Warning: This article contains a discussion of suicide which some readers may find distressing.

In a scathing letter sent last week, nine former UK health secretaries – every one from the last 20 years – jointly decried the “enduring injustice” faced by mental health patients and accused the government of neglecting pledges to help.

The situation has become dire: children affected by eating disorders are denied treatment until they become severely thin or suicidal. The self-harm rate for young women has tripled over the last seven years. The number of young men committing suicide is rapidly increasing. The injustice has dehumanised those affected, leaving them to fight a system that seems insurmountable at times. In the UK, 75 per cent of those affected, do not receive treatment. Within the academic community, an estimated 53 per cent are affected by mental health issues.

I fall within that statistic: I’m a PhD student here at Cambridge and the last 15 years of depression have taken me through tough days. Attempted suicide by pill overdose, waking up in a hospital room with an easily fatal 0.38 blood alcohol content, becoming a university dropout, and experimenting with drugs. 

I’ve taken nearly every antidepressant on the market, with little success. I spent the past year in Cambridge on sertraline, one of the most commonly prescribed medications, and saw zero improvement. If anything, I became lethargic and regressed. I finally returned to the US over the summer, and went to visit my home town doctor as a last ditch effort. 

My doctor is like the supportive dad you wanted, but didn’t quite have. I sat on the examining table banging my head against the wall. I was in tears. Nothing was working. My doctor felt my desperation and he offered me a path we hadn’t tried. Bupropian was outside of the standard class of selective serotonin reuptake inhibitors.  

I was willing to try anything at this point. I wasn’t naive: I knew it would take three weeks for any impact to show. So I waited. They were long days. Slowly – but surely – my rhythmic clock returned. Instead of sleeping 15 hours a day and having no appetite, I was sleeping for seven hours and eating three meals. My motivation gradually increased, and I began working part-time. About eight weeks after I started, I was functioning fully and boarded a plane back to Cambridge.

“I felt marginalised in a way I have never felt before”

I settled in and went to my GP in Cambridge to get a bupropian refill. But I was denied. The doctor informed me it was a controlled substance. Knowing the consequences of stopping, I refused to leave without a prescription in hand. She grudgingly wrote me a 30-day prescription, but informed me that I would need a note from my doctor in the US stating the purpose and duration of my treatment. I got the note and returned a few weeks later. The new doctor seeing me informed me that it wasn’t a note that they needed, but that the practice, as a whole, made a decision not to prescribe it.

Why? After running in circles for five minutes, she finally simplified it: it’s too expensive. I asked her a couple of questions: if I had a heart condition, would I get medicine? Yes. If I had a neurological disorder, would I get medicine? Yes. A psychiatric condition? Not exactly. Per NHS rules, the treatment was too expensive for depression. I was losing hope quickly. As a last ditch effort, I asked if I could see a specialist. Without so much as a hesitation, she told me no: they don’t send cases of depression to the psychiatrist. 

“I’m not depressed,” I muttered. “I’m bipolar II.”

It’s a severely under-diagnosed condition, marked by repeat bouts of severe depression alternating with only slightly elevated highs. I was misdiagnosed for 11 years as being clinically depressed. She looked up and asked me if I had attempted suicide. I confirmed, grudgingly. She informed me that I now met the qualifications of meeting a mental health specialist. But she still couldn’t prescribe me bupropian because it was expensive. I finally asked the million dollar question: how much is too expensive? The answer: £20 for a one-month supply.

A mental health crisis is coming – the University must do more

I felt marginalised in a way I have never felt before. I thought back to the nights when I’d toyed with committing suicide; the months at a time that I didn’t want to get out of bed; the many years of on-and-off substance abuse; and the desperation that led me to drop out of university, settle into emotionally destructive relationships, and lose any semblance of joy. It wasn’t worth £20 to NHS. But there was a silver lining to growing up with a mom who didn’t believe depression existed: I learnt how to advocate for myself at an early age. I finally asked my doctor if I could pay for my own medication. The answer was yes.

However, one of the bright spots in Cambridge is the University Counselling Service. I’ve gained immeasurably from my sessions there: how to develop mechanisms to withstand depression, handle toxic family situations, build an accountability system, etc. Nevertheless, because they are funded (or indeed underfunded) by the colleges, they are only able to provide short-term care, typically one term or less. 

The transition to private counselling is expensive – between £45-60 per session. Reduced rates are available, but they are limited, require long waiting lists, and are provided by significantly less experienced counsellors. I’m fortunate, that I have the income and savings to support my medication and therapy costs. But for the many who cannot afford it, the NHS has damned them. 

Beyond this, we still live in a society where discussing these issues is a sign of weakness, and as result, we keep quiet. But given the statistics, it’s likely that one of the two people you’re sitting next to is also battling their own mental health challenges. And they should expect to be treated just as they would if their illness were physical