“I changed from being a senior psychiatric social worker one day to being a mental health user the next day on the opposite side of the table. A very strange kind of bizarre experience.”

Mike Bush is one of the many people in mental health who’ve had their own experience with suicidal thinking and actions, though few speak out as openly as he has. I came across him while researching mainstream mental health groups in the UK, intrigued by their focus on campaigns for rights and social justice. Mike played an early role in organizing support for loss survivors after losing his father to suicide four decades ago. Years later, he became suicidal himself. Clinical depression, he found, was far harder than bereavement _ and he feels he still hasn’t adjusted to his father’s death.

Here, Mike talks about finding Christianity during his recovery, his latest campaign to help other caregivers protect themselves from stress and the tight bonds between the poor economy and despair: “You slash people’s services, benefits, the economic situation is in peril, it has a very detrimental effect on well-being. This is what’s happening.”

Who are you? Please introduce yourself.

I’m, well, I suppose I wear a lot of hats. I’ve been actively suicidal myself, and I’ve been bereaved through suicide. I lost my father over 40 years ago now. I worked 30 years as a mental health social worker. So I’ve been involved in lots of campaigning on suicide issues, particularly bereavement, a very important part of suicide prevention. If you don’t support those left behind, you’ll get further suicides, you know? Certainly in Britain, which has one suicide every 90 minutes, every suicide has six to eight people who are deeply affected, but many more than that are also affected. So yeah, it’s been a central issue for me ever since my father died. I’ve been involved with a group for 15 years, and I’m involved in setting up another group with better information and networking between agencies.

How much did losing your father affect your own experience? And how much time has passed?

Research shows that if you’re bereaved, you’re more likely to have mental health problems and an increased risk of suicide yourself. Obviously any great trauma, like losing someone through suicide, takes its toll. I don’t think I ever reached adjustment. I lost my mother from cancer when I was 15. It was over 40 years ago when this happened, but my father’s death was three years later and that feels sort of like it happened five or six years ago. More recent in memory. I think you don’t ever reach an adjustment through losing someone through suicide. At best, you reach an accommodation. I’ve adjusted to my mother’s loss, but my father’s feels like it happened far more recently. All bereavement is really hard, but with suicide you’re bereaved by that person’s hand, so that makes it uniquely difficult for those left behind. A whole kaleidoscope of emotions and feelings swirling through your mind constantly and “What if?” questions that people torture themselves with. There’s a book, “A Special Scar,” that says bereavement is like a personal holocaust. It really seriously messes up people’s lives. That’s why I’m passionate about people getting support and help. The best way is peer support. They better understand what it’s like.

You’ve been pushing for more support for this over the past 30 years?

Yeah! A long time

What was support like back then?

Well, we set up a group in the early ’90s. At that time, there was no support at all in the area. We had people coming from all Yorkshire, from all the way around. There was just nothing else around. The situation’s improved in the more recent years. There are quite a few branches around for survivors of bereavement suicide. I’m in the process of setting up a branch. They have a national helpline people can ring. I have a national campaign going on 38 Degrees calling for a national suicide bereavement service. It’s done really well in Australia. I think we need the same over here. In Britain, it really depends on where you live. Some have quite decent support, others none at all.

Where did you get support?

When my father took his life, it was just what my sister and I could provide to each other. Really tough. And so when I worked as a mental health social worker in Leeds, in the early 1990s, one day I saw a letter on the bulletin board about the idea of setting up a group for those bereaved. The words jumped off the page at me. A great idea. I contacted the mental health chaplain, he had lost his father through suicide. We set up the Leeds organization of survivors of suicide. We used to meet twice a month for a couple of hours. And we would see people individually, because groups are not for everyone. We’d like people to come to the group if possible. We learned an awful lot about suicide issues. We’d get so many different stories.

What surprised you?

