This Week in Mentalists – Hayfever Edition

There’s a big yellow thing in the sky. I think it’s the god Ra. I must have displeased Ra, because he’s making me sneeze and my eyes itch. This post is brought to you through the power of loratadine.

Trigger warnings: bereavement, self-harm, institutional abuse, suicidal ideation.

The Small Places lists some transcripts from the House of Lords Select Committee on the Mental Capacity Act, discussing the Winterbourne View scandal. Some of it makes for powerful reading.

Q61. Dr Margaret Flynn: It is very clear that patients at Winterbourne View hospital were scandalously silenced… the police found written complaints in an office drawer that had been drafted by patients that had not been addressed, and neither were the concerns of families addressed. The very typical response to the concerns of families from staff at the hospital was, “Well, your daughter”—or son—“would say that because she doesn’t want to be here. That is what happens—that is why they are here”. So they had no voice. On the issue of advocacy—more generic advocacy—some people did not appear to have access to anybody.

Dr Margaret Flynn: I gather from conversations with relatives who have experience of assessment and treatment services elsewhere in the country that there are enormous concerns about the safety of their relatives when they are detained.

Flynn’s last comment is especially poignant given that My Daft Life’s son (who has autism and learning disabilities) died in inpatient care this week.

Our beautiful, hilarious, exceptional dude was found unconscious in the bath in the unit before a planned trip to the Oxford Bus Company. The psychiatrist from the unit who called me at work around 10am to say that LB had been taken to hospital, gave no steer he was pretty much dead. I asked her (as an anxiety induced after thought) if he was conscious when he left the unit in the ambulance. She said they’d cleared his airway but he hadn’t regained consciousness. She made no suggestion I should urgently go to the hospital or that I should go with someone. It was a care less call. Much like the ‘care’ he’d always experienced outside home and school.

This is an exceptionally sad event. Even more so because it’s clear from reading previous posts that the author and the rest of her family had enormous love for LB. RIP.

In another possible failing of care, concerns have been raised about the deaths of four patients at St Andrews Hospital in Northampton due to side effects of clozapine. It seems the hospital subsequently made an internal report, which it sent to the Care Quality Commission.

But the existence of the report came to light only shortly before a second inquest was held last week into Johnson’s death. The lawyer for his family asked why it had not been shared with them or the coroner during the original inquest.

“I have never been involved in a case where a report as serious as the Grafton report was never provided to those affected, or even raised with a coroner at an inquest,” said Mark McGhee, a partner at Fentons Solicitors. “Four deaths over a seven-month period where there is a potential contributory cause linking the deaths, has to be exceptional, grave and serious, and as such demands a full inquiry of the most public nature.”

Nurse With Glasses reflects poignantly on the loss of his mother.

The police said the skidmarks showed she had noticed 20 meters before she saw the traffic jam. Too late. She didn’t suffer. That’s comforting. And I’m glad nobody else got killed which was quite a miracle. The police officers who were involved in handling  my mothers case were amazing.  One of them lost his father in law in an accident the year before so it was very confronting for him too. They really made a difference.
I remember her phone number. I called it a few times the weeks after she died because I didnt want to believe she was gone.
I went to see her car with my brother. My brother took the cassette tape out of her radio so I could listen to the last song she ever heard and probably sang.The police said the skidmarks showed she had noticed 20 meters before she saw the traffic jam. Too late. She didn’t suffer. That’s comforting. And I’m glad nobody else got killed which was quite a miracle. The police officers who were involved in handling  my mothers case were amazing.  One of them lost his father in law in an accident the year before so it was very confronting for him too. They really made a difference.
I remember her phone number. I called it a few times the weeks after she died because I didnt want to believe she was gone.
I went to see her car with my brother. My brother took the cassette tape out of her radio so I could listen to the last song she ever heard and probably sang.

You Make Me Sick compares herself to a fictional character, which produces a worrying thought

This really struck me when watching the film Prozac Nation (2001), starring Christina Ricci. The main character, Lizzie, can be selfish. Impulsive. Dramatic. Above all deeply, deeply irrational and disconnected from those around her as she pushes her friends and family away.

Her depression develops into a fundamental disconnection, and that terrifies me.

As I watch it, I have moments where I grow cold towards the character as her self-absorption reaches new heights of delusion. And yet I’m also suddenly deeply uncomfortable. I realise that just minutes ago, I penned off a needy, rambling, solipsistic, neurotic message (or succession of messages) to a friend. Who is very happy, very much on holiday in a fabulous country. I feel like some bedraggled cat- not even a cute cat, a really mangy one- scratching at his door constantly mewling ‘me, me, me’.

Therapists say to be honest, doctors say to reach out to those around you. But why drag them into your little microcosm of misery? Sadness is catching, don’t you know?

What if, as a result of being ill, I’ve turned into that character? Alienating, unpleasant, disconnected? Selfish. Hurtful. Sad.

