If your A&E is "not the right place for
#mentalhealth
crisis" then MAKE IT SO.
There is no humane, ethical, professional or medical justification for not equipping your A&E to be able to cope with ALL health crises human beings have. None at all.
One of the bizarre things I've learned about psychiatry is that an assessment is often limited to how you present to them in that moment.
That's going round for a coffee in someone's kitchen, then later telling all your friends it was a weird house because it only had one room.
I'm not "fighting" mental ill-health. It's not a "battle" I can "win" & that's not a personal failing. It's true for many of us with mental or physical health conditions, especially ongoing or long-term ones.
I manage it. I strategise. I negotiate.
And I need help with that.
I would like everyone - ESPECIALLY
#mentalhealth
staff - to see just how well - smiling, well-groomed, chatty, eye contact - Catherine looks, despite being sectioned & on 1:1 obs (someone following her 24/7).
We do not all sob & clutch our heads all the time.
#MothersOnTheEdge
All 3 visits so far from the Home Treatment Team have been positive & supportive & have made a real difference to me. Without their support, goodness only knows where I wouldβve ended up over Christmas, so thank you.
Good
#mentalhealth
care can make such a difference.
πππ
Some phrases routinely used by
#mentalhealth
professionals should be eliminated
Eg "failure to engage"
Any professional who finds themselves using such phrases should see it as a RED FLAG to stop, take a look at the service where they work in, & reflect on their own conduct
One of the nurses who's just come on shift has just knocked on my door to introduce herself (I've met her once before) and say they are around, & to come & see them if I need anything.
That's one example of the kindness on the ward. There is a lot of kindness on the ward.
Saw a psychiatrist say "personality disorder is a diagnosis made over time by specialists" but it seems to me it's more typically "diagnosis by impression" by a doctor in a one-off meeting with a new patient who's in crisis, regardless of any existing diagnoses eg SMI, ND, PTSD
Sorry,
#mentalhealth
services, but those of us living with psychiatric conditions can't just ... stop ... for the duration of the pandemic.
If you're funneling all your resources into new services & new referrals, we still exist. We still need care.
#MadCovidDiaries
#Covid19UK
A problem with psych wards is they mainly seem to cater for the visibly & vocally distressed. If you're struggling alone in your room, it won't be picked up by location checks. You have to ask, ask again & keep asking for help. That eloquence & persistence is beyond many of us.
My lovely neighbour just checked in with me to see if there was anything I needed. Heβs said I can knock on the door any time I need help - or just want a chat π
#COVIDkindness
#goodneighbours
#bekind
I'm fed up of politicians arguing for
#mentalhealth
funding to be diverted to prevention & early intervention
Any functioning healthcare system requires ALL THREE of the following:
* Prevention
* Early intervention
* Ongoing care for folks with long-term conditions
All three
I keep thinking about a population of ghost
#mentalhealth
patients, unseen by services, no longer on the books, walking among us but not noticed, sometimes moving to an entirely different area hoping to get needed care, sometimes too poorly to fight any more
If you have friends or family on a psychiatric ward, NOW is the time to visit them - even for just a 20 minute visit to show your face & check if they need anything.
Weekends, especially long ones, can be really difficult for patients due to lack of senior staff & supervision.
@politicalhackuk
So much for making the experience of claiming social security βmore like workβ - nobody loses 8 weeksβ pay for once being 15 minutes late.
@SusanCalman
@keviclifton
It's been wonderful watching you develop into such a beautiful dancer, & seeing you fall in love with what your body can do for you (rather than how society often expects women to look).
#KeepDancing
ππΊ
When I see what's done to whistleblowers like consultants - professionals with status & credibility - & the extent head honchos & people working in hierarchies go to to protect the organisation & system, there's no hope
#mentalhealth
patients can successfully challenge poor care
PIP is not a work-related benefit
You receive it whether you're in work or not
It is paid to working age people to go towards the additional costs of disability
@elliereeves
@BBCr4today
Housing insecurity & poor living conditions are big contributors towards poor
#mentalhealth
.
