Thanks to my followers for sticking by me even though I haven’t blogged for ages.
During November last year I very quickly became depressed and also experienced horrendous anxiety. During the last few depressive bipolar episodes I have been frightened by the pace that I have become unwell. This episode was no different and I very quickly developed awful paranoia, debilitating suicidal thoughts and the black cloud was heavier than ever.
Although the symptoms seem to come on more quickly than they did a few years ago, I am grateful to my GP for also acting just as quickly. She upped my PRN medication, referred me back to the community mental health team (CMHT) and helped to facilitate reduced working hours as part of a reasonable adjustment. My employers were amazing and acted quickly on my doctors recommendation, ensured I had enough support and probably most importantly for me allowed me to carry on with my job which is hugely important during an episode if at all possible.
It quickly became apparent that the referral to the community mental health team wasn’t going to be as quick as it had been in the previous year. I was hearing from other contacts and healthcare professionals that patients were waiting weeks in all areas to be contacted even when the referral was marked as urgent. I was surprised that the number of referrals had increased so much that the waiting time for someone who was actively suicidal had increased from 1 day in late 2015 to at least 7 days in late 2016.
One of the consequences of this delay is that the local accident and emergency department takes the brunt of the loophole. Those people who are not quite in crisis when referred by their GP end up crossing that line into crisis and often end up in accident and emergency before they are seen by the community team.
I am hugely grateful to my family and friends who supported me whilst waiting for the CMHT to respond and even though I reached crisis point during that wait I wasn’t a statisitic in Accident and Emergency because of the network I am so lucky to have around me.
In a weeks time I am meeting with the trust to look at this serious loophole, discuss possible solutions and most importantly see if the issue regarding Accident and Emergency not being a suitable place for people in a mental health crisis can be addressed more successfully than it is at present.
I want to know why prevention doesn’t seem to be at the forefront of professional’s thinking in so many mental health areas and why there seems to be a reluctance to provide any consistency in care for many experiencing mental illness. I am also interested in the role of the crisis team as I am hearing more and more how the support from some crisis teams is not what it should be.
By Christmas I had thankfully turned the corner and the care that I received from the CMHT once I was contacted was helpful. As always I dreaded January but it has been a really positive month and the hope that I found at Christmas through my faith and the love and support of those around me has strengthened me even further than I dared hope for 2 months ago.
As during previous mental health crisis’ I made the difficult decision to go to the local Accident and Emergency department yesterday. It seems pretty ridiculous that this is the only way for me to access crisis support when experiencing a bipolar episode but sometimes I can’t see any other way. I had also waited nearly 2 months after my GP refered me urgently in early February and I had experienced the toughest weekend.
We decided that yesterday morning might be a sensible time to go but it doesn’t take away the huge anxiety that is associated with that place and also reminds me every time of the most horrendous recent experiences that I have had there.
On arrival there is now a process of ‘streaming’ to ensure that people are directed to the relevant department. One thing that I immediately noticed here was that the ‘streaming’ nurse didn’t say hello or introduce herself. It is a shame that one of the large London hospital trusts (not the mental health trust) haven’t signed up to ‘hello my name is….’ or if they have that staff aren’t using it which is a shame especially for those facing patients walking through the door.
She spent less than a minute with me, just writing down my surname, date of birth and handing me a piece of paper to take to the main desk. After checking in we waited in a slowly filling up waiting area which I would find anxiety provoking at the best of times for about an hour before seeing the accident and emergency triage. The nurse here was actually supportive and explained that the mental health nurses would be contacted from the other trust to come and see me. She was slightly more friendly than the ‘streaming’ nurse but did have that ‘lets get you out quick’ approach!
We then waited for what normally is an eternity to see the mental health team. After only half an hour we were pleasantly surprised when a nurse appeared and as we were walking to a consultation room she greeted us warmly, introduced herself and another nurse and was just amazing from the moment we met her. As usual though she had been given a totally inappropriate room to conduct her assessment in – it had a bed and 1 chair. My friend and I decided to help them out and sit on the bed and they managed to beg a chair from the hospital staff (another problem of having to go to another trust to see mental health staff).
Once sorted in this rather strange room I was immediately reassured by the mental health nurse and given my currently state that is some achievement. Instead of going through a laborious checklist assessment she talked freely with me and completed different parts of the assessment as she went. This approach immediately puts me at ease and staff concerned get a much better overview of where I am at the moment instead of just concentrating on receiving one or two word answers to sometimes irrelevant questions. The other member of staff made notes and asked a few questions which weren’t at all helpful but probably she felt she had to ask something! The senior staff nurse not only grasped quickly the severity of my crisis but also grasped the type of support I so desperately need. She didn’t appear shocked and at every opportunity reassured me and treated me like a fellow human being.
After about 40 mins she left to speak to a doctor and when she returned she explained that unfortunately the crisis team or home treatment team that it is sometimes called had no capacity. She had though noticed that I had a Liason Intake Assessment (LIT) on Friday and was pretty sure that they would refer me to the Short Term Intervention team (SIT) so she was able to do that for me there and then and therefore I wouldn’t need to go to the probably rather pointless LIT appointment on Friday.
I am now waiting for the SIT team to contact me and hoping they do very soon as it is a little frustrating to go through the accident and emergency process only to be still without the support I so desperately need. I am hugely grateful to the nurse who saw me yesterday and proud to be a governor for the trust where she works and impressed that they and obviously she are using ‘Hello my name is ….’. I just hope this isn’t a one off and that the system is slowly improving and that the people I will see during the next few days and weeks will be as equally supportive and professional.