Tag: inpatient

Inside a Children’s Psychiatric Unit At Christmas

There is a group of ill children in hospital that probably never cross your mind. You won’t find them in slushy adverts or the subject of a charity single. Nor will A-list celebrities drop by their wards to wish them a Merry Christmas. They are mentally ill children and young people in inpatient psychiatric units. These children and young people are just like any in a hospital ward, they are away from home because they have an acute illness that needs specialist treatment. They don’t get the attention of celebrities or the tireless work of charities like kids with other illnesses do. For all intents and purposes mentally ill children and young people in hospital are all but forgotten at Christmas.

So what is it really like to spend Christmas in a CAMHS unit? I found out last year. If I gain nothing else from spending Christmas 2014 in hospital, at least I have some writing material to take away from it.

The setting was hardly festive; decorations on *Heron unit were extremely lacking since the unit tree had been taken away a few days before Christmas because the patients had found a way of extracting metal spikes from the artificial stem. There was no tinsel (ligature risk) and no lights. Staff did their best to make our isolated snowglobe world festive with activities and films- but there are only so many paper chain and toilet roll tube crafts that depressed teenagers can partake in before losing interest in Christmas entirely. The Wednesday before Christmas patients were told in X Factor audition style if they’d have time away from the unit over the holidays. Both joy and desperation were on the unit that day, but when Christmas itself came along everyone had a glazey-eyed determination to try and make it ‘OK’. The patients made a pact to try not to cause incidents and try to prevent the bellowing wail of the pinpoint panic alarm as much as we could.

We all woke up to a basket of fairly edible croissants from the kitchen. At around 9am the procession of relatives began to file through the locked doors of the unit. They wore smiles and laughs like uniform as they met their offsprings. There was no illusion- it was not going to be a typical Christmas for any of the families.

My Dad brought with him presents which I opened like every Christmas previous. These were then searched and risk assessed by a member of staff who placed half in the office for supervised use or safe keeping. One of the confiscated gifts was a tin of teabags because they weren’t decaffinated.

 The only leave I had been granted was to go to church on 1:1 with a unit nurse. This was one of the best parts of the day as I had always found her easy to be around. I knew she was a strident atheist which made me somewhat jubilant with the hilarity of her accompanying me to church. I think she was a little overwhelmed by the clapping and singing and we ended up secretively giggling for the most part of the service.

I went back to the ward where I met my Dad for Christmas dinner. I was on a meal plan so the meal was compulsory. To quote my Dad: “It will take until new year to digest”. While our intestines struggled with the dinner we played board games; chess and monopoly. We attempted Cluedo but discovered that the unit set had had the knife confiscated for safety reasons. 

By lunchtime I was really struggling. I found it difficult to be out of bed for any period of time. I fell asleep under my blanket on the floor. Dad left shortly after because it had clearly got a bit much for me. Several of the patients like myself had family over for only part of the day. Though our families understood we were ill we still felt a pressure to try to perform our way through the day. There was intense guilt for, if nothing else, putting them through the dinner! One girl on the ward’s family brought her tiny pet chihuahua to come and see her. The family then made the executive decision to go out for lunch but left the dog with their daughter and the adoring ward. I seem to remember we watched frozen and cooed over the chihuahua for the rest of the afternoon.

When all the families and relatives had made tracks the mood dropped, as it did most evenings. The kitchen staff had the night off so we had a strange assortment of pre-made samosas and egg sandwiches for dinner. No one enjoyed it or found it edible, we all laughed as we dissected strange lumps to try and work out what they consisted of. I don’t remember the rest of the night very well. The faces we had all put on to get through the day were beginning to crack and there were alarms and medication.

It wasn’t a bad day on the ward, it was actually quite a good one. But Christmas in hospital could not compare to Christmas at home. Spare a thought this Christmas for those in CAMHS units and their families. If you can, donate safe items to your local unit. Chocolate and cake always go down a treat- and teddies, games or a good DVD! Children and young people in psychiatric care are often forgotten about in comparison to children in general hospitals. We don’t get to hug celebrities or have charities to help us. Just knowing that someone donated something out of kindness could make a patient’s day. That was my Christmas last year. I hope this year will be better for myself and the others I spent last year with. I can also hope that anyone spending Christmas in the same way is safe and a tiny bit happy in the morning. They deserve it.