When I was evicted from my long-term home so the landlord could make a bigger profit, I lost not only my home but also my community & place in society.
People need homes.
But
#mentalhealth
services are only commissioned to see a minority of patients
Folks like me with serious, lifelong conditions (eg schizophrenia, bipolar) now receive only short-term care before being discharged to GP
I have no care plan, meds, therapy, social care
#Offrolling
Jeremy Hunt says he wants those who feel unable to work because of physical or mental health conditions to receive medical and therapeutic help as a condition of receiving their out-of-work benefits uplift, as a pathway back to work. But this seems less than practical - evenβ¦
11 years ago,
@BBCPanorama
used secret filming to expose support workers abusing vulnerable people with learning difficulties at Winterbourne View
Now they've gone into a psychiatric hospital,
@GMMH_NHS
's medium secure Edenfield Centre
On next week >
@guardian
How is Young going to represent the interests of students - by getting his dad to ring up & get them places on courses even though they didn't get the grades?
It's horrifying when you know you're really unwell & need help, & you're asking for help - clearly, repeatedly - & the professionals discharge you anyway
I can't fix myself from severe & enduring mental illness
But somehow that seems to be ... NHS policy now?
#DustbinPatient
#Mentalhealth
professionals who tell patients they are "falling through the gaps" between MH services are far too optimistic
The UK does not have a comprehensive system of MH care with unfortunate gaps
Instead, there are small islands of care, with zero help for everyone else
Every
#mentalhealth
service that trains staff to use physical restraint techniques, every service that detains patients against our will, should also be providing a service that gives open-ended support to patients to help us to deal with the after effects of what they do to us.
The year after I was discharged from an inpatient psychiatric ward, I was diagnosed with
#ptsd
caused by what
#mentalhealth
staff did to me under section
A decade on, I've still not had treatment for ptsd, & have spent years being treated appallingly by the community MH system
If you work in
#mentalhealth
services & a patient says they've experienced poor care from services (yours/another), be prepared to consider that this is in fact true. Just be prepared to consider it. It might help you escape from diagnostic traps - & improve the care you deliver.
I felt too shy to go to my door to clap but then the sound exploded in my little street & I ran to the door & there we all were, clapping & cheering from the warm glow of our porches. On & on it went, all of us smiling at each other, cheering, joined together as a community ππ
I see some psychiatrists are objecting to a conference speaker being filmed without consent during their
#RCpsychic
talk
Will they be speaking up about the NHS inpatient wards installing Oxevision systems that film patients in their bedrooms without consent?
#StopOxevision
Good to see schizophrenia referred to as a "common mental illness".
That term is usually taken to mean depression & anxiety, giving the impression that schizophrenia is rare or unusual.
It is not.
People living with serious
#mentalhealth
conditions walk among you every day.
If I'd started medical school the year I was first sectioned, I could've qualified as a consultant by now
If I'd given birth that year, the child now would be in secondary school
When people say "stay strong", "reach out", "keep fighting", they don't realise what they're asking
Among the dedication, skill & compassion in last week's
#Hospital
was the scene where a manager shouted over/at a patient identified as needing
#mentalhealth
input as "disrupting sick patients" & "taking up valuable resource" needed by "really poorly people".
#parityofesteem
Almost all mentions of
#mentalhealth
around
#Covid19UK
are about the risks of the general public & frontline staff developing new MH issues - anxiety, depression,
#ptsd
.
Thereβs barely any mention of folks with existing serious psychiatric conditions, who are *more* vulnerable.
With
#COVID19
forcing millions to stay home,
#mentalhealth
seems to be a pressing concern for all.
In our latest blog,
@UCLMentalHealth
Director
@ProfTonyDavid
explores the 'one in four' statistic - and discusses ending the stigma around mental illness.