It was not at all uncommon for us to be dealing with families with more than one suicide. If somebody close to you takes their life, it’s like the Rubicon’s been crossed, like it gives you permission to follow the same. When my father died, I sort of wanted to do it, to be with him. I’ve worked with a family where there have been three suicides. So this is why it’s so important that you try to provide the best support to people. To prevent this happening. We can’t bring people back to life again, but we can enter into that suffering and share with it. One of the first things people tend to ask the support group is, “Have you been bereaved by suicide?” We can say that. I’ll always remember a man who came in, he had been seen by a clinical psychologist for two years, but he said, “I’ve found it more helpful tonight than those two years. This has been indescribably helpful to me.” One thing we also found is, the majority of people who came were mothers, girlfriends, wives. We’d rarely see men. That doesn’t entirely surprise me. In Britain, two-thirds of suicides are male. Issues around masculinity, be strong, you can’t show feelings. A lot of men aren’t good with the emotional stuff.

How did you get into your work as a mental health social worker?

I got into it quite honestly because my mother was a very caring, supportive person. She helped a lot of people locally, and she set me a really good example. And I kind of got involved in volunteer work in school. I realized when I was 13 or 14 that I wanted to be a social worker. So it was before I lost my mother and father. But part of going into mental health social work is what happened to my father, yeah.

How have you protected yourself, with all of the work you do?

I lost my father when I was 18. I kind of buried myself in my work. It was my way of coping. I didn’t want to be emotionally close to people. I didn’t want to get too close to anyone because of the impact of the loss. So I kind of threw myself into social work. And you can work 24-7 in social work if you want to. It was my way of coping, rightly or wrongly.

Did you feel like you had to save people?

I just wanted to be involved in helping people across the board. Obviously, my personal experience informed my understanding. So yeah, it contributed to it in that sense.

Did you tell people about your experience?

Not in my professional role, no. But certainly in the work I did with the loss group.

(I mention how it might be helpful for clients to know the person they’re confiding in has had their own experience, but professional boundaries prevent that.)

On occasion, I have told. There are times when it’s appropriate to disclose, and I have done it. But there are other occasions when it doesn’t feel appropriate to do that. So you have to use your judgment about that.

How did your own suicidal experience come about? Your e-mail mentioned overwork.

This was many years later. I had far too much on my plate. I was doing two social work jobs, covering for someone else who was out for months. I was working in a tough area with the community health team. Also, I was on three or four different management committees, plus I was working a lot with people bereaved by suicide, straight after work or sometimes during my lunch break. Also, I was suffering with a bad sleep disorder and was tired all the time. I was a union rep. I was struggling but basically coping. My boss was very good. But unfortunately for me, our boss left and the boss from hell came along, who literally would scream and shout, throw things about. I had three colleagues who were so distressed they were crying on my shoulders. I would take up grievance procedures with management.

Long story short, stress builds up and up. Anxiety, not sleeping for days, and everything was spinning out of control. I just couldn’t cope, go on any longer. I got on very well with the manager of the community psychiatric nursing, we talked things through, and we both realized I needed help, to get away from it. She drove me to see my general practicioner, my GP, and I went in to see her and she said to me, “You know a lot more about mental health than I do. What do you want to do?” I said I’d assessed myself as needing to see a consultant psychiatrist.

I changed from being a senior psychiatric social worker one day to being a mental health user the next day on the opposite side of the table. A very strange kind of bizarre experience. I was so used to being in the helping role. And now finding I was useless and needing help myself. Very difficult. I can’t put into words how much I learned, what real mental distress was actually about. No academic learning can give you that. That lived experience. It was an education in many ways.

Any examples of what you learned that you had thought you knew?

It made me understand how useless and vulnerable you can feel, frightened, terrified out of your mind. You have no energy at all. Just walking across the room was like climbing Everest. I couldn’t decide whether I wanted a cup of tea or coffee, whether to turn left or right. These simple things seemed too much. Depression consumes every atom of your being. That’s what makes it so difficult to deal with. It changes your whole way of thinking. You lose all hope. You lose all … yeah. You just lose everything. Even my sense of taste. Everything used to taste like cardboard. It affects you in every sphere of your life. I’d have given everything I owned for five minutes of respite.