The Findings and Thoughts of a Newly Released Inpatient

  1. Toilet seats are very underrated.
  2. Oh shower with temperature control I love thee…
  3. AND I don’t have to dance around to keep it going.
  4. Sleeping in is a simple pleasure.
  5. There’s food that tastes like something I would want to eat here.
  6. Windows and doors that actually open are fantastic.
  7. Fresh air has never felt so good!
  8. I can even do my own tea the right way. In case you need clarification on this: water, teabag out, sugar THEN milk.
  9. The reality of having more than the same two options every day for lunch is mind blowing.
  10. Toilet paper in the real world is so soft!
  11. Go out? Now? Brilliant!
  12. Watching something on TV at the same time as everyone else rather than slumping over iplayer is doing wonders for my Twitter life.
  13. Space to dance around in is a good use of space.
  14. Support workers? Who have time to support? Wow.
  15. Having free reign of my phone feels so good.
  16. It’s a pain having to walk more than a couple of meters to see a doctor.
  17. The real world is a lot calmer than the inside of a CAMHS unit.
  18. Bedroom access is useful during the day for quick naps or picking up forgotten items.
  19. Space to hang my clothes means I don’t have to work the crinkled bag look.
  20. And just the knowledge that I’m no longer in hospital is pretty amazing in itself.

  

So Called Safe

Times like this I shouldn’t be here
Its not stopping my stress it’s stemming it
I’ve been helped
alongside the girls who eat tape measures
and the boys who breathe fire.

But I’m angry that as I lie in bed
I’m whispering to my pillow
“The door’s locked.
The door’s locked.
The door’s locked.”
And for once it’s not the OCD talking.

I’m scared because they’ve been kicking the doors in for hours
and we are three members of staff down
and as they storm the siren screaming doors
the agency blokes don’t know their names
to phone for the police.

But what are parents supposed to do?
When Seb is sixteen and suicidal so sent to be safe.
The psychiatrist is supposedly stalling their son’s surge for suicide.
But in a moment Finn throws a fist and Seb’s got stitches.
Seb’s mind must be bad for six stitches to be the safest.
How scary is that?

The ceiling screams when we do,
Staff scatter.
Skin splits.
And sewn on the skin of my teeth
Are slideshows of scenarios
Seen in children’s psychiatric settings.

But we’re safe. Right?

A Non-Definitive List of Things I Will Not Take for Granted Once I Have Left Hospital

I have now been in CAMHS inpatient care for nine months: AKA far too long. I’m now approaching my discharge and, as it edges closer, I become more and more desperate to get out. The gripes and the grudges build up until I just have to make a list. So here it is.

A Non-Definitive List of Things I Will Not Take for Granted When I Have Left Hospital

  1. Being able to get a drink whenever I am thirsty and not having to wait for staff to be free to get it for me.
  2. Sleeping in when I am tired.
  3. Going to bed when I am sleepy.
  4. Being able to say that I have a headache without a doctor pouncing on me.
  5. Not being questioned on how I care for my dog.
  6. Having the option to be with people or not be with people.
  7. Not being surrounded by distressed people constantly.
  8. Not suffering the horrible noise of the panic alarms which seems to change pitch as you move your head.
  9. Absence of people playing ‘devils advocate’ every time I just want to have a little grumble.
  10. Choosing who I spend my time with.
  11. Going out when I want
  12. Going where I want
  13. Singing at the top of my voice
  14. Going to College
  15. Being with friends
  16. Not being alone
  17. Internet access
  18. Social media support
  19. Independence
  20. Food which isn’t from a silver tray
  21. Privacy
  22. Organisation
  23. The power to change the central heating temperature
  24. Not being observed
  25. Not having an ever changing conveyor belt of staff in charge of my care
  26. Having more than one 16th of control over the television remote
  27. Watching soaps without people moaning
  28. Long dog walks to nowhere in particular
  29. Loud music
  30. Laughter
  31. Doors that aren’t locked
  32. Being able to go and see people
  33. Being stable enough to make plans with more than a 60% chance of it actually being carried out.
  34. Gyms and swims!
  35. Fresh air
  36. Not having visiting times to stick to.
  37. No ‘compulsory’ workshops to go to.
  38. Watching DVDs rated above a U
  39. Not being woken up during night observations (they turn the lights on once an hour)
  40. Not being in hospital!