Once when under the care of the crisis team - very poorly - I got a letter calling me in for DWP interview
I showed the letter to the OT & psychiatrist who came to my bedroom that day, & they said I had to go
So I got up & went straight to the DWP, still in my filthy pajamas
It's obviously completely wrong, even by DWP's own rules, for someone on a mental health ward to be asked to attend a Jobcentre appointment
But it's an unsurprising consequence of a system built around achieving compliance rather than genuine engagement
Discharging patients with severe & enduring
#mentalillness
from community
#mentalhealth
teams seems widespread NHS policy now
But it's done sneakily, without staff explaining to patients that "You can be referred back any time" is a ruse to make it easier on them to get you out
I tried to describe my experiences of being brutalised on an inpatient ward to my consultant psychiatrist
He'd held senior posts at
@rcpsych
He insisted patients did not leave hospital with trauma, & showed me the door
That was 2011
How much longer? How many more patients?
1/ The Royal College of Psychiatrists is alarmed by the disgraceful scenes on Panorama showing unacceptable behaviours towards vulnerable adults with a mental illness, by some care staff at the Edenfield Centre.
Inpatient
#mentalhealth
staff have told me mixed-sex wards are needed since the presence of women patients calms the men down & they are less volatile than all-male wards
As if women can't just receive needed care themselves - but must also, while unwell, help staff care for men
If you want to know some of the background to the
#HighIntensityNetwork
SIM programme and its "evidence base",
@HantsPolice
, where SIM started, has just published this information in response to a Freedom of Information (FOI) Act request >
#StopSIM
Iβve been pondering the βReach outβ βJust ask for helpβ βHelp is thereβ βItβs good to talkβ messages promoted by
#mentalhealth
βawarenessβ campaigns, how hollow they sound to those of us who *have* asked for help, & what my medical notes reveal about some of possible reasons.
Having a little weep because a doctor's letter I was copied in on was fine. Yes, when you've been on the receiving end of largely poor care for a very long time, receiving a bit of care that isn't poor can be emotional.
I'm hearing about patients with long-term serious
#mentalhealth
conditions like schizophrenia & bipolar disorder who are being discharged from secondary mental health services despite still being very poorly, in contravention of both national policies & local guidance.
The number of people on NHS
#mentalhealth
waiting lists (2 million!) does not include folks like me who couldn't even make it onto a waiting list
I don't show up in any NHS figures
Yet I live with severe & enduring
#mentalillness
for which I've been sectioned
#offrolling
Single biggest thing government could do to reduce number of economically inactive people who are long-term sick is sort out our mental health services.
Two million people in England are on NHS mental health waiting lists.
A question for psychiatrists & other
#mentalhealth
professionals:
Is it common practice - routine, usual, ordinary, to be expected - for staff to look up their patients on social media to see what they are posting?
In addition, while it is true that a patient can be referred back to
#mentalhealth
services at any time, that referral *** may well not be accepted *** by MH services
Referral back is far from a guarantee of treatment of help
This goes entirely against the ethos of my field Assertive Outreach
Even a rudimentary understanding of severe mental illness is enough to know that some people who are very ill either canβt/wonβt engage
Engagement is a two way street and removing support is simply unethical
Do any of the materials being tweeted out about
#ptsd
mention it can be caused by inpatient psychiatric care though?
Detention, seclusion, repeated forced medication - all while you're at your most vulnerable & need the most compassionate care & support.
No?
It really should.
Myth: PTSD only affects veterans who have fought in a war.
Fact: People can experience PTSD as a result of many different traumatic experiences.
There's lots more info on PTSD from our friends
@MindCharity
:
βI could not have been more informed about his condition & history, & yet I couldnβt get help for my brother.β
Even a consultant specialising in psychosis could not get needed care from a dysfunctional NHS
#mentalhealth
system, in case you thought you just need to keep trying
I wonder if there's a scheme anywhere that puts together little gift bags of essentials & treats for psychiatric inpatients? Many of us get no or few visitors so there are things we need, or would appreciate.
