Before You Read: The CAMHS Inpatient Chronicles

It’s an odd feeling to write down memories- they are like moths in my head with fragments slowly disintegrating in the light. Please excuse the date, I am actually writing this in 2017. The reason this post is dated 2014 is because I needed it to appear first in this section of this blog. This is your guide for what is to come. 

This category “The CAMHS Inpatient Chronicles” runs from the beginning of my inpatient journey to the end (ascending order). We start at ‘If’ (the next post) and go forward in time from there. The reason I’ve done this is that several people have requested an easier way to read the whole series of blogs. So, as I’m looking at this chronicle again anyway, I have decided to do something new: rewind blogs. 

img_0523In my first unit in particular we had no access to the internet or mobile phones. Even though I was an avid blogger there was nothing I could do to record what happened in those months. So with the help of others who were on the unit at the same time as me and the scrapbooks I kept along the way I will to fill in some of the gaps. These blogs will begin with the ‘Rewind Blogs’ image and will be in a dark green colour. Please note that these blogs are written in hindsight and dates are approximate. It is really important to me that I get these memories down and this is the best way I could think to do it. I want to protect the integrity of the blogs I wrote during this time- but also get out the things I couldn’t publish back then. If you are subscribed you will still be notified of a new post as normal- they will just be dated 2014/2015 instead. 

Enjoy! 

If.

I am currently staying on a hospital ward, I’m by myself so my internet friends are the ones to keep me company most of the time…

If I had pneumonia I could curse my lungs in the comments of my latest status update.

If I had norovirus my friends would accept that it could get worse before it gets better.

If I had a broken leg most people would feel comfortable about asking how I am doing.

If I had cancer it would be despicable to say that it is my own fault that I am ill with the disease.

I have none of these illnesses. But I am in hospital with an illness which makes me the odd one out on the ward. And so begins the most difficult and agonising blog post I have ever had to write…

I have a chronic and acute condition. It is there all the time. It dabbles around inside me and latches onto anything and everything. It makes me do things I don’t want to do. It keeps me up at night. It makes me painfully bony and my skin coarse. It makes it hard for me to do anything, because it hurts so much sometimes.

What is it?

No nasties are attacking my nervous system and no cells are concocting chaos. It is a disorder which is invisible to the naked eye, but shows up like wild fire on a brain scan.

I have Obsessive Compulsive Disorder and Depression.

Why does no one ever mention that like a physical illness a mental illness can kill you if you don’t get the treatment you need? OCD has had several cracks at trying to win the tug of war for my life. But there is no way I will let it win.

So I am in hospital. I got rushed here in an ambulance. Not that dissimilar from a severe asthma sufferer my illness had stopped me breathing. On arrival I was assessed and told that I am too ill to return home. Just like the man in front of me in the queue who had just had a stroke. A normal heartbeat for someone my age is around 100bpm but mine spikes around 170 due to the anxiety which is coursing through my capillaries. My muscles ache from being forced to repeat the same actions again and again. My skin is full of potholes, where the wheels of the condition have dug in too deep for me to bare. My body is a puppet and my life feels like it has disappeared. Below all of the layers of this condition’s destructive attempt at self soothing is the girl who is left to write this post. Scared, Ill and battered.

I am in a paediatric ward at the moment; waiting to be transferred to an inpatient psychiatric unit especially for young people. I am lucky enough to be in receipt of an NHS funded place at a private hospital. I will stay there until I can move to a different unit closer to my own psychiatrist. I don’t know whether I will be able to blog while I am in there, and I don’t know how long exactly I will be there for. But when I come out of the other side I hope to feel a lot better!

If it is so hard, why am I telling you? Well I want to live in a world where people can go into hospital to regain mental health, just like they can physical health. I want people to see these conditions as a real threat to not just people’s happiness, but to their lives. Mental Illness is not something that just happens to the weak. It is by no means a choice. It is also not something that a positive mind alone can solve. My experience with mental illness is that it explodes, smoking in the most distant parts of your mind and rapidly growing outwards. But it can also lurk under a person’s skin for a lifetime. In my opinion, as far as bullies go, mental illness is the biggest coward of them all.