I don’t know the author, but I suspect she probably isn’t anywhere near as dislikable as she worries she might be. My gut feeling is that this is more about self-doubt and low self-esteem than how she genuinely appears to others.

Mental Health Cop discussed the new proposals for “street triage” of people in a mental health crisis, to be done by mental health nurses and police officers working in tandem. He raises a few concerns.

What about physical healthcare needs? – what about the possibility that the person is suffering an underlying problem that is being masked or fogged by alcohol and aggression? How do we take that into account and – no offence to any mental health nurses anywhere in the UK – the triage car nurse would not be trained in the pre-hospital urgent care like our 999 colleagues in green. Remember, mental health nurses are (usually) not dual trained as general nurses. Would they carry with them, blood pressure cuffs, blood sugar testing equipment, thermometer, etc.? I realise that mental health nurses can / do physically examine patients, my question is “will they?” I’ll be frank: mental health nurse or not, I’d probably still be calling an ambulance – chapter 11 of the MHA Code of Practice stands.

How do we get the person to wherever they will be detained? – in most of the 11 ambulance services in the United Kingdom, they wouldn’t attend such a call anyway for various bureaucratic and on occasion discriminatory reasons. I’m pleased to say, the ambulance service where I work “get this” completely and would almost certainly attend, priority of unusual demands permitting. But yet again, knowing they may not feel obliged or able to attend, is no excuse for then doing the wrong thing – chapter 11 of the MHA Code of Practice stands.

You see the reason I have a deep, underlying fear of what is being suggested is not because I think it will fail to bring any benefits. I think there will be loads of benefits in terms of information sharing, s136 avoidance and I genuinely welcome that and more. Having said that, I can think of other, less resource intensive and probably cheaper ways of doing the same thing, but I do welcome it.

He concludes.

And again, we see the trap being fallen into – this stuff will not go wrong very often, but when it does go wrong it will go really, really, wrong. Bearing in mind that nurses also have very different training around the use of force and restraint, I’m also concerned that we will see again, nurses flagging concerns about the use of force even where officers are acting in a text-book fashion, according to their training. We’ve seen this in the Olaseni LEWIS case and others: we’ll see it again until somebody defines the problem we’re trying to fix and designs the solution to fix that problem.

I’m not hoping to fix the problem to which “street triage” is the answer – for that, you need to fix CrisisTeam services as a whole and it will take more than free security and a lift from the police. Street triage is “pulling people out of the river”. Eventually, as Desmond TUTU rightly said, “we have to get upstream and work out why they’re falling in.”

Because I Cannot Be Still offers some poetic reflections.

Some days are good, and we laugh and smile and wonder if things are finally headed upwards.

Some days are not so good, and we write good-bye letters in our heads and wonder what the best way to end it would be.

Some days we want to give up, throw in the towel, cry out that we have done enough and can handle no more.

Some days are peaceful; we can be reflective and see where this rocky journey has taken us.

Some days we try to change, whether that is hairstyle or lifestyle or something more dramatic.

Some days all we can do is hold on, to the ones we love, to our head as we pound it on the wall, to what’s left of our sanity.

Some days we count days, until our next therapy appointment, how many days since we were last hospitalized, how many days in our depression cycle we have left before we bottom out.

Some days we just simply cry, for no reason, without wanting comfort.

Some days the slice of a knife across our arms in more soothing than even the warmest of blankets.

Some days the burn of alcohol takes us to a happy place where we forget that some days we just want to die.

We’ve covered some difficult topics so far, so I think it’s important that we balance it out with something hopeful. Two years ago Beauty from Pain realised that she didn’t want to die. Now she looks back on her achievements since then.

In my blog from this time last year I said: ‘I love my life and I am so happy to be alive right now.’ 

am still happy to be alive. My illness is still there, and I have to work hard at managing it. I’m not sure if I thought it would be much easier than this another year on. In a way, it just feels as hard as it has ever been.

But I need to remind myself that I made a lot of changes this past year – changes which were for the better, changes which I chose, but changes which still bring upheaval into my life. I moved to another town. I left my full-time job and set up a mental health training business. I stopped seeing my CPN who had been my constant rock over the last few years. So many changes, but all for the better.

Yet they still have an affect.

I hope that by this time next year things will feel easier. Today things feel just as much of a struggle.

Yet I feel like I am much, much happier overall. Yes, things are as much of a struggle, but the rewards are greater. That is something to focus on.

Time for the Wildcard. Here’s a selection of classic movie scenes, with added Batman.

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About Zarathustra

Trained as a nurse, currently working in Child and Adolescent Mental Health Services (CAMHS). Co-editing the Not So Big Society blog. May possibly be an incorporeal being called Phil Dore. All views expressed are in a personal capacity and not necessarily the views of my employer.

One Response to “This Week in Mentalists – Hayfever Edition”

  1. banned?

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