"Nobody should experience a health service as a landscape of abuse. The growing number of βservice-avoidersβ [...] reflects the existence of something very dark and very disturbing within NHS mental health services."
Important read for everyone working in
#mentalhealth
services
I recently had a paper published by the Journal of Psychiatric and Mental Health Nursing, about my experiences of harm in mental health services; how this caused me to self-discharge; and my life now as a "service-avoider". It's available here:
I've never understood why psychiatric inpatient wards don't take sleep seriously when the impact of sleep deprivation on
#mentalhealth
is so clear.
* Provide eye masks & ear plugs
* Quieten common areas/turn down lights from 10pm (esp as we're woken at 7am)
* Blackout curtains
Guys- re: nonpharmacologic interventions. COVID ARDS pt extubated after >3 weeks with paranoid, agitated delirium for days. got him ear plugs and an eye mask so he could sleep in the open PACU/ICU and he snored for 10 hours, woke up a new man.
People who dismiss twitter as trivial or vitriolic can miss some of the most extraordinary, human, touching, productive exchanges between folks who might otherwise never have the opportunity to engage this way.
Is it inevitable that psychiatry as now practised in the NHS - snapshot assessments in crisis, rather than continuity of care for patients with lifelong serious conditions - will cause more harm than good?
If you work in emergency services & tweet about your work or your workplace is planning a live-tweeting event, ask your employer for their social media policy - especially on live-tweeting about folks in
#mentalhealth
& suicidal crisis.
Weβre a vulnerable minority, not PR.
People who think mixed sex wards are just fine for women with serious
#mentalhealth
problems are ignoring what the evidence says & what most women want. It is unacceptable to require women to share wards with men when so many of us have experienced abuse. We have different needs.
I am pondering what may happen to
#mentalhealth
services in the aftermath of
#covid19uk
.
I am concerned that cuts over the past 10-15 years to services for folks with serious lifelong psychiatric conditions in favour of those with mild to moderate conditions will accelerate.
Dozens of doctors, nurses, nursing associates, healthcare assistants & other staff at Highbury psychiatric hospital in Nottingham are currently suspended
Dozens of them
That's not a few bad apples - it's systemic abuse
This is not an acceptable way to treat anyone, let alone someone poorly
Detained for their own safety -in a cell with a broken window on a freezing night, no food, no meds, no coat, no bedding, watched via CCTV
This is basis stuff staff could & should fix now
#humanrights
As a matter of principle, I object to police being involved in any way in the provision of
#mentalhealth
care. Full stop.
It is plain wrong to bring police officers to work in community MH teams as enforcers for clinical staff.
It is wrong to criminalise psychiatric patients.
It is utter nonsense to say that "anyone" experiencing a mental health crisis "can" call their local helpline: some of us really struggle to use the phone, especially when poorly.
Strangers on phone lines really help some folks; for many others, they're an extra barrier to help.
Anyone experiencing a mental health crisis can call their local helpline, and you can also call on behalf of someone youβre worried about. Support is available for all ages.
Visit to find out more about urgent mental health support.
Now the Met police aren't going to wait in hospital with folks they bring in under s136, hospitals aren't going to suddenly going to conjure up more trained
#memtalhealth
staff, are they
It'll be minimum wage agency security guards "guarding" patients
Your periodic reminder that having a diagnosis of mental illness & seeing a psychiatrist do not mean you are a risk to others. Nor are they the underlying explanation for all reprehensible behaviour by political figures.
#mentalhealth
@SkyNewsBreak
Hundreds of thousands of us in the UK live with schizophrenia.
The judge said it was not causal, but the drug abuse was - ie the Β£600 of crack cocaine the attacker took the day before.
Stop perpetuating outdated stereotypes that cause real harm to vulnerable folks.
