Making Plans

Julie wants to learn to drive.  She got the application form for her provisional license from the post office, and found out that because she has a mental illness she has to fill in an additional medical questionnaire, and they will want further information from her consultant.

It's no big deal, and her consultant is encouraging, but it is yet another reminder - if one were needed - that things that are other people take for granted, are conditional for Julie upon the word of a doctor.  In fact, for the rest of her life, even if she goes on to make a full recovery, there are circumstances when she will always have to tick the box that says "I have had a mental illness" and then explain that illness to strangers, some of whom may not be sympathetic.  I am not in a hurry to spell this out to her, but it must be very strange at such a young age to find yourself regarded as an automatic hazard.

There are also pitfalls to avoid when she does discuss details of her illness that I will have to teach her at some point in the future.  Some day, for example, I will have to teach her the difference between voluntary and involuntary admission - a difference that probably seems rather abstract to her at the moment. So far Julie has never been detained in hospital against her will (known as sectioning here in Britain), and all her admissions have been voluntary.  This is critical because a history of sectioning is often associated with higher levels of discrimination and stigma in the world outside the hospital (insurance forms often ask, for example, if you have been detained involuntarily).  But it only takes a short stay in hospital to discover how thin the line is between voluntary and involuntary admission.  Staff on adolescent wards make no distinction between patients in these categories, and strict rules are applied indiscriminately - control is applied to who you see, what you do, and when you leave.  Harassed staff can display poor judgement, particularly over weekends when cover is stretched: we were threatened with sectioning once when we asked to take Julie out of the hospital on a family outing, for example.  It would be easy to cross that line once you are in the system, particularly if you have poor support outside the hospital.  She may well cross it herself at some point in the future.

Application for sixth form has also meant ticking a box, this time labelled "needs additional support", which leads to another assessment.  It is nearly a year until Julie has to start sixth form, but the school has begun revving the engines.  For Julie it begins even earlier than everyone else: there are extra forms to fill in because wherever she goes to study they should be prepared to support her.  We spent an hour this week with a social worker giving details of the support she receives at present, and our best estimate of what she might need in a year's time.  Julie was anxious, worried that describing how her illness affects her might give sixth forms grounds to reject her application.  I can certainly imagine it will give them pause for thought - such support is not cheap, and although there are certain funds that can be applied for, the money is not guaranteed.  Money from the council relies, for example, on Julie being assessed by a community paediatrician, who may have little experience of mental illness.  Nevertheless, I have told her that no one can refuse her application on the grounds of her illness - not because I know this for a fact but because I have a naive faith in our equal opportunities legislation.  I just hope that I am right because, though I am prepared to fight for her right to the education of her choice, I really don't want to see her disappointed, and by the time I reach the High Court she should be finished with her education.