If you are judging me by making assumptions because you cannot see my condition just think: my eyes mean I don’t always notice when people are using walking sticks. But just because I can’t see the stick does it mean that the person can walk fine?

 

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A Very Impatient Inpatient

It is five months on from my last post. I did, as expected, move a couple of days after the post to a CAMHS (Children and Adolescent Mental Health Service) psychiatric bed. I was admitted into *Heron with my guide dog Noodle early on a Tuesday morning. By lunch time my bags had been searched, half the items removed, and I was sitting staring at the four white walls of my room. The ones I am staring at right now.

Since coming into hospital I have been surrounded with the love of those closest to me. In fact within the first few days of being here I had received so many letters of support that Social Services (Smile Stompers) banned me from receiving mail from all but one or two friends. The days were slow at first but, like water coming to boil, the time hazed into one expanse and fogged up my glasses. Most staff on the unit are amazing people dealing with limited resources, abundances of procedures to follow and (of course) eleven mentally ill teenagers all needing care.

Out of time and out of date- a zombie apocalypse could have happened and I wouldn’t be aware. Five months on the unit is disorientating, I could be anywhere for all I know of the outside. I don’t know anything about the city I am in. But what has happened here? The time has been spent trying to get my see-saw of symptoms somewhat stable. In these walls I have had a shield, every day the staff protect you from the monster inside your head and stop it from hurting you. Because that’s what it comes down to; the person and the illness. In a car you can see who’s driving, in people you can’t.

What have I not received? In the unit there has been very limited therapy. An hour of 1:1 psychological therapy a week tops. In my experience this wasn’t anywhere near enough to combat the 24 hour symptoms of my illness. I haven’t been cured, but I wasn’t expecting that. Well maybe I was a bit. I want to learn to manage my brain, but I haven’t had the specialist help to achieve this as much as I hoped I would. This makes me sad. But Heron has undeniably kept me alive with this terminal mental illness when I don’t think anywhere else would have been able to. I can only thank them for that. These conditions have made me really try to stop living, just stop, because it is too painful. Without being on the ward I don’t think I’d be here to write this.

I am moving to a new unit in the next couple of days, but I plan to schedule some blogs in which I will talk about my experiences in *Heron and my overall findings as a CAMHS inpatient. The posting may not be regular because it is rare to get internet/sim opportunities but trust me- I am still writing and doing my best!

In the meantime I am just a very impatient inpatient fighting to get better.

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How to Smuggle a Dog into a Hospital

A Dog in A Hospital?

“No.” She said. “Definitely no.” The rather pinkish woman, introduced to me as the ward manager of the PMU, was looking down at a rather sheepish looking Noodle and I. Myself, in a hospital gown and a tired Labrador curled at the end of my bed. It is the 14th of August and soon to be my second night on paediatrics. The previous night Noodle had returned to a friend’s house to be fed but from the second she arrived back on the ward she made it quite clear she had no intention of moving again without me. The little dog had spent the day watching members of the psychiatric team coming in and out- sending the message ‘don’t hurt her’ telepathically through her chocolate eyes. Now she was tired and warm and just wanted to sleep the night away by my side.

“We can’t.” The woman reconfirmed.

“You can.” I say, my voice wavered as I begged my eyes not to fill. “She’s a guide dog, I need her to move around. She’s my eyes.” I don’t want to have to have this conversation- I am after all here because I can’t deal with the normal stuff, let alone advocate myself.

“The other children don’t have dogs in.” She continues. “Their dogs are special too” I grimace at the word ‘special’. Then to my great relief a mental health worker returns and after a ‘quiet word’ the pinkish lady’s orders had lifted, though her scepticism hadn’t.

