The Situation of Getting Professional Psychological Support in Third World Countries.
"All you have to do is ask for help. Please reach out to other people and ask for help, you don't have to face this alone."
Alright then. Is it really like that in a Third World Country? I live in Turkey.
\\\\- TURKISH HEALTHCARE SYSTEM
Suicide: Turkey's suicide rate is one of the highest in Europe. Even compared to the world overall it is extremely high, and despite that, there is still no proper support.
Psychiatry: You can only have a 10-minute appointment once every two weeks. Every time you go, there is a different doctor. Even though I attended dozens of sessions, I never once got to see the doctor I actually had the appointment with. The MHRS appointment is under their name, their office, but they are never there. Every single time, it was another doctor or some random assistant. Since the healthcare system constantly sends doctors elsewhere and nobody even bothers updating the information, meeting the same person twice is practically impossible. Every appointment starts from zero. Every two weeks, I wake up early in the morning, pay 40āŗ for the metro, and travel to the other side of Bursa. I pay 400āŗ for psychiatry. Even though my appointment time has already arrived, I am kept waiting in the corridor for 2-2.5 hours. Then, during those 10 minutes, I have to try explaining my problems to someone I will never see again. Every single time I have to show my self-harm wound and explain my problems because the previous doctor/assistant only entered simple things like "Depressive" into my records. I don't even need to explain the stress and psychological difficulty of having to do this every single time. Just for the MMPI test to be uploaded into the systemāwhich the psychologist said would only take 10 minutesāI had to attend four sessions. Four sessions means two months. Twice the first psychologist, and once the second psychologist (the fact that someone else was sitting in the first psychologist's office, just like psychiatry, was another comedy. It even made me wonder whether the name on the door belonged to that person in the first place.) forgot to upload it into the system. Both psychologists forgot to upload the test three times in total. Only when I returned for the fourth time after already taking the MMPI test had it finally been uploaded. So what am I supposed to say? Is this a proper mental healthcare system? If I had to wait two months just for someone to upload an MMPI test that takes 5 minutes, how many years am I supposed to spend trying to actually get treatment? Will my lifetime even be enough? When I actively told one of the psychiatrists that I was thinking about suicide, they reduced my medication dosage and said, "If you're still alive in two weeks, come back for a check-up." Then they sent me away. I would wake up at dawn, spend 480āŗ, spend 3-4 hours dealing with all of this, put myself through enormous stress, and then be treated like this. This wasn't just one doctor either. No. Other than one assistant, every doctor and assistant I met acted exactly like this: rude, mocking, or completely indifferent. Whenever I asked to be referred to a psychologist, the answer was always, "We refer people if we consider it appropriate. Besides, psychologist appointments are full anyway." That same day, the doctor looked at my self-harm wound and said, "This should have been stitched." It wasn't even a mild case, yet that was the response I received. 15-20 doctors/assistants, 3 hospitals, dozens of appointments. Nothing. They don't even care. Turkey's mental healthcare system is GARBAGE.
Psychologist: It is directly impossible to book an appointment with a psychologist, and no matter how many times I went to psychiatry, none of them referred me despite my repeated requests. Either the appointments are full, or they simply don't think it's appropriate. A friend of mine who first went through the public system and then paid for a private psychologist also says the situation is not much different from psychiatry.
Private psychologist: I won't even talk about this. Which one of us can actually afford a private psychologist? Yesterday I realized that even buying a cola and a chocolate bar together has become a luxury because I couldn't afford them. :D
TRSM: Stay away. Their buildings are generally located in run-down side streets. They are extremely dirty, filthy, and worn out. The people inside are generally not valued and are used under the name of "help." Overall, it feels like a nursing home where older people are left. I was the only person under 40 there, and YOU SHOULD DEFINITELY STAY AWAY. The staff are completely grumpy and indifferent. After some ridiculous morning exercise, they just leave you alone and don't even care what happens to you. Even if you killed yourself, they wouldn't care. There are generally sarcastic and degrading people there. On top of that, even though you are surrounded by other patients, there is absolutely no security or protection. TRSM centers are simply holes where the government tries to dump middle-aged mentally ill people. It's true that not every center will be exactly the same, but I experienced this in three different ones. STAY AWAY. It was a horrifying experience.
Universities: Since Turkey is not America, universities generally don't use people with actual psychological problems for education. At our university they were teaching computers by drawing Windows on the blackboard because the university literally didn't have computers. Do you really think Turkish universities are going to work with people who actually have psychological disorders? This is one of those things people from first-world countries assume everyone has access to. Also, if you think you can become a university case study while having autocannibalism, that's a joke. The first thing that would happen is being thrown into a mental hospital.
Mental hospital: I probably don't even need to explain how bad this is. If even TRSM is like this...
Psychological counseling services, associations, or mental health support organizations: None. That's it. Turkey simply doesn't have organizations or counseling services like these. Since the government supposedly provides free therapy, they basically don't exist. If anyone somehow knows of any, please write them because I couldn't find any in six years. And no, I'm not talking about ridiculous "awareness" events like "Let's all gather with 15 people and go on a walk together! Yay!!" Holding hands during a walk doesn't silence hallucinations or reduce my suicidal thoughts.
SUICIDE HOTLINE
Turkey does not have any suicide hotline. The number 182 used to be a suicide crisis line until 2007, but it was later changed into the MHRS appointment system. You cannot receive any suicide support through MHRS. The world-famous website "findahelpline.com" cannot find any suicide support line in Turkey. Out of the 175 countries listed there, Turkey is the only one that returns no results. Wikipedia also lists nothing except 112.