How does it compare with the sadness of losing someone? Is sadness sadness, or are the two different?

Completely. Grief bereavement is very hard. But clinical depression is far harder. It affects you in a far deeper way. Yeah.

How did you get out of it?

I was very lucky. Two things: I have an exceptionally good wife and an exceptionally good psychiatrist, who was very good at listening and understanding what I went through. Very therapeutic in the whole interaction. He was also very supportive to my wife. He really was excellent. I can’t say I felt the medication helped me, very strong antidepressants, tranquillisers and mood stabilizers. I’m not sure how much that helped or not. A lot of drugs didn’t seem to work. The best medication was how he was with me. I think it was the passage of time, thinking things through, that played a part. Wife, friends.

Interestingly, I became a Christian. One day when I felt particularly suicidal, I felt myself turning to the local church. I’d always been a strong atheist, but a very good friend of mine had been a priest, a vicar, and he’s just a great guy, we were very close friends. He said one day, “Come in and join is, the water’s warm.” His smile would light up the room. That phrase was going round in my mind when I found myself walking to the local vicar’s house. Something was strongly saying to me, “Go see the vicar.” I did. He was in, very supportive. He talked to me about something called the Alpha Course, an introduction to Christianity. I basically became involved with that. Intellectually, I couldn’t take it, but I did pick up the love and concern that was around me. Particularly a woman who had suffered from depression, she gave me the hope that things would get better. What she said, but also how she said it. To me, it was my first conscious experience of the love of God, you know?

I started going to the church and people asked, “Can we pray for you?” I felt like that was something really important. It acted as validation. I wasn’t getting that from psychiatric services because of professional boundaries. It was something that mattered to me a great deal. We are three elements: mind, body and spirit. I feel there’s a spiritual dimension to depression. We are these three elements for optimum health. These three elements are interrelated. So that was an important part of my recovery, becoming a Christian. My faith is very important to me now.

How long did it take before you felt well?

I began to sort of pull out of my depression after about 12 months. You can imagine a big factory, like a big power plant, with the turbines and generators, and in my case it was like all of a sudden one of the generators came to life, started to move, then got faster, then others started to work. I felt life returning to me, coming back into me. A wonderful feeling. The darkness lifted, and I started to see life in colour. It was the most wonderful thing, and once it started to pick up, it picked up pretty quickly.

It became very important to me that I became involved in user and carer voluntary work. I threw myself into that heart and soul. It got me using my brain again, meeting with people. It wasn’t formally written into my care plan. I stumbled upon it myself and found it very helpful. It took me three years before I got back into working as a social worker. It kind of built up my confidence bit by bit. Initially I thought I would never work again, then maybe I’d work a lower-level job. Then I thought, “Why not get back into social work?” I’d always loved it, loved the people. It wasn’t that social work had made me ill, it was the really a bad bullying management experience, and too much on my plate. An important part of my recovery was to get back into social work. I did it for another five years.

How old are you now?

59.

How did you get into speaking out?

I feel I’ve always been a pretty outspoken person, perhaps even more so now. I realized the importance of being upfront and honest. And also the importance of using the experience to convey to other people insights and understandings. I read a very good article in the British Medical Journal by the president of the Royal College of Psychiatrists, called “Doctors as Patients,” about his own experiences of depression. I felt this was good, this guy was able to do that. And it kind of made me think, “I should write an article.” I wrote about my own experience and got it published in a counseling and psychotherapy journal. I also wrote about becoming a Christian. I found the writing very therapeutic. I was in floods of tears while writing it. Heart-wrenching, really, but also very healing. A very useful thing to do. I think others have found that as well. I also wanted to convey to other people the sense of hope as well. It’s one of the things you have to do when helping people in mental distress. Hope is one of the first casualties. I think the important thing in helping people is to hold hope for them. They can lose the capacity to hold hope.

