self harm

My sadness over the system

~ katcopley ~ Leave a comment

Just enjoying a therapeutic chat with a good friend and talking about my sadness that society and the health system we have today cannot accept that some people will never recover from long term mental illness.

Why do we have such a problem with this?

It basically means that the most vulnerable in society who need constant care for their mental health illnesses don’t get this due to a recovery model which seems most worried about patients developing any sort of therapeutic relationship with mental health staff than actually providing a safe space and the consistent care people need.

We can all find examples of physical health conditions which rightly require care for the entirety of someone’s life and this is often provided with the care and compassion that they deserve. It is also fair to say that some people do fully recover from some mental illnesses and that is great and this is not a criticism of them but just as with physical illness, everyone is different.

What I struggle to understand is why the way that physical illnesses are viewed is so different to mental illness?

This whole conversation with my lovely friend was sparked when we came across a lady in her 60’s who was obviously extremely mentally unwell. It was very upsetting to see and it was obvious that this lady needed full time mental health care. I don’t think there is anything wrong with saying that but I am absolutely certain that she wouldn’t have fitted in to a mental health shaped care box that was probably made available to her.

After nearly 30 years of mental health treatment I now do not tolerate any care professional or acquaintance trying to suggest ways that I might fully recover. I often say do you think I deserve treatment for a finite amount of time? Have I used up all my care tokens or will you not want anything to do with me if I don’t get fully better? For me that is how it seems and I make it clear to those that are involved in my care that after all these years I haven’t got the headspace to deal with the criticism and discrimination and shouldn’t have to.

I am one of the fortunate ones who have a support network around me who accept my illness for what it is. When chatting with my friend earlier she said that people often say to her when hearing I am having an episode, ‘what brought that on’ or ‘did something trigger this’. She always responds – that is what her head does, that is the illness. I am so grateful for this and just wish it was the norm and especially for those without the support that I have.

Recently, whilst having a telephone consultation with a community mental health nurse being assessed back in the system after 5 years I made this very clear. I know what I need, I know what helps me, what I won’t put up with and what are serious red flags. If I decline certain support (the most recent being group therapy to manage emotions!) then this doesn’t mean I am refusing help but that I know this wouldn’t work for me and that when you fight on your own without proper mental health support it would be silly to accept help that could exacerbate symptoms. I am now less than a month away from my first psychiatrist appointment in 6 years which seems bonkers for someone on the severe mental health register and also with a diagnosis of bipolar but I do feel this time that I am in control and unlike that lady I saw today able to advocate for what works for me.

Oh and finally, this opinion does not mean I wouldn’t love to be fully better. Of course I would but I am a realist and I am not going to add to my distress by guilt tripping myself over being unwell for longer than a set amount of time that society deems is acceptable!

So please think about how you respond to people who have a long term mental health illness. It can happen to anyone and we are a group of people where the care available is totally unfit for purpose at the moment.

Another assessment is not what I need …

~ katcopley ~ 1 Comment

Nearly a month ago my GP re-referred me to the Liason Intake Team part of the Community Mental Health Team (CMHT) in my local trust. Even though I am bipolar and have been receiving mental health treatment for 17 years I was discharged a couple of years or so ago and therefore my GP coordinates my care. As I have mentioned before she is excellent but felt last month that I needed further support.  

I was promised previously that if I needed CMHT intervention that it would be easy to access, that I wouldn’t need to wait for ages or explain to loads of people a summary of the past 17 years. Each time I need a referral back to CMHT I come up against similar challenges so this referral is sadly not a great surprise.  

A month on in this referral I am no nearer any support and in fact a conversation I had with the CMHT yesterday just left me exasperated and added to the mental distress that I am currently experiencing.  

What is incredible is that when I called yesterday to chase the referral I was given no update, no apology or understanding regarding the wait and worst of all no one asked if I was ok or how I was getting along.  They couldn’t get me off the phone quick enough – this is far from quick easy access to the CMHT.    

In addition to that, I know I will have to go through an assessment before any further support is offered and the likelihood is that there could be another huge gap between assessment and any support being implemented.  Even worse is that after assessment and all of this uncertainty I could be referred straight back to the GP without any on-going support.

I am no better than a month ago and the poor mental health care does have a huge negative impact and certainly increases my distress.  As I get slowly worse I find it harder to speak to people I don’t know and so the well organised approach from my doctor of referring when I reached the point I did will slowly become useless.  It also means that I am more likely going to end up accessing crisis care services in unequipped Accident and Emergency departments possibly in acute mental distress. 

