Northern Ireland, United Kingdom: Caitriona Cassidy

Health experience related to: emotionally unstable personality disorder; mood disorder

Rapid access to health professionals in critical situations prevents injuries and stabilizes health, while patient–provider relationships built on trust and empathy strengthen people's resolve to stay involved in their care.

I have experienced suicidal thoughts and self-harm behaviour since I was 13 years old. For the past 12 years, I have been receiving continuous psychotherapy and psychological help. Recently I asked my psychiatrist whether I have an official diagnosis, and he explained that I do – emotionally unstable personality disorder – but could not tell me exactly when my condition had developed. I began visiting him several years ago, after the antidepressants and anti-anxiety medications I had been taking stopped working. The psychiatrist helped with adjusting my medications and linked me to other psychological services.

The most stable period of my life was during the 10 years I was receiving psychodynamic psychotherapy. I started seeing a psychologist in the past year, and my condition is vastly improved now. That has been very stabilizing to me and I continue to work with her once a week.

My relationships with the psychotherapist and the psychologist were a lifeline, and my psychotherapist certainly kept me alive many times. I had easy access to him that enabled me to reach him in times of crisis. I haven't self-harmed or attempted to end my life since 21 October 2014. Before that I tried to self-harm often, sometimes up to 3 times a week.

There is a crisis response helpline in Northern Ireland where one can call and talk to qualified counsellors. They keep a record of patients' notes, so they do not have to repeat their whole psychiatric and social history every time. They do check-in calls and update your general practitioner or send an ambulance if you are in crisis. It's an amazing service.

I started using the helpline in August 2013. During that time I was really unwell and was calling them up to 90 times in a month. They eventually assigned me to a key counsellor, and she called me once a week so that I could talk things over with her, hopefully to prevent crises from happening in the first place. She became a stable and close presence in my life.

Helplines have a statutory responsibility to inform callers' health care providers of all risks. So if I call them and say I have self-injured, they would phone my general practitioner or my psychologist straight away, and one of them would call me back and invite me to visit her that day. That was great, because it took the pressure off from me having to explain, and sometimes I didn't remember the details about what I had done to myself. Whenever I was admitted in the hospital, I could keep in touch with the helpline from the ward by phone.

However, the helpline and the psychologist are secondary services. What would have helped me even more would have been a place where I could go before I would injure myself. Having a safe place as an alternative to the hospital, where one could go and have a cup of tea and a face-to-face talk with a counsellor at the precise moment when one is in crisis, could help de-escalate the situation.

I don't want to be self-harming and be a danger to myself. I am compliant with treatment and am prepared to try anything that the providers recommend, because I trust their judgment. I think it takes as much work from the patient as it does from the providers. It's a two-way process.

I feel very lucky to have had such good providers, and the fact that they worked so well together for my health was key. That strengthened my resolve and determination to stay well. As an extension of the excellent professional services and encouragement I received, I made a safety plan with my friends in order to help me stabilize and recover further.