It’s NHS Change Day today and mental health is on the table. All over the Twittesphere people are coming forward with their stories and support of this initiative and I am adding my voice to the conversation.
I’ve posted an article about Early Intervention in Psychosis http://justdontsayimcrazy.com/2015/03/10/spotlight-on-early-intervention-in-psychosis/ services in the UK, which has been my main source of support over the last three years. My experience with them has been entirely positive and now I’m coming to the end of my time under their care I am somewhat nervous about where I’ll be sign posted next.
Less positive, however, have been my experiences with the Home Treatment Team. This service aims to support people in crisis to stay in their own homes and avoid hospitalisation. The teams cover large areas and work 24/7 on shift patterns and their role is to make home visits daily (sometimes twice a day) to keep tabs on their clients mental health. They can arrange referrals on to hospital or crisis units if they feel the service user needs more intensive support. The problems lie in the lack of continuity and care; it is normal to be under their services for a few weeks when in crisis and not see the same nurse twice. This problem comes mainly from the shift patterns they operate to cover 24 hour care.
I have two notable bad experiences with the team from late last year. The first saw me making a visit to the mental health ward to meet with one of the HTT nurses. I went straight from the office after a particularly difficult day; raging anxiety and suicidal depression had mixed to push me to the edge of what I could cope with. I sat with the nurse in a little meeting room and lost the last of my composure. The mask dropped and I sobbed and talked for an hour straight about not feeling able to carry on, my plans to hurt myself and a million other sentiments to that effect. As I cried she listened, but I didn’t feel heard (there is a big difference between listening to and actually hearing someone). It was my cry for help and she didn’t take it seriously. That night I went home, got drunk and tried to forget about my overwhelming life.
The next bad experience was whilst I was in the crisis bed in a mental health housing program. I had been admitted by my Care Co-Ordinator in the EIiP team who did pay attention to and act on my issues at the time. During my time in the crisis care unit my psychiatrist had decided it was the ideal opportunity to make the switch from risperidone to olanzapine. As we tapered off the risperidone I became progressively more psychotic and HTT were brought in to visit daily to monitor the situation. On the worst day I had stood at the top of the shopping centre with Eve at the front of my mind pleading with me to jump off; thankfully I was stronger than her and walked away. I shared this event with the nurse from the HTT who came out to see me later the same day. I told him I didn’t know how I’d kept myself safe. Looking back, I would have admitted myself to hospital had I had the clarity to do so. But his attitude was one of indifference. He acted as though he didn’t care and didn’t believe me or take me seriously.
There have been better experiences than those two with the HTT too. Some nurses have been very caring and supportive. It just is that the bad ones are the ones that stick in my mind, and for good reason. When I couldn’t keep myself safe, I needed someone else to have the insight to see that I was in a desperate situation.
Another NHS service I have used has been ICB crisis care units. I’ve been admitted to these units twice, most recently in Dec 2014 for the two weeks leading up to Christmas. In essence the set-up is a room in a mental health care home, with 24 hour staffing and support available. Unlike hospitalisation, the service user is free to come and go as they wish during the day which means some semblance of normality remains. My admission to the ICB in December was beyond amazing. The staff there were very attentive and supportive, the other service users were friendly and the break from the overwhelming pressures of looking after myself were lifted. I still cooked my own meals and did my own shopping but I didn’t have to worry about surviving another day at work whilst I felt so awful. It also meant my husband got a break from looking after me and trying to keep me safe. He also got a break from worrying about me 24/7.
Overall the experiences with accessing care for mental illness on the NHS have been positive. I have been well supported and looked after. Notably, I’ve been kept away from hospitalisation through the proactive services offered in this area. Looking to the future, I’m not sure what will happen next. I hope that whichever team I wind up with has the same attitude as the EIiP team towards client care.