I have done what I can to help myself, especially over the last few weeks including paying for some online counselling to try and get some consistant care.  I hope that when well this will become another useful tool in my Wellness Recovery Action Plan (WRAP) toolkit but at the moment I am just grateful for the support even though I am paying for something the NHS should be providing.

If any healthcare providers read this can I ask you to ask the question “does someone with a history similar to mine really need another assessment and surely some support could and should be implemented quickly?”

Loving the sun but not the short sleeves and inevitable questions

~ katcopley ~ 1 Comment

So far the summer of 2014 has been kind weather wise. Long hot days and an opportunity to wear some of those clothes that might not venture out of the wardrobe for 48 weeks of the year! I love the sun, it does help my mood and I also love wearing summer clothes but I dread the questions and stares about my self harm scars. I started self harming when I was only 14 & only stopped a year or so ago and I have many scars on my arms, legs and even my stomach. My legs are actually not that noticeable but my arms are and so I often wear long sleeved tops in certain situations when it is really too hot to do so. If I do wear short sleeves I am constantly worrying about answering difficult questions, offending people or triggering others.
I run a Brownie pack and never wear short sleeves and often boil as a consequence but children are inquisitive and I have had enough of difficult questions.
Over the past few years I have become ‘braver’ but at work I always wear a cardigan or a jacket and most of the time this is because I don’t want others to feel uncomfortable but probably I am embarrassed even though I know this is part of who I am. Maybe a question would get a conversation going and help someone else in the future?
I suppose with time the scars will fade more and I will become more comfortable and hopefully there will be summers in the future that won’t be so difficult.

A post for #selfharmawarenessday yesterday

~ katcopley ~ Leave a comment

I write this post as someone who self harmed from the age of 14 until only a year or so ago. So for over half my life I had been consumed by self harm. I both hated it with a passion but relied on it like a good faithful friend.
I remember the first time I self harmed I was at school and sat on top of a toilet cistern to hide away and cut my arm with a compass point.
What I felt when I did this was a massive release and relief from the mental pain just for a small amount of time. It wasn’t at all about gaining attention (even though others thought that was the case) but more a way of coping and getting through an enormously difficult time. I didn’t really know much about self harm and certainly it wasn’t a public thing or part of any group action.
Yes it frightened me; but as I got older it actually probably saved my life. At times when I was immensely suicidal the release by self harming and therefore the small focus away from the mental pain sometimes gave me respite from intense suicidal feelings.
As my bipolar became more prominent the fact I self harmed seemed to distract psychiatrists away from a bipolar diagnosis even though there was a clear family history. This was frustrating as it seemed the only symptom/end result that was focused on and even when I had a bipolar diagnosis other psychiatrists who I might see during crisis or within the home treatment team would convince themselves my bipolar diagnosis was incorrect and just focus on the self harm.
This happened most recently 2 years ago and after that very distressing crisis assessment I made an official complaint and actually got to meet with the trust medical director and correct my medical records. Self harm can be a symptom of many psychological diagnosis’ and consistency of professionals is vital in ensuring the full picture is taken into consideration.
People often ask me how I stopped self harming. I actually stopped over a year before I actually stopped wanting to self harm. I stopped because I convinced myself that it wasn’t working like it used to and that I had managed to build up a tool box of other coping mechanisms that actually worked better. Just stopping didn’t though take away the debilitating urges and horrendous flashbacks to times that I had self harmed which in turn would lead to dreams and images recalling horrendous episodes of mania and depression time and time again.
When I started my second cycle of EMDR it was clear that tackling the self harm was a priority and so this is what we concentrated on. It was absolutely horrendous and I re-lived some terrifying experiences but since last May ( a couple of months after finishing EMDR and throwing all my blades away) I realised that I no longer wanted to self harm.
The first major depressive episode that I experienced was the ultimate ‘test’ but not once did I want to self harm and not once did I buy any blades. Yes I felt desperate and suicidal but the urge to self harm had disappeared and not returned.
What would I say to people that have an urge to self harm – this is a hard one but I hope that they have somewhere or someone to turn to instead of self harming. I realise that this isn’t often the case and therefore self harm might be the only option in some peoples minds and if people do self harm they need to be given support, safe places and not judged because they self harm. It is not attention seeking behaviour and often as in my case a life saving coping strategy. I actually often would text the Samaritans when I had an urge to cut. This did stop me more than just a few times as it gave my mind a different focus and so became another coping strategy.
I wish I had never started but also know it part of my story.