What have been the reactions to your being open about this?

I think it’s been very positive. Fortunately, I’ve not had any negative responses. People have said they found it very moving. It’s helped them to understand. Yeah, it’s been positive.

It seems like more people are speaking openly, and there are more anti-stigma and awareness campaigns. But the suicide rate keeps going up. What needs to happen?

I can only talk about my country, Britain. Certainly over here, we’ve got a lot of problems. With mental health problems, there’s a macro thing and micro elements. Over here, we’ve got awful problems with a right-wing government slashing and burning our welfare state and trying to privatise our precious National Health Service. It seems hell-bent on privatizing whatever it can. A lot of services, as well as other health and care services, are being slashed. It’s hitting disabled people particularly hard, including people with mental health problems.

We’ve also got a terrible recession. A lot of poor and disabled people, and over a million young people, can’t get work. The people who are at work are worried about losing their jobs, being made redundant. They can’t afford mortgage payments. A lot turn to soup kitchens, food banks, as we call them here. Parents go without food so children can eat. It’s just dreadful. Obviously, mental health is affected by these social economic issues. It’s not rocket science to work out why. You slash people’s services, benefits, the economic situation is in peril, it has a very detrimental effect on well-being. This is what’s happening. A really bad scene.

How to make this a more comfortable topic?

Very difficult, isn’t it? I do think education is vitally important. I think we should be teaching children right from the early ages the importance of looking after themselves. I do a lot of work now, I teach on university courses, a lot of work on what I call looking after ourselves, strategies for protecting and promoting the mental health of people in caring professions. There’s so much pressure now in Britain, with less people to do more and more work. Demands are increasing. I think social work is bad at addressing this whole agenda of looking after ourselves. When I did my own course back then, there was nothing. I’ve been doing sessions on this seven years now.

I was astonished. I was talking with social workers in their third year of their degree course. I asked, “Prior to me, had you done anything on this at all?” “No, we haven’t looked at it.” It’s crazy, because you’re training people do one of the most stressful jobs. It seems ludicrous. It’s easy, if you’re committed and conscientious and in the stress of meeting other people’s needs, to forget about your own, and stress is very insidious. It takes over bit by bit. It becomes normal to you. Then all you need is a bit of extra pressure and stress, and you’re over the edge. If you don’t fill your tank, it runs on fumes and it stops. You know?

(I ask about the tension or misunderstanding at times between the bereaved and attempt survivors, sometimes after confusion over the term “suicide survivor.”)

I came within a breath of taking my life. Obviously as someone who was suicidal myself, I understand what depression is, what it does to people. If you haven’t had that experience, you can’t fully understand it. There are some experiences you have to have in life to fully understand. You know, some people, if they’ve lost someone, they feel a whole kaleidoscope of feelings. They also feel angry and resentful at the person leaving them with the wreckage of it all. So their level of understanding is very skewed, very limited. So that’s why you get that reaction from some people. They don’t understand, so they tend to get angry about it. I do agree with you very strongly, there’s a need for groups for people feeling suicidal to get support. I agree it’s a desperate need. A need also to provide support to their friends and relatives. I know that’s an area of the national suicide prevention strategy for England.

Your writing has mentioned Maytree and the Leeds crisis center. Do you know of others?

Those are the two main ones. We are desperately short of crisis houses, crisis centers. A real big need. We really should have one in every town and city. Because it gets away from the medical model, away from the psychiatric pharmacy approach to mental distress, and provides a wider, holistic approach. I think that’s something really important. It’s actually a lot cheaper than putting someone in a psychiatric hospital, and a lot less stigmatising. I think you’re talking about my blog on the Mind site. We have kind of  postcode lottery. Some areas, people get good care, some bad.

What else would you like to see changed?