Noodle spent the night alternating between my bed and the chair beside my bed. The floor was freezing cold and I had nothing to offer her in the way of a blanket. She then went on to spend every night with me in the PMU, a favourite with the nurses and a source of curiosity for passers-by. In fact her stay had gone embarrassingly well for the reluctant pink lady. After a couple of nights I find myself sitting with the duty psychiatrist, who kindly popped in everyday regardless of when her shift ended, at the end of my bed. We were discussing my fears of Noodle being rejected again. I knew I was going to go to hospital but I had no idea where, finding a CAMHS bed is like a cut-throat level of bidding on Ebay. Beds were hard to find for anyone, let alone a girl with a dog.

“She has to come with me.” I tell the psychiatrist as I stroke Noodle’s ears.

“I know…” she replied, biting her lip as she watched us carefully. “I have put in all the referrals that the dog is non-negotiable. Both of you or neither.”  She smiled and I smiled back, though her voice was that of someone who was attempting to build a hadron-collider in their basement.

News came back on Friday that there was a possibility I would be going to the *Heron unit. They had to check that there was no one on the ward with an allergy or a dog phobia and everyone’s parents had to be called. I later found out that in the gap between that Friday and my arrival on the Tuesday there had been several calls to guide dogs. Most of the queries were on the ‘will it poo everywhere?’ variety. Within a week of arriving on the ward Noodle was the favourite of all the patients. Her determination to keep me safe never wavered, running to get staff when I needed help and sitting in the corridor outside my room to show if I was about to do something dangerous. She even tried her hand at carrying cards with messages on to the staff!

Now, as I am about to be transferred, the ward is having trouble contemplating what they are going to do without a dog on the ward. A far cry from the ‘infection control risk’ they reluctantly took in. I hope that they find themselves a PAT –Pets as Therapy- dog. Though I think that the ward manager is quite keen on getting her own dog and bringing it to work with her every day! Overall, this dog belongs with me. No matter what.

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Guide Dog of The Year: Beyond the Call of Duty

It isn’t every day that you find out that your guide dog has won an award. Let alone the prestigious ‘Guide Dog of the Year’. She was nominated several times over for her work to help me fight OCD and mental illness. I was too unwell to attend the awards, however myself and Laila (AKA Noodle) did have a mini award ceremony in the Unit. The best part of the experience though was having a photo-shoot on the hospital grounds and a video made. Laila goes beyond the call of duty every day and expects nothing in return. In the video you will see just some of the reasons why she won.

The Great Escape of Snap, Crackle and Pop

In the name of confidentiality, and my own amusement, I will rename the characters in this story Snap, Crackle and Pop. This is the story of the most successful escape I witnessed in my time on *Heron psychiatric unit.

Snap is seventeen, likes smoking and being right about things. She had been in the unit for the longest and during her time there her hatred had only increased for the way things were run. Known for her rebellious streak; she was the classic escapee.

Crackle is younger. She likes a bit of mischief but is generally cool headed. She was not thought to be the escaping kind.

Pop is new to the unit. She had already been in hospital once before and on her first night in Heron ward managed to climb the garden fence. She was very determined.

It was a normal October night and the day shift was drawing to a close. Well I say a ‘normal October night’ but for some reason Heron ward is always shrouded in either an icy veil or Saharan heat- alternating at oxymorons to the rest of the world. The night staff were in the handover meeting and the day staff were packing up for home. In the unit there was a slight tension in the air, like a precursor of what was about to happen. Most of the patients could be found whispering to each other: “what’s going on?!”

Go back to lunchtime. Snap is up to mischief. As the rest of the ward sits around the table scrapbooking she has snuck into the office. She has been doing similar all day, keeping the staff well on their toes. Most around the table don’t even realise she is in the office, a place forbidden to patients. When a nurse enters to find Snap pretending to type notes she bursts out laughing and merrily tells her to get out.

I have moved from the table in the communal area to the lounge with fellow patient D.
“What’s going on?” I ask after observing the tension in the air surrounding us. Mentioning it feels uncomfortable, itchy.
“I don’t know…” She replied. “But Snap, Crackle and Pop have jumpers on.”
“Jumpers?!” I ask as I rearrange my pyjama vest top. No one gets dressed on the unit. Pyjamas are our dress code and any layer of clothing of a thermal variety instantly attracts suspicion within the Saharan heat.
“Yeah…” She mumbles, miming taking a puff on a fag.
“Ah… Must be” I reply knowingly. The three had been known to sneak in cigarettes and lighters to smoke beneath the bathroom fans. The jumpers must have been so they had a removable layer that didn’t smell of smoke.

