at home they respond better they maintain their independence which is really important."
Someone who has experienced being forced into hospital is Steve Austin.
He was diagnosed with paranoid schizophrenia as a teenager and has been sectioned in the past.
Although reliant on medication he is trying to manage his illness at home.
Steve explains how it felt, "I woke up one day and dropped ill, waking up alive but badly damaged inside and mentally.
"I have felt weak ever since that time."
Steve is now trying to manage his illness with the help of the Crisis Team.
He is living at home with his mum but he always has access to the crisis team's hotline and continues with his medication.
Steve has never been considered a danger to anyone else but his illness causes severe mood swings and he hears voices which torment him.
"I still think they are manipulating me with voices and that," says Steve.
Hopes for the future
The downside of home treatment is that the burden of care often rests with family and friends.
His mum, Jean Austin, believes Steve will get better but she is also finding it hard and doesn't like to leave him on his own.
"Sometimes it is a bit difficult because I feel a bit trapped if I go out. I rush back. Sometimes he doesn't really want to be on his own," says Jean.
"When he gets good days, it is nice."
"Sometimes it really gets to you and you think... when is it going to end?"
Steve is optimistic about the future, and the crisis team is hoping he won't need any more home visits… at least for now.
"I would like to have a family and that sort of thing. I would like to have all sorts of things and do all sorts of things."
For Steve art and painting is a vehicle through which he can express his feelings.
"It is one of the main things in my life," he says smiling.
Funding for mental health has increased but the Royal College of Psychiatrists believes that services are badly overstretched
Barry Wreford has over 40 years of working in mental health. He says he's having to deal with the increased demand as more people need support:
Depression - helping in a crisis.
"One in four people will suffer from a mental health illness in their life and who knows it may be a lot more than that.
"So far the service has been reactive one and there increasing demands on the service."
Looking after patients at home can be difficult but this is the future for mental health care, with hospital being the last resort.
But patients can have bad periods when they require more intensive professional support.
Facing the future
Just after Inside Out met Steve Austin, he went back into hospital voluntarily.
He felt overwhelmed by his condition.
But Steve is due out any day and his mother Jean is waiting for his return.
She tries to be positive about the future:
"Some people feel a bit threatened when he is angry - and get a bit worried but I think on the whole people understand.
"A lot of people know that Stephen is a nice person and he is not The Hulk."
Dealing with depression
Jean Austin told Inside Out how she feels about mental health care and dealing with depression:
"I get very tired sometimes - we muddle through somehow. You get support from the hospital - they’re very good but they could do with a bit more support actually from the government funding... for facilities in the hospital, more things for people to do and occupy their minds so they feel that they are worthy of themselves…
"When someone’s got depression, there could be a lot more help given from the government to the mental health… the mental health (services) are very, very pressured…
"You really need to be in therapy three times a week so then you can be weaned off the tablets gradually and become the person you should be.
"Patients get more confidence through therapy and they're able to get on with life and fulfil things they need to do instead of being stuck in yourself which you are through fear... Behind depression is fear that makes people stuck and feel stagnated.
"But there is a way out of this. You must always remember that you can do it - you can always get out of depression - it’s not a prison forever…
"In fact depression can sometimes be a learning point in our life - it gives us the tools to move on... to move on to do things, to create beautiful things, to use our creativeness that we’ve been given.
"And with this comes hope and more confidence so you don’t have to be stuck in depression forever.
"There’s a way out - believe you me, there is..."
last updated: 23/10/2008 at 13:16