I think the really important issue is education. The importance of understanding emotions and well-being, developing strategies to build emotional resilience. For everyone. To learn how to be mentally healthy. We get a lot of stuff about physical health. Not about mental health well-being. You go into the GP and there’s loads of stuff on the wall about physical health problems but often nothing at all about mental health. There’s a report called “No health without mental health.” Supposedly, there’s supposed to be equal parity between the two. How we feel mentally will affect us physically, and the other way around. I’m afraid when it comes to reality, it doesn’t measure up. Mental health services tend to be one of the first things that get slashed back.

(I ask for his impressions on mental health groups in the UK like Mind, which seem to put more importance on rights and social justice than the large mainstream groups in the U.S.)

I think Mind is very good. Also, there’s another organization called Rethink that deals with serious mental health issues, they do very good work as well. Also the Mental Health Foundation. We’re lucky, we’ve got some very good national mental health organizations. Another one is called the Depression Alliance. They all have a very strong campaigning arm to them. We are lucky in that respect.

You do automatically think of rights and social justice in terms of mental health in the UK?

Yes, we have what’s called a psychiatric survivor movement. As a result of experiences in the old what were called lunatic asylums, there was a feeling built up that it was so terribly wrong how people were treated. People formed associations for a more enlightened approach, and gradually through the years organizations like Mind were established. Another organization is called Papyrus, which specializes in supporting young people who are suicidal.

In everyday life, how will people react if someone talks openly about their experience?

I think it’s a mixed bag. Generally, it’s respected that users and carers are important people, that their stories should be heard. But in reality, it’s a mixed picture. In some areas, there’s some really genuine user involvement, taken seriously. There are other areas where it’s very tokenistic, not really embedded in practice. Very superficial.

Do you worry that the depression will come back, and how do you protect yourself?

I think what’s really important is, certainly, the mental health system over here isn’t always terribly good at helping people stay well. I think the important thing, obviously, is to help people stay well. I learned the hardest possible way the importance of mental health, how central it is to your whole life. I learned a valuable lesson myself, understanding myself, the trigger points, understanding the importance of being mentally healthy. Having meaning, purpose, friendship. Enjoying life, in other words. In my case, my faith as well is important. I’ve got to say I don’t worry. I feel very positive. I feel I’ve got my life very well on stream.

What a mental breakdown does is, it brings you sharp up against yourself, forces you to take stock of your entire life and to really work out what you need to do about that to change your life to a more positive sort of pattern. One of the most useful things I read was a brilliant book, called “Depressive Illness, The curse of the strong.” Very interesting, because it makes the point that often people who are very committed, very conscientious are often more prone to have stress and depression because those who aren’t so much won’t take things on so much, they will drop out of things. The others will carry on, soaking up stuff all the time. Those who aren’t don’t get so stressed or become depressed. It made a lot of sense. I’ve lent it out to a lot of other people. It was recommended to me by the Depression Alliance. It’s by a psychiatrist, but it takes a holistic approach. So I think books can be very helpful. I actually said to my psychiatrist, “You know, this is a book you might like to refer to patients. It’s not the question of getting them well, it’s helping them stay well.” Fortunately, I’ve been discharged from him for many years.

Who else are you?

I am very committed to my mental health work. It’s a very important part but, as you say, it’s not the sole part. And it would not be mentally healthy for it to be so. I’m teaching these sessions to social work students, and if I can’t realize the importance of looking after myself, I can’t teach others, yeah? So I have lots of other interests. My friends matter a great deal. I enjoy ecotherapy, the sort of walking with people in green areas, enjoying nature. To me, one of the best things in life is to go on a walk with friends. That is one of most therapeutic things you can do. Ecotherapy is at least as effective as antidepressants in mild to moderate depression. I’ve got an interest in Roman history. I’ve got an interest in astronomy. I like gardening. I’m into photography and computers. Yeah, I also like music a lot. So it’s very important, no matter how committed and conscientious about your work, very important to do things that have nothing to do with that work. So, rest and relaxation are really important. And you’ll work far more effectively as well.