“Why have I not got a key on my belt?” Asked a member of night staff as they tried and failed to let a visiting parent out.
“Has anyone seen Snap, Crackle and Pop?” Asks another looking worriedly at the observation folder.
“Shit.” We say simultaneously. “They’ve got a key.”

After telling staff the ward was alive with an excited buzz. How long would it be before they were brought back? We took bets. Snap appeared to have used her time in the office well and had taken the key fob for the main doors from one of the staff’s key chains. We later found out that a lighter and cigarettes had gone for the ride too.

Police came in and out examining the mugshots of the three patients, taken from the front of the observation book. As I let Noodle out in the garden for her final wee we could hear a police helicopter circling above.

“I noticed Snap had jeans on. I thought it was odd!” A member of day staff exclaimed to the group, having stayed three hours after her home time.

At around half past eleven Snap and Crackle appeared looking quite morose. The rest of the patients were sent to bed early so that all staff could help in conducting strip searches. “That was the worst bit of the night.” Snap recalled days later.

Concerns were rising for Pop, sectioned under the mental health act and out in the dark alone. The helicopter circled and circled until eventually in the early hours of the morning I heard her bedroom door close and her returning to bed.

The key, which the three had claimed to have thrown as soon as they got out, was handed in by an anonymous source where it then spent some time in the office in a cup labelled “Do Not Use”. I’ll leave it to you to imagine where it was inserted in order to go unnoticed in a strip search. Management wanted it to be disinfected and put back on the key chain. Staff wanted it incinerated. Staff won and an automatic closer was put on the office door.

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The Positives of CAMHS Inpatient Treatment

Having been an inpatient on *Heron ward for the last five months I feel I have gained enough experience to write a bit about the positives and negatives of inpatient treatment. Please note that I have only experienced two hospitals, and treatment varies from unit to unit. This first post will be on what I consider to be the positives of inpatient treatment.

Hospital treatment means that you are in a place of safety 24/7 and have round the clock care. For those who need it this makes inpatient treatment the safest out of the tier four CAMHS care options. This can take the pressure away from a family which is likely suffering from the stress of maintaining the safety of a mentally ill young person. Family therapy can also be used to build better communication in the family for when the young person’s inpatient treatment ends and they return home.

The amount of actual 1:1 psychological therapy received varies from unit to unit, but nursing and care staff, in my experience, are kind and supportive- these are, after all, the qualities they get paid for. I have seen members of staff stay on after a twelve and a half hour shift, sometimes for four hours or more, because the ward is in trouble. This is because they care, nothing more and nothing less. They understand that a patient in crisis can throw the whole ward out, and they want to try to keep everyone as safe as possible. Depending on the ward or unit different therapies are available; DBT, CBT, art therapy, occupational therapy, family therapy, psychotherapy or groups. It means you can often do more than one therapy at a time, in theory making therapeutic success much more likely.

In hospital you also get some space away from all the *stuff*- the static in your day to day life which can wear you out and make a mental illness trickier to fight. Things like the constant bombardment of social media, deadlines and commitments. Not that these things should be avoided, but that it gives you a rare opportunity to focus on purely recovery.

When in hospital medication can also be altered straight away without waiting for a consultant’s appointment, and for anyone who has experience of attempting to get hold of a duty psychiatrist in the middle of the night this will come as a massive pro! It also means that PRN (as and when medication) can be given when immediately, this is really good for people whose illness fluctuates or those who experience episodic symptoms.

So those are my positives of inpatient treatment, however it is definitely not something which works for everybody and I also think there are a lot of negatives. To get the balance, keep an eye out for my Negatives of CAMHS Inpatient Treatment post coming up in the next couple of days.

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