This story on Bristol psychiatrist Ben Sessa gets worse the more you read
The whole course of his treatment of the patient over 2 years was skewed towards a sexual relationship
She's now dead
Doctor admits relationship with former patient who's now dead
"Women attempt suicide at greater rates than men. Yet almost nothing is known about why - including whether menstruation plays a role."
There's a long way to go to make up for the long-standing lack of medical curiosity about women's experiences of distress, suffering & death
TW Suicide
Should menstrual phase be determined at autopsy after suicide? Fascinating work shows there may be a link between periods and suicide, but as with all things in women's health, it's under-researched. Better understanding could save lives
#PMDD
Speaking to a
#mentalhealth
nurse today about my experiences of detention, forced treatment & seclusion, & resultant
#PTSD
. She said she'd carried out restraints, but never realised how traumatising they were or how long the effects lasted.
They *really* need to hear this stuff.
I am constantly impressed by the awesome
#mentalhealth
folks I stumble across on twitter. Mental health tweeps contribute in so many different & varied ways, whether that's sharing academic or clinical knowledge or the depths of their struggles or a tip for getting through. π
No, I will not discuss meds at a hatch in a busy corridor, nor with my bedroom door open & the staff member standing outside. I need privacy & dignity, & medical confidentiality is a fundamental part of healthcare not something cooked up by me to be awkward or waste staff time.
Shocking as the figure of 15,000 deaths is, it only includes patients who were RECEIVING care from a community
#mentalhealth
team in 2022-3
It does not include folks who, like me, have been excluded by NHS MH services because of policy of
#offrolling
SMI patients
I've just been canvassed on the doorstep by a Tory party member
If nothing else, I stopped him bothering anyone else for 15 mins
But I also opened my front door to show him the reality of cuts to local council budgets & the impact of not receiving needed
#socialcare
support
@Shrink_at_Large
Does 'abandonment therapy' consist of sticking the person on an endless waiting list; cancelling appointments at the last minute; saying one thing then doing another; setting appointments without telling you about them then discharging you without notice
Aka treatment as usual
@Naylor007
My response is "Why do you ask?"
It's polite, efficient & multi-purpose - it's useful for any intrusive question, doesn't require me to use any spoons thinking up a witty, tailored response, & throws responsibility for providing info back where it should lie: with the stranger
"Manipulative"
Do people realise quite how potentially toxic & long-lasting the effects are when a person in a position of authority (eg parent, doctor) describes someone in a vulnerable position (child, patient) this way?
Would they stop labeling others that way if they knew?
Yet again wondering why national
#mentalhealth
charities organise events supposedly aimed at folks like me but starting early morn:
* Rush hour travel is inaccessible for many with anxiety
* Off-peak travel passes can't be used
* It's too early for folks on sedating meds
πππ
The consultant psychiatrist is reported to have pushed for this vulnerable young woman - autistic, diagnosed with PD, anxiety & depression, sectioned under the MH Act - to be prosecuted for attempting to take her own life
What's his name? His patients need to know
#StopSIM
Pondering why
#mentalhealth
staff behave as if having "insight" - knowing I'm poorly; asking for help for SMI - means I don't need help.
Does knowing my leg is broken mean I can fix my broken leg myself?
Do doctors believe they won't get disease because they've studied disease?
Last weekend, I bought a paper & sat on the beach all day reading it. It was the first time Iβd been able to read a paper for ages.
Doctors should definitely be prescribing beaches π
Does anyone who is
#ActuallyAutistic
think that Simon Baron-Cohen & his team of researchers studying the diaries of Caitlyn Scott-Lee - who took her own life at age 16 - will improve the care, treatment & support for autistic children & teenagers?
"As service users & carers, we are not inspired by measures of readmissions & inpatient bed-days; we want to know what difference interventions make to the quality of peopleβs lives & wellbeing."
Research rarely looks at what matters to us. It's all about service convenience.