I am currently camping in a coffee shop making my time off the unit last as long as I can!

If you have been in hospital, what will you never take for granted again?  

Bollocks to BPD

Diagnosis ain’t easy.

I first heard of Borderline Personality Disorder (BPD) at Heron. The psychiatrist there seemed to be trying to fill a ward quota of 25% of female patients being diagnosed with BPD. I wasn’t in that percent.

The next time I heard it I was sitting in my CPA meeting for professionals. My new psychiatrist reeled off my conditions and then the letters- B.P.D. After the meeting was over and myself and my key nurse were on our victory lap around the village I asked if she’d heard it too. She wasn’t sure.

I asked for confirmation when I saw the doctor next. He quickly drew a grid with numbers and the disorders I have come to know. Then there it was- BPD. He said something about how this is what he suspects my problem lies within- my Jabberwocky to fight.

“Personality disorders have a stigma to them.” He added. “But don’t worry, it’s not the one serial killers have.”

Looking it up on the Internet isn’t pleasant. People with BPD were clingy and unstable. All the stories I could find were negative. ‘WHERE ARE THE REAL PEOPLE?!’ I found myself mentally screaming. And I’m ashamed to say I didn’t want to make myself one of the few who spoke up. The stigma seemed huge. But if no one speaks up, who else will be scared into silence by this monster? I tentatively took my first move with my poem borderline and now this.

To make matters worse in my quest for information, symptoms listed on every website I searched seemed increasingly vague or scary. Out of desperation I hit the books and surfaced with “Sometimes I Act Crazy“. Which gave me the broadest picture of the disorder and those living with it. I would highly recommend it for anyone else scared away by the Internet.

I think the description of BPD on rethink is the best:

  • “Borderline personality disorder (BPD) can mean that you are prone to strong emotions, mood swings and feelings you can’t cope with easily and may feel distressed a lot of the time.
  • Around 1 in 100 people have BPD.
  • There may be different reasons why someone develops BPD.
  • There are a number of different approaches to treating BPD, most of which include different types of one-to-one and group talking therapies.
  • Complications can arise if you have BPD, including problems with substance misuse and self-harm.”

It’s still vague; but every warrior is different. The thing with mental illness diagnosis is that it says more about your past than your future. My brain developed a little different. I see and hear things you can’t. My moods swing in ways you can’t predict. But whatever it says about me now, or me then, I am going to have CONQUERED my Jabberwocky soon. Just you wait. It doesn’t matter what it’s name is. If it is one disorder or three. It’s going down.

And then I will stand in the street; in the rain, in bare feet and scream at the top of my lungs: 

“I made it!!”

And I don’t care who hears me. 

 

Because I’m getting out alive.  

The Life of Robyn- Let’s Evaluate and Do Something

This is my blog following the catchily named ‘Discover’ Children and Young People Evaluation Workshop. I hasten to add that there was no ”s’ on the end of ‘people’ on the sheet I have, probably because this was a gathering mostly for professionals who work with and around the Children and Adolescent Mental Health Service. It was not an event for the direct attendance of service users, but it was certainly a day with young people completely central in all points of discussion. Sitting at the tables were the people who can actually change things.

It started at *Cheery Lodge a few weeks ago with a group of patients and a pretty awesome storyteller. We were told about an enquiry into the CAMHS service which is currently taking place in our region. It is called Discover and we spent a very long session discussing the imagery used to represent the process. This was a logo of a missing puzzle piece being slotted into place within a silhouetted head. Is it too simplistic? Is it implying that there is just a missing piece that we as services users need to be given in order to be cured? Does it imply that we are broken? We weren’t sure.

Our awesome storyteller asked us to create a character together to use as an Everyman in all of our stories. We came up with the name of Robyn (unisex) and formulated the average age of sixteen. We left it at that and then set to telling our own stories through the life of the elusive Robyn. Poor Robyn had a multitude of lives- in some making a full recovery, winning the lottery and beating the system and in others being homeless and ending up stuck in an adult inpatient facility. We audio recorded our stories and then added pictures in order to create a presentation.