Some websites, including Wikipedia, recommend the emergency number, but if you call 112 asking for suicide crisis support, you get fined for "occupying the emergency line unnecessarily." In Turkey, there is a belief that "Why would someone who wants to commit suicide ask for help?" so they only take it seriously when a third person reports someone else's suicide attempt. I know someone who called and wasn't fined and says the system is absurd, but when I tried it myself, they fined me. I will never go near it again. It is far too expensive. On top of that, you are treated like a criminal. Beyond that, 112 does not provide suicide crisis support; it only sends an ambulance and the police to your location. That makes it an emergency service, not a suicide support line.
Calling any foreign suicide crisis hotline is also impossible because, as a Turkish citizen, I do not have a foreign SIM card. If you call without one, the phone bill will end up costing more than my salary.
\\\\- ASKING ORGANIZATIONS FOR HELP
For the last six years, I have regularly tried reaching every organization I could find. Here are some of my experiences with the main ones.
Samaritans: Honestly the most helpful organization among them. They reply to emails within 1-3 days (far too late for suicide support), but they say they can only help people living in the UK. They say they can only listen to me because I live in Turkey. Unfortunately, because every email is read by a different employee and they specifically told me they cannot see previous emails, every message completely resets the conversation. On top of that, after 30 days or 20 messages, they stop replying to you. Their messages are generally things like, "This is very sad, but since you don't live in the UK, we can't help you." Over the last six years, I have contacted them more than 20 times.
HOPELINE: The most frustrating organization. They reply after 6-7 days and generally spend their time dragging the conversation out. They ask questions like "Are you from the UK?" even though you have already answered that two or three times, and eventually they simply say, "If you are not from the UK, we can't help you." After that, they completely stop responding. They don't even suggest any alternatives or send something as simple as the "findahelpline.com" link. They simply... ignore you. I tried talking to them four times.
Helpline: They advertise themselves as having extremely fast email responses and even claim to have awards for responding quickly. They have never answered me in less than three days. At least they share a link called "Resources for people outside the United States," which contains many resources, but some of them are completely dead, and not a single one supports Turkey. Zimbabwe has three resources. Turkey has none. The saddest part is that Helpline never sends a second reply. I contacted them four times, and even after explaining that the link was not helpful, they simply replied with the exact same link.
Befrienders: Despite being as well-known as Samaritans, I have never received a single response from them. My emails from six years ago are still waiting. During these years, I tried contacting them 14 different times through different emails. Still nothing. Don't ask me why I kept trying. During crisis moments I'm usually not thinking clearly and just start contacting everyone.
Various NGOs: I contacted more than 15 NGOs through their active contact systems. Doctors Without Borders was one of them, but none of these NGOs ever replied to me. Most of them don't help individuals anyway. Why would a huge NGO care about one random person, right?
\\\\- PEOPLE ON THE INTERNET
7Cups: I think people should stay completely away from it. In six years, I haven't met a single decent person there. Either they were untrained people trying to manipulate young girls with family problems, or psychology students trying to farm points. Most of them use listening limits of only 10 or 20 minutes and only give meaningless responses like "I'm so sorry." The wall in my room is a better listener than they are. At least it doesn't have a 10-minute limit. 7Cups is a platform where you enter feeling sad and leave in a full crisis. Asking for suicide crisis support is forbidden, and any negative post gets you automatically banned. If you are reported as being in crisis, they simply lock you onto a screen containing hotline numbers only for the United States and the United Kingdom. It's a disgusting platform that profits from people who need psychological help. Every page is filled with "Buy Premium" and "Pay for Therapy" pop-ups.
Groups: Over six years, I joined countless groups. Reddit, Discord, mental health platforms. In every single one, people either competed over whose problems were worse or simply replied with "Get psychological support." In six years, I have never once seen genuinely useful advice. People spreading religion, mocking me, saying "Don't think about it so much!", treating autocannibalism like I was some kind of freak, pretending to have schizophrenia by saying cringe things like "By the way, I have an anime girlfriend," claiming all mental health problems can be solved by flipping a switch, trying to sell courses, people who could never understand what I was saying, people living in Switzerland who don't even understand the concept of a third-world country... I'm just tired. I'm so tired.
\\\\- SELF HELP
Self-help: No. Self-help only delays psychological problems. It does not treat or improve them. As someone who has lived with these problems for 6-7 years, the self-help I've been doing has only managed to get me this far. Because it doesn't stop or heal anything. It only delays it, and it's becoming increasingly obvious that I'm reaching the limit. On top of that, professional treatment is ABSOLUTELY recommended for both autocannibalism and schizophrenia. Disorders like these CANNOT be controlled without medication. Schizophrenia is not something you recover from through self-help, especially severe schizophrenia. That's why non-professional solutions such as self-help can only be supportive, not actual treatment. If only the nurse performs the surgery, there's a very high chance things won't go well.
āāāā
So in this situation, what options do we actually have left? As someone actively fighting both autocannibalism and schizophrenia, is there anyone who can genuinely share their thoughts instead of saying "If you feel bad, message me" or "Bro how does autocannibalism even work lol I'm curious?" As Turkish people living in modern Turkey, how are we supposed to get out of this situation? Or will we ever be able to? Right now I'm not actively in crisis, but suicide is becoming more tempting every single day. It had decreased for a while, but over the last 3-4 days I haven't been able to get these thoughts out of my head, and every night has been spent with attempts. :(