Tag: inpatient care

Why I Might Need to Say Goodbye

Through being in hospital I have come into contact with around a hundred other young people. Possibly more. Some were just brief acquaintances- admitted for a day or so and some I built friendships with.  But there are a lot of people who I won’t stay in contact with post-discharge. I have to let go.

In particular I am talking about people who I follow online who share their struggle with the world. Like me they share experiences but most do it through social networks. Minute by minute highs and terrifying lows. Rushed instagrams about pills and razors. I have called the police several times for several people who said they were trying to end their lives online. Every time I stayed up all night until the police got back to me and said that they were fine. My OCD goes overboard with the worry and it is frustrating to be so useless in a situation. I know these posts are sometimes cries for help or attention but if something happened I couldn’t live with myself. What if they are doing something bad but no one else hears the cry? 

I’m not going to lie- this action is completely selfish. I can’t cope with what I’m seeing. I know that some people feel great benefit from lsharing during their deepest darkest moments but I personally don’t. This blog is written in hindsight. I would never post anything that would make people concerned to the point that they would phone the police. Truthfully this is because in those times I don’t want anyone to save me so posting would be an unnecessary risk. It has never occurred to me to publish that I am in the process of, or planning to, hurt myself. I talk about the times I have been- but I am always standing in a better place when I do. Sharing my story and my experience is my attempt at awareness raising so I try hard to keep my blog rational, honest and informative. 

When I go on social media I don’t want to be reminded of my time in hospital. Hypocritical as it sounds from a mental health blogger, I don’t want to look at it. I’ve had traumatic experiences involving other patients in hospital and though people didn’t mean to hurt me the memories spark from the smallest of posts. I need to process my experiences for myself and having other people rip off the metaphoric plaster and making me remember is hard. Plus when you struggle with thoughts about weight and food the last thing you need is a selfie by someone who hasn’t eaten for a week or a picture of a salad they’ve nibbled when you just fought the demons and ate a burger. I know that behind the usernames they are struggling, even if they do not realise it. However, for people trying to recover, following those accounts is the equivalent of swigging G&T at the back of Alcoholics Anonymous. 

I want to make clear that I do genuinely care about everyone who I have met during this process. I really do. I wish them nothing but positive things. But I’m not able to actually help any of them, and by trying to I am hurting myself. I write letters to people I want to stay in contact with because the fact that they take a while to produce and arrive means they are less spontaneous. Where as with a few taps of a finger you can share your perils online. I might follow people on some platforms (the ones they share with family and real life friends) but not the ones they use to network with other warriors or vent. I feel safer like this because there are other followers who would be much more of a help than I if a crisis came about. I don’t even know the addresses of the people I was in hospital with and if something happens I can only offer the police a mobile number at best.

I won’t forget those I’ve met and I’m so angry that these illnesses have intruded into such vibrant young lives. I wish I could help more. If I do step away from you online; I hope you can understand that I wish nothing but the absolute best for you, but this is a step I have to take for my own recovery and I hope one day you will take it too.

  

Kids in Crisis: The Bits It Missed

Channel 4 recently showed a documentary discussing problems in Child and Adolescent Mental Health Services, focusing mainly on the country’s overall lack of child inpatient psychiatric beds and lack of early intervention provision. Over the past year I have noticed many news articles and reports on these subjects. But there is one thing I think they missed.

Yes there aren’t enough CAMHS inpatient beds, but there also aren’t enough staff to cover the ones we’ve got.

In both CAMHS inpatient units I have been to there have been serious problems with staffing. Friends of mine have confirmed experiencing the same problems in other units. There are often not enough regular staff who work on the ward on shift, so numbers have to be topped up with bank or agency staff. Sometimes these workers become regulars on the unit, thus getting to know patients. However a lot of the time they are coming on to the unit for the first time, know none of the patients and have very limited experience of the setting. In one of the CAMHS units I went to, which was a closed unit, patients used to use the ignorance of the agency staff to break the rules. One of the most notable examples I remember of this was a member of agency staff being persuaded by patients that the toaster could be plugged in in various bizarre places around the ward. This resulted in patients being found smoking in an ensuing after lighting cigarettes from the toaster. It’s funny but there are many other examples I could give ended with a patient getting hurt.

Having a team of regular staff covering a shift is vastly different to having numbers topped up by agency or bank. Funnily enough patients, often with complex past relationships with adults, tend not to open up to relative strangers. Though these workers count as bodies on the ward a lot of their work is observation and directing regular staff to the young people who need them.

If there were enough staff in each unit the quality of care and patient turnover would be much higher. The increased knowledge built up over time of patient’s case alone can make a huge difference to care. Bank and agency staff get a short handover about the ward and the patients however the information given is based on what has happened recently. Staff nurses and health care assistants who work on units regularly will build up the trust and the life story (often quite complicated) of a patient; thus helping them identify crisis triggers, early warning signs and risks.

The documentary did portray really well other points, such as how children and young people can be moved all over the country from hospital to hospital and how this is often a fast decision based on their condition fluctuating. I felt sorry for parents who had to deal with their child being passed around, sometimes hundreds of miles away from home. Dealing with relapse is hard enough but if it results in more moves and being further away from home it will be even more devistating for patients.

Some psychologists are campaigning for CAMHS services to cover up to the age of twenty five. I will probably write another blog about this soon as it is something I believe passionately in. The move from children to adult services is drastic and for many traumatic. The attitude appears to shift from CAMHS teaching you to cope with what you have to adult telling you to just deal with it. There is a huge difference.

A mother expressing her concerns over her daughter becoming institutionalised made me think of the many, many, young people I have met for whom moving from unit to unit has become a way of life. I have met patients who have been in hospital for years at a time. That is years of living away from home, years out of education and years without socialising with people who are mentally healthy. Who can blame these young people for becoming comforted by the safety and routine? Especially when many will have had bad experiences with outpatient care or have difficult home lives. These units are vital but there needs to be clear paths for patients to move on.

To sum up:

  • We need to staff the beds we have appropriately to improve the safety and the treatment of young inpatients. Then we need more beds.
  • Families should not have to wait for a young person to deteriorate in order for them to become an inpatient to get the treatment they need. Early intervention must improve.
  • Ideally every region should have some sort of provision for mentally ill young people.
  • Where possible young people should go directly to the most suitable security level provision to avoid more moving, and disrupting other patient’s care in lower security units.
  • Young people should be covered by children’s and a transitional service until the age of 25. The 18 – 25’s bracket could be used as a transitional stage between the two services and their massively different approaches.
  • There are so many things that need to change. 6% of the Mental Health budget is not enough to support the country’s mentally ill young people.