Myself and *Izzy decided we would quite like to go to present what we had made to the big fishes of CAMHS and other services. A room smelling of coffee and pens was the venue for all the big bosses. As Izzy said: “Adults talking adult stuff”. “They’re just people. Just like you and me.” I whispered back before suggesting we get involved in whatever they were discussing in order to prove this point.

A minor crisis occurred at the start when the audio part of our presentation refused to co-operate with us and despite our increasingly desperate pleas it continued to make demands for a file type we had never even heard of. Having only a first draft of the recording on paper we had to improvise big style by reading the transcript out and improvising the bits we had added in after it had been printed.

Unable to read the tiny words of our notes I had to reduce my non-existent professional image somewhat by borrowing a very kind gentleman’s iPhone, hastily panorama photographing some paragraphs and blowing them up. My own iPhone camera had been disabled on admission to *Cheery Lodge in order to protect patient confidentiality on the unit and such. Thank heavens for understanding and generous people because the loan of the phone was what made it possible for me to take part as planned. We made it through the presentation and got really good feedback.

Suddenly these professionals didn’t seem as big and scary. They were just people. Trying to do their best for so many young people who’s stories are so hard to follow. They did truly listen and pick up on the points that were made- early intervention is needed, more awareness and more training for physical health practitioners. We discussed how differently the subject of mental health is treated in comparison to physical health. One is the train platform, common ground and a safety zone to be observed and preserved. A talking point in a classroom and a measurement in the doctor’s office. The other is the railway track- vital but understated and yet live and silently taking casualties. Sadly the gap between the station platform and the railway track is vast. Far too vast.

When I do this kind of thing I always judge how well a presentation has been received by comparing the initial reaction to my guide dog with the end reaction to the talk. No matter how ignored I am in comparison to my furry companion at the beginning of an event I don’t mind as long as by the end people are more interested in the point that I am making than what my dog eats. Judging by this theory I think myself and Izzy pulled it off big time despite huge initial canine interest!

I did give my blog a cheeky plug at the end as the ‘Inpatient’ blogs I have done recently are all about CAMHS and the opinions of myself and others I have met. I hope they can do some good. If you are here for the first time- welcome. Please take a look around and if you like what you see I would encourage you to subscribe and hang about. The truth is that it’s all very well sitting and talking but mistakes need to be learned from and things need  to be improved. The message of today was definitely one of hope and change. One size will never fit all, but we need to stop so many people slipping through the net and I am so honoured to be a small part of trying to make that happen.

BRAIN BLEED. An Unwanted Hospital Adventure for the Very Anxious.

During a dissociative episode this week I hit my head. It was really frightening and once the episode had died down I found myself very, very concussed. The incident happened between six and seven that evening and by half ten the symptoms still hadn’t calmed down so the on call doctor was called out to the unit. The poor Doctor was a little confused over the event and her assessment was complicated by the fact that I do not remember anything from any of my dissociative spells. Therefore it was very hard to tell the severity of my head injury. Likewise my eyes move constantly, making the eye checks very hard to carry out. I’m never an easy patient! After doing the best she could of an examination she left the room to call A&E to get advice. It was nurse *Stan who broke the news- I had to go to A&E if I had been sick more than once… And I had been sick for the second time during the ten minutes that Stan and the doctor had been talking. Cursing the wall in question and very concussed- off to A&E I went. 

Having been promised by Stan that the trip would be just ‘in and out’ I was not overly surprised to find myself in a very slow moving waiting room. Because I am under eighteen I had to be accompanied by a member of staff from *Cheery Lodge so it was *Emma who had the job of trying to keep me awake during the wait. Suffering with fatigue at the best of times; it was way past my bedtime and the bump was making me yawn non-stop. Myself and Noodle seized a bariatric chair at the back of the waiting room because it was easily wide enough for both of us to sit side by side. I don’t know what it is about general hospitals but they make Noodle very protective, refusing to move out of arms reach of me. Of course I don’t mind this at all, feeling vulnerable her care is very much appreciated.

At around 1am; myself, Emma and Noodle were put into a side room to wait for a doctor. By this point I was beyond exhausted and feeling the effects of not being given my medication. I was certainly not impressed when a very peculiar junior doctor appeared. First he asked me to follow with my eyes a white pen. Against the white wall this would be impossible for me on the best of days. Confused- he decided to move on to questioning my psychiatric history. At one point myself and Emma were convinced he was going to try and refer me for an inpatient assessment- despite us both telling him repeatedly that I am already a patient on a psych unit. He, like the doctor on call, disappeared to consult somebody else on the medicinal chain. 

On returning he asked to see Emma’s papers for me as if I was some kind of antique he was thinking of buying. A photocopy of my drugs chart and details of my illnesses. 

“What kind of OCD is it?” He asked. A question I dread.

“Erm it’s mostly hygiene and health concern based. But other ruminations and fixations too.” I have learned my lines. It was because I told him this quite so clearly that I was surprised at what he said next.

“Right we are going to get you into a CT scan as there is a possibility you may have a brain bleed.” 

“It could be a brain bleed making the hallucinations worse.”

Brain bleed.

Brain bleed.

Brain bleed.

He honestly then continued to use the phrase ‘brain bleed’ at least six times. Leaving me… Anxious. Very much so. I held onto the belief that if he really thought I was going to turn into a gory waterfall he would have done more checks and probably kept an eye on me… Or possibly have offered me a drink of water.

The CT scan was carried out at about 3am- an odd experience which made me feel like I was in some kind of verticle belidrome with the cylindrical spinning and whirring. It was over very quickly but sadly the results took much longer to arrive, leaving poor Emma to reassure me during the wait again and again that it is unlikely that I would have a brain bleed and, yes, CT scans are 100% safe. She was at the stage of pulling up online evidence when the results came through. My brain was 100% ay-okay! Relief hit me like a tidal wave- if nothing else I was just overjoyed. To be allowed to go to sleep. Myself, Emma and a loudly snoring Noodle headed back to Cheery Lodge.

“In and out?!” I asked Stan as we shuffled through reception at 4am. As way of a commiseration he told me he wouldn’t wake me up at 7am that morning. Of course it is much better to be safe than sorry- but I was absolutely exhausted the following day! Medical staff- if you are treating patients with anxiety disorders please be careful of what you say and how you phrase things! 

 

Stop the Clock

Not beating about the bush- this is a miserable blog post. I wrote it yesterday when I was freaking out about OCD and recovery and TIME. Time before I have to go into adult inpatient services (which I don’t want to do) and time I need to be getting better in. But I don’t seem to know how to do that… Anyway: here’s the poem.

Stop The Clock
Time is sneaking away from me.
Six months been and gone.
Six months of doors with windows.
And six months of pills in pretty white pots.
Stop the clock- I need to take stock.

Time is pulling me along.
The days are carved into six slices where I must eat and drink,
The place I want to run away from.
But that I hope will save me.
Before I sink.

Time is dragging me down.
Soon I’ll be an adult
Support being switched.
So I am a case number in other people’s books.
If I don’t hurry; In the psych wards where I’m told old men give you funny looks.
It’s the adult services which make my twitter friend’s despair.
Timelines telling tales of a care service without care.
Stop the clock- I need a rock.

Six months of trying.
Six months of fighting.
But my best just isn’t enough.
How can it be- when I’m still laden with all this stuff.
I’m pushing the pedals as hard as I can, Trying to make the damn thing go.
Go somewhere sunny.
Somewhere safe.
But the recovery car just won’t go.

They push my compulsions down like a game of whack-a-rat,
Causing sheer black distress to crash and shatter around me .
It’s torture as they squeeze and pinch at it.
But as the tide settles, the problems just pop up somewhere else.
I tell them “I’d take X symptom over Y“.
But they tell me it is a disease with which you cannot compromise.
“We will get it all. That’s our job.” The nurses say
Six months.
And I’m still waiting for ceasefire day.
The clock won’t stop – and I’m going to pop.

Time is running short.
How can we batter them all?
I’m pushing the pedals so hard.
But I’m scared that maybe it’s the motor that’s broken.
Stop the clock: because I can’t take another